Treatment of malignant germ cell tumors
Identifieur interne : 002729 ( Main/Exploration ); précédent : 002728; suivant : 002730Treatment of malignant germ cell tumors
Auteurs : G. Daugaard [Danemark] ; H. H. Hansen [Danemark] ; M. R Rth [Danemark]Source :
- Annals of Oncology [ 0923-7534 ] ; 1990.
Abstract
In an unselected group of 278 patients with germ cell tumors, disease-free status was obtained in 97% by a treatment program including a surveillance-only strategy for stage I testicular cancer, and low-or high-dose cisplatinum-etoposide treatment for patients with more extensive disease. The overall follow-up period was a median of 40 months (range 20–62 months). At present 100% of patients with stage I disease, 91% with stage II disease, 86% with stage III disease, 75% with extragonadal germ cell tumors, and 3 of 3 patients with germ cell tumors in the ovary are alive and without disease. Among 36 patients treated with high-dose cisplatinum and etoposide there were six toxic deaths, four of them in patients with residual malignant disease. Three patients died of progressive disease. There were no toxic deaths among 54 patients with disseminated disease but without poor prognostic features who were treated with low-dose cisplatinum-etoposide; six of these patients died of progressive disease. It is concluded: 1) that surveillance is a feasible and reasonable strategy for patients with stage I disease; 2) that excellent survival results can be achieved with standard-dose cisplatinum-etoposide in patients with disseminated disease and a favorable prognostic profile; and 3) that disease-free status can be obtained in nearly all patients with poor prognostic features at the expense of significant toxicity. Standardized criteria for selection of patients with poor prognoses are needed. Randomized trials should be carried out to define the role of high-intensity treatment and, finally, measures to decrease or prevent serious toxicity should be explored.
Url:
DOI: 10.1093/oxfordjournals.annonc.a057721
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R Rth</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:07A460138DA867DED40DAF90E58DA1F60753E2D5</idno><date when="1990" year="1990">1990</date><idno type="doi">10.1093/oxfordjournals.annonc.a057721</idno><idno type="url">https://api.istex.fr/document/07A460138DA867DED40DAF90E58DA1F60753E2D5/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002F43</idno><idno type="wicri:Area/Main/Curation">002B53</idno><idno type="wicri:Area/Main/Exploration">002729</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Treatment of malignant germ cell tumors</title><author><name sortKey="Daugaard, G" sort="Daugaard, G" uniqKey="Daugaard G" first="G." last="Daugaard">G. Daugaard</name><affiliation wicri:level="3"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology ONK, The Finsen Institutet, Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Hansen, H H" sort="Hansen, H H" uniqKey="Hansen H" first="H. H." last="Hansen">H. H. Hansen</name><affiliation wicri:level="3"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology ONK, The Finsen Institutet, Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="R Rth, M" sort="R Rth, M" uniqKey="R Rth M" first="M." last="R Rth">M. R Rth</name><affiliation wicri:level="3"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Oncology ONK, The Finsen Institutet, Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="1990">1990</date><biblScope unit="volume">1</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="195">195</biblScope><biblScope unit="page" to="202">202</biblScope></imprint><idno type="ISSN">0923-7534</idno></series><idno type="istex">07A460138DA867DED40DAF90E58DA1F60753E2D5</idno><idno type="DOI">10.1093/oxfordjournals.annonc.a057721</idno><idno type="ArticleID">1.3.195</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0923-7534</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">In an unselected group of 278 patients with germ cell tumors, disease-free status was obtained in 97% by a treatment program including a surveillance-only strategy for stage I testicular cancer, and low-or high-dose cisplatinum-etoposide treatment for patients with more extensive disease. The overall follow-up period was a median of 40 months (range 20–62 months). At present 100% of patients with stage I disease, 91% with stage II disease, 86% with stage III disease, 75% with extragonadal germ cell tumors, and 3 of 3 patients with germ cell tumors in the ovary are alive and without disease. Among 36 patients treated with high-dose cisplatinum and etoposide there were six toxic deaths, four of them in patients with residual malignant disease. Three patients died of progressive disease. There were no toxic deaths among 54 patients with disseminated disease but without poor prognostic features who were treated with low-dose cisplatinum-etoposide; six of these patients died of progressive disease. It is concluded: 1) that surveillance is a feasible and reasonable strategy for patients with stage I disease; 2) that excellent survival results can be achieved with standard-dose cisplatinum-etoposide in patients with disseminated disease and a favorable prognostic profile; and 3) that disease-free status can be obtained in nearly all patients with poor prognostic features at the expense of significant toxicity. Standardized criteria for selection of patients with poor prognoses are needed. Randomized trials should be carried out to define the role of high-intensity treatment and, finally, measures to decrease or prevent serious toxicity should be explored.</div></front></TEI><affiliations><list><country><li>Danemark</li></country><region><li>Hovedstaden</li></region><settlement><li>Copenhague</li></settlement></list><tree><country name="Danemark"><region name="Hovedstaden"><name sortKey="Daugaard, G" sort="Daugaard, G" uniqKey="Daugaard G" first="G." last="Daugaard">G. Daugaard</name></region><name sortKey="Hansen, H H" sort="Hansen, H H" uniqKey="Hansen H" first="H. H." last="Hansen">H. H. Hansen</name><name sortKey="R Rth, M" sort="R Rth, M" uniqKey="R Rth M" first="M." last="R Rth">M. R Rth</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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