文献詳細
特集 進行期精巣腫瘍の診療─難治症例に挑む
〈導入化学療法〉
文献概要
▶ポイント
・進行性精巣腫瘍に対する導入化学療法後の残存腫瘍摘除は,腫瘍マーカーが正常化していることが大前提である.
・セミノーマでは,残存腫瘍が3cm以下,または3cmを超えてもFDG-PETで集積が認められない場合,経過観察が可能である.
・非セミノーマでは,残存腫瘍を完全摘除することが重要である.
・進行性精巣腫瘍に対する導入化学療法後の残存腫瘍摘除は,腫瘍マーカーが正常化していることが大前提である.
・セミノーマでは,残存腫瘍が3cm以下,または3cmを超えてもFDG-PETで集積が認められない場合,経過観察が可能である.
・非セミノーマでは,残存腫瘍を完全摘除することが重要である.
参考文献
1) 日本泌尿器科学会 (編) : 精巣腫瘍診療ガイドライン2015年版. 金原出版, 東京, 2015
2) Herr HW, Sheinfeld J, Puc HS, et al : Surgery for a post-chemotherapy residual mass in seminoma. J Urol 157 : 860─862, 1997
3) Heidenreich A, Thüer D and Polyakov S : Postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumours of the testis. Eur Urol 53 : 260─274, 2008
4) De Santis M, Becherer A, Bokemeyer C, et al : 2-18fluoro-deoxy-D-glucose positron emission tomography is a reliable predictor for viable tumor in postchemotherapy seminoma : an update of the prospective multicentric SEMPET trial. J Clin Oncol 22 : 1034─1039, 2004
5) Oechsle K, Hartmann M, Brenner W, et al : [18F] Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy : The German multicenter positron emission tomography study group. J Clin Oncol 26 : 5930─5935, 2008
6) Stenning SP, Parkinson MC, Fisher C, et al : Postchemotherapy residual masses in germ cell tumor patients : content, clinical features, and prognosis. Medical Research Council Testicular Tumour Working Party. Cancer 83 : 1409─1419, 1998
7) Hendry WF, Norman AR, Deamaley DP, et al : Metastatic nonseminomatous germ cell tumors of the testis. Results of elective and salvage surgery for patients with residual retroperitoneal masses. Cancer 94 : 1668─1676, 2002
8) Albers P, Weissbach L, Krege S, et al : Prediction of necrosis after chemotherapy of advanced germ cell tumors : results of a prospective multicenter trial of the German Testicular Cancer Study Group. J Urol 171 : 1835─1838, 2004
9) Logothetis CJ, Samuels ML, Trindade A et al : The growing teratoma syndrome. Cancer 50 : 1629─1635, 1982
10) Donadio AC, Motzer RJ, Bajorin DF, et al : Chemotherapy for teratoma with malignant transformation. J Clin Oncol 21 : 4285─4291, 2003
11) Korkolis DP, Aggeli Ch, Passas I, et al : Surgical resection of residual tumor masses after chemotherapy in testicular cancer. Hellenic J Surgery 84 : 84─91, 2012
12) Spermon JR, De Geus-Oei LF, Kiemeney LA, et al : The role of (18) fluoro-2-deoxyglucose position emission tomography in initial staging and re-staging after chemotherapy for testicular germ cell tumours. BJU Int 89 : 549─556, 2002
13) Fox EP, Weathers TD, Williams SD, et al : Outcome analysis for patients with persistent nonseminomatous germ cell tumor in postchemotherapy retroperitoneal lymph node dissections. J Clin Oncol 11 : 1294─1299, 1993
14) Mosharafa AA, Foster RS, Leibovich BC, et al : Is post-chemotherapy resection of seminomatous elements associated with higher acute morbidity? J Urol 169 : 2126─2128, 2003
15) Rabbani F, Goldenberg SL, Gleave ME, et al : Retroperitoneal lymphadenectomy for post-chemotherapy residual masses : is a modified dissection and resection of residual masses sufficient? Br J Urol 81 : 295─300, 1998
16) Beck SD, Foster RS, Bihrle R, et al : Is full bilateral retroperitoneal lymph node dissection always necessary for postchemotherapy residual tumor? Cancer 110 : 1235─1240, 2007
17) Heidenreich A, Pfister D, Witthuhn R, et al : Postchemotherapy retroperitoneal lymph node dissection in advanced testicular cancer : radical or modified template resection. Eur Urol 55 : 217─224, 2009
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