TY - JOUR
T1 - Management of Germ Cell Tumours of the Testes in Adult Patients
T2 - German Clinical Practice Guideline, PART II-Recommendations for the Treatment of Advanced, Recurrent, and Refractory Disease and Extragonadal and Sex Cord/Stromal Tumours and for the Management of Follow-Up, Toxicity, Quality of Life, Palliative Care, and Supportive Therapy
AU - Kliesch, Sabine
AU - Schmidt, Stefanie
AU - Wilborn, Doris
AU - Aigner, Clemens
AU - Albrecht, Walter
AU - Bedke, Jens
AU - Beintker, Matthias
AU - Beyersdorff, Dirk
AU - Bokemeyer, Carsten
AU - Busch, Jonas
AU - Classen, Johannes
AU - De Wit, Maike
AU - Dieckmann, Klaus Peter
AU - Diemer, Thorsten
AU - Dieing, Anette
AU - Gockel, Matthias
AU - Göckel-Beining, Bernt
AU - Hakenberg, Oliver W.
AU - Heidenreich, Axel
AU - Heinzelbecker, Julia
AU - Herkommer, Kathleen
AU - Hermanns, Thomas
AU - Kaufmann, Sascha
AU - Kornmann, Marko
AU - Kotzerke, Jörg
AU - Krege, Susanne
AU - Kristiansen, Glen
AU - Lorch, Anja
AU - Müller, Arndt Christian
AU - Oechsle, Karin
AU - Ohloff, Timur
AU - Oing, Christoph
AU - Otto, Ulrich
AU - Pfister, David
AU - Pichler, Renate
AU - Recken, Heinrich
AU - Rick, Oliver
AU - Rudolph, Yvonne
AU - Ruf, Christian
AU - Schirren, Joachim
AU - Schmelz, Hans
AU - Schmidberger, Heinz
AU - Schrader, Mark
AU - Schweyer, Stefan
AU - Seeling, Stefanie
AU - Souchon, Rainer
AU - Winter, Christian
AU - Wittekind, Christian
AU - Zengerling, Friedemann
AU - Zermann, D. H.
AU - Zillmann, Roger
AU - Albers, Peter
N1 - Publisher Copyright:
© 2021
PY - 2021/2
Y1 - 2021/2
N2 - Objectives: We developed the first German evidence-and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes therecommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. Materials and Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. Results: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. Conclusion: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.
AB - Objectives: We developed the first German evidence-and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes therecommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. Materials and Methods: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. Results: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. Conclusion: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.
KW - Extragonadal tumours
KW - Follow-up
KW - Germ cell tumour of the testes
KW - Guideline
KW - Metastasis
KW - Non-seminoma
KW - Palliative care
KW - Quality of life
KW - Seminoma
KW - Stromal tumours
KW - Supportive therapy
KW - Systematic review
KW - Therapy
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=85100114228&partnerID=8YFLogxK
U2 - 10.1159/000511245
DO - 10.1159/000511245
M3 - Review article
C2 - 33486494
AN - SCOPUS:85100114228
SN - 0042-1138
VL - 105
SP - 181
EP - 191
JO - Urologia Internationalis
JF - Urologia Internationalis
IS - 3-4
ER -