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Nichtseminom CS I: Adjuvante Therapie

  • Peter AlbersEmail author
Living reference work entry
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Die adjuvante Therapie im klinischen Stadium I des nichtseminomatösen Hodentumors hat zum Ziel, das Rezidivrisiko erheblich zu verringern, ohne die Rate der Langzeittoxizitäten durch eine Chemotherapie zu erhöhen. Grundsätzlich steht die Überwachung nach Ablatio testis, die adjuvante Chemotherapie oder auch das operative „staging“ durch eine retroperitoneale Lymphadenektomie zur Verfügung. Abhängig von validierten Prognosefaktoren (lymphovaskuläre Invasion, VI), den daraus resultierenden Rezidivraten und den Therapiewünschen des Patienten muss die adjuvante Therapie gemeinsam mit dem Patienten festgelegt werden („shared decision making“). In den meisten Fällen wird man bei Patienten ohne VI und einem Rezidivrisiko von ca. 13 % eine Überwachung empfehlen, Patienten mit VI und einem Rezidivrisiko von ca. 50 % entscheiden sich häufig für eine adjuvante Therapie mit einem Zyklus BEP Chemotherapie. Eine Überwachung unabhängig von Risikofaktoren ist grundsätzlich möglich, beinhaltet dann aber für 50 % eine stadienorientierte definitive Chemotherapie mit 3–4 Zyklen BEP.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Urologische KlinikUniversitätsklinikum DüsseldorfDüsseldorfDeutschland

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