Objective: To review the available literature concerning the management of postchemotherapy testiscancer.
2
Advanced stage nonseminomatous testiscancer is commonly treated with chemotherapy and surgical resection.
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Context: Some controversy still exists regarding the management of testiscancer following chemotherapy for disseminated disease.
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The National Health Service in the U.K. stipulates various testiscancer care modalities be delivered through supra-regional network.
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Recurrence of teratoma or carcinoma in testiscancer patients found to have teratoma at post-chemotherapy retroperitoneal lymphadenectomy is well recognized.
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Desmoid tumor should be included in the differential diagnosis of tumor recurrence in testiscancer patients previously subjected to post-chemotherapy retroperitoneal lymphadenectomy.
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It was acknowledged that non-guideline-concordant care in testiscancer occurs frequently, in the range of 18-30%.
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Until clinical staging improves, patients presenting with clinical stage A nonseminomatous testiscancer should be offered the option of initial nerve-sparing RPLND versus surveillance.
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The principles of dose-response and combination chemotherapy were basic to the design of the initial curative standard-dose treatment regimens for leukemias, lymphomas, and testiscancer.
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At the Canadian TestisCancer Workshop, the rationale and feasibility of regionalization of testis cancer care were discussed.
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An International TestisCancer Linkage Consortium has been formed to pool resources and will investigate these findings further with the world-wide collection of families.