Germinalni tumorji. Sodobno zdravljenje bolnikov z rakom mod

Abstract

Germinalni tumorji (tumorji mod) spadajo med redke vrste raka, med mlajšimi moškimi, starimi od 20 do 40 let, pa je to najpogostejša vrsta raka. Če diagnostiko in zdravljenje bolnikov z germinalnim tumorjem vodijo strokovnjaki z izkušnjami na tem področju, je bolezen dobro ozdravljiva tudi v napredovali, metastatski fazi. Zdravljenje lokalno omejene bolezni (klinični stadij I) je konzervativno. Po orhidektomiji, ki je nujen diagnostično-terapevtski poseg, bolnike večinoma sledimo s pogostimi rednimi kontrolnimi pregledi, s katerimi aktivno iščemo morebitno metastatsko bolezen, pooperativno dopolnilno zdravljenje s kemoterapijo (KT) ali obsevanjem (RT) ali retroperitonealno limfadenektomijo (RPLND) pa uvedemo le redkim bolnikom. Bolnike, pri katerih ob kontrolnih pregledih ugotovimo metastatsko bolezen (kamor v klinični praksi štejemo tudi lokoregionalno razširjeno bolezen z zasevki v retroperitonealnih bezgavkah), zdravimo po standardnih načelih zdravljenja bolnikov z metastatskim germinalnim tumorjem. Zdravljenje bolnikov z metastatsko boleznijo načrtujemo s pomočjo napovednih dejavnikov poteka bolezni – histološkega tipa primarnega tumorja (seminomi/ neseminomski germinalni tumorji (NSGCT)), kliničnega stadija bolezni ter serumskih vrednosti tumorskih označevalcev bolezni α-fetoproteina (AFP), β-horiogonadotropina (ß-HCG) in encima laktatdehidrogenaze (LDH). Zdravljenje bolnikov z metastatskim germinalnim tumorjem praviloma začnemo s kombinirano KT, s katero pri bolnikih z manjšim obsegom metastatske bolezni lahko dosežemo ozdravitev, pri bolnikih z obsežnejšim metastatskim NSGCT pa zdravljenje navadno nadaljujemo operativno z odstranitvijo vseh zaostalih zasevkov.

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Data

Language:	Slovenian
Year of publishing:	2009
Typology:	1.04 - Professional Article
Organization:	OI - Institute of Oncology
UDC:	616.64/.68-006.6
COBISS:	848251
ISSN:	1408-1741
Parent publication:	Onkologija
Views:	2473
Downloads:	512
Average score:	0 (0 votes)
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Secondary language:	English
Secondary title:	Germ-Cell Tumors: New Improved Treatment Method of Testicular Cancer Patients
Secondary abstract:	Germ cell tumors (testicular cancer), though a rare cancer type in general, are one of the most common cancers of young adult men aged between 20 and 40 years. Treatment of germ cell cancer is potentially successful, even in metastatic settings, if the diagnosis and treatment are performed by experienced professionals. The treatment of localized disease is conservative. After orchidectomy which is the initial therapeutical as well as a diagnostic procedure, the patients are thoroughly followed by watchful waiting. Adjuvant treatment in the form of adjuvant chemotherapy, radiotherapy or selective retroperitoneal lymphadenectomy is performed under specific circumstances. Patients who during watchful waiting develop metastatic disease (in clinical practice also metastases in regional lymph nodes are considered as a metastatic disease) are classically treated according to prognostic factors which consist of histological type (seminoma vs. nonseminomal germ cell tumors) of tumor, clinical stage of the disease and the level of serum tumor markers α-fetoprotein (AFP), β-choriogonadotropin (β-HCG) and LDH. Metastatic disease is initially treated by combination chemotherapy which, in the settings of metastatic seminoma and limited metastatic non-seminomal germ cell tumors, could be the ultimate treatment modality, while the patients with metastatic non-seminomal germ cell tumors with residual metastases after the normalization of serum tumor markers need resection of residual metastases.
Secondary keywords:	Testicular neoplasms;Diagnosis;Therapy;Testis, novotvorbe;Diagnoza;Terapija;
URN:	URN:NBN:SI
Pages:	str. 114-116, 152
Volume:	ǂLeto ǂ13
Issue:	ǂšt. ǂ2
Chronology:	dec. 2009
ID:	10957668