Current Management of Disseminated Germ Cell Tumors

Urol Clin North Am. 2019 Aug;46(3):377-388. doi: 10.1016/j.ucl.2019.04.003. Epub 2019 May 21.

Abstract

The modern treatment of disseminated germ cell tumors (GCT) relies largely on cisplatin-based regimens, particularly combination chemotherapy with bleomycin, etoposide, and cisplatin. This article reviews the evidence supporting its use as well as common alterations based on prognostic grouping or contraindications to bleomycin. Special topics around the management of intermediate/poor prognosis choriocarcinoma and brain metastases are included. The management of residual masses for both seminoma and nonseminoma is discussed as well as long-term follow-up care of patients. Finally, the management of relapsed disseminated GCT is addressed.

Keywords: Chemotherapy; Disseminated germ cell tumor; Management guidelines; Testis cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Biomarkers, Tumor / analysis
  • Bleomycin / administration & dosage
  • Cisplatin / administration & dosage
  • Etoposide / administration & dosage
  • Humans
  • Male
  • Neoplasms, Germ Cell and Embryonal / drug therapy*
  • Neoplasms, Germ Cell and Embryonal / pathology
  • Practice Guidelines as Topic
  • Prognosis
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / pathology

Substances

  • Biomarkers, Tumor
  • Bleomycin
  • Etoposide
  • Cisplatin