17. Anhang – Hodentumoren

Version 1.1 · Februar 2020 · AWMF 043/049OL
Leitlinienprogramm Onkologie · Deutsche Krebsgesellschaft · Deutsche Krebshilfe · AWMF

17.1 Übersicht der Prognosefaktoren zum nichtseminomatösen KZT Stadium I

Tabelle 23: Übersicht der Prognosefaktoren zum nichtsemino-matösen KZT Stadium I

Prognostischer Faktor

Outcome

Positiver
Zusammenhang

Negativer
Zusammenhang

Percentage of embryonal carcinoma
(categorical)

Relapse
Yes/No

[135], LOE 2b; OR 1.02 (95% CI 1.00–1.04)

Embryonal carcinoma (present/absent)

[131], LOE 2b
HR 3.00 (95% CI 2.14-4.22)

Lymphovascular invasion (dichotom)

[131], LOE 2b
HR 2.62 (95% CI 2.03-3.39)

[132], LOE 4
OR 5.02 (95% CI 1.17–21.62)

[134], LOE 2b
OR 8.67 (95% CI 1.38 - 54.37)

[133], LOE 2b
OR 6.52 (95% CI 1.87–22.72)

Epididymis invasion (dichotom)

[131], LOE 2b
HR 1.77 (95% CI 1.13-2.76)

Invasion of rete testis (dichotom)

[131], LOE 2b
HR 1.74 (95% CI 1.37-2.23)

Tunica albuginea invasion (dichotom)

[131], LOE 2b
HR 1.49 (95% CI 1.16-1.90)

hCG elevated (dichotom)

[131], LOE 2b
HR 1.42 (95% CI 1.15-1.74)

Choriocarcinoma (dichotom)

[131], LOE 2b
HR 1.42 (95% CI 1.10-1.84)

Yolk sac tumor (dichotom)

[131], LOE 2b
HR 1.25 (95% CI 1.02-1.54)

[133], LOE 2b
OR 3.53 (95% CI 1.07–11.62)

History of cryptorchidism
(dichotom)

[132], LOE 4 OR 0.07 (95% CI 0.01–0.34)

Craniocaudal nodal length (cm)
(continuous)

[134], LOE 2b
OR 1.15 (95% CI 1.01 - 1.31)

Estimates for every 3-mm increase (continuous)

[134], LOE 2b
OR 1.52 (95% CI 1.03 - 2.25)

Embryonal carcinoma
(dichotom)

Relapse-free sur-vival
(RFS)
time from orchiecto-my until detection of relapse or death of GCC

[131], LOE 2b
HR 2.73 (95% CI 1.94-3.85)

[228], LOE 2b
HR 1.74 (95% CI 1.10-2.74)

Vascular invasion
(dichotom)

[131], LOE 2b
HR 1.57 (95% CI 1.22-2.02)

[228], LOE 2b
HR 3.22 (95% CI 2.17–4.78)

Rete testis invasion
(dichotom)

[131], LOE 2b
HR 1.30 (95% CI 1.02-1.69)

LOE: level of evidence, CI confidence interval, HR hazard ratio, OR odds ratio

17.2 Tabellen zur Erfassung der Nachsorge

17.2.1 Seminom Stadium I: Überwachung

17.2.2 Seminom Stadium I: nach adjuvanter Carboplatin-Gabe

17.2.3 Seminom Stadium I: nach adjuvanter Strahlentherapie

17.2.4 Seminom Stadium IIA und IIB: nach Strahlentherapie

17.2.5 Seminom Stadium IIB/C-III: Gute Prognose Gruppe nach Chemotherapie (CR oder Residuen <3cm oder Residuen > 3cm aber PET-negativ)

17.2.6 Nichtseminom Stadium I niedriges Risiko: Überwachung

17.2.7 Nichtseminom Stadium I hohes Risiko: Überwachung

17.2.8 Nichtseminom Stadium I hohes Risiko: nach adjuvanter Chemotherapie

17.2.9 Nichtseminom Stadium II-III Gute Prognose-Gruppe: kompl. Remission nach Chemotherapie allein oder kompl. Remission nach Chemotherapie gefolgt von der Resektion von Residualtumoren

Nichtseminom Stadium II-III Gute Prognose-Gruppe: kompl. Remission nach Chemotherapie allein oder kompl. Remission nach Chemotherapie gefolgt von der Resektion von Residualtumoren

17.3 Muster-Fragebogen EORTC QLQ-TC26

Literaturhinweise

[135] Williams, S.B., Kacker, R., Winston, D., Bahnson, E., Steele, G.S., Richie, J.P., Predictors of positive retroperitoneal lymph nodes in patients with high risk testicular cancer, J Urol, 2011. 186(6): p. 2245-8.

[131] Daugaard, G., Gundgaard, M.G., Mortensen, M.S., Agerbaek, M., Holm, N.V., Rorth, M., et.al. Surveillance for stage I nonseminoma testicular cancer: outcomes and long-term follow-up in a population-based cohort, J Clin Oncol, 2014. 32(34): p. 3817-23.

[132] Dong, P., Liu, Z.W., Li, X.D., Li, Y.H., Yao, K., Wu, S., et.al. Risk factors for relapse in patients with clinical stage I testicular nonseminomatous germ cell tumors, Med Oncol, 2013. 30(1): p. 494.

[134] Howard, S.A., Gray, K.P., O'Donnell, E.K., Fennessy, F.M., Beard, C.J., Sweeney, C.J., Craniocaudal retroperitoneal node length as a risk factor for relapse from clinical stage I testicular germ cell tumor, AJR Am J Roentgenol, 2014. 203(4): p. W415-20.

[133] Li, X., Guo, S., Wu, Z., Dong, P., Li, Y., Zhang, Z., et.al. Surveillance for patients with clinical stage I nonseminomatous testicular germ cell tumors, World J Urol, 2015. 33(9): p. 1351-7.

[228] Sturgeon, J.F., Moore, M.J., Kakiashvili, D.M., Duran, I., Anson-Cartwright, L.C., Berthold, D.R., et.al. Non-risk-adapted surveillance in clinical stage I nonseminomatous germ cell tumors: the Princess Margaret Hospital's experience, Eur Urol, 2011. 59(4): p. 556-62.