Kontroverzie v manažmente neseminomatóznych germinatívnych nádorov testis v I. klinickom štádiu

English version

Authors: D. Ondrus ¹; K. Kajo ²; V. Stastna ³; M. Ondrusova ^4,5
Authors‘ workplace: 1st Department of Oncology, Comenius University Faculty of Medicine, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic ¹; Department of Pathology, Slovak Medical University, St. Elisabeth Cancer Institute, Bratislava, Slovak Republic ²; Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University in Trnava, Slovak Republic ³; St. Elizabeth University of Health and Social Sciences, Bratislava, Slovak Republic ⁴; Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic ⁵
Published in: Klin Onkol 2015; 28(2): 112-115
Category: Original Articles
doi: https://doi.org/10.14735/amko2015112

Overview

Prísny dohľad po orchiektómii samotnej sa stal populárnym v manažmente neseminomatóznych germinatívnych nádorov testis v I. klinickom štádiu (clinical stage I nonseminomatous germ cell testicular tumors – CSI NSGCTT). Úsilie identifikovať pacientov s vysokým rizikom progresie ochorenia viedlo k vyhľadávaniu rizikových faktorov u CSI NSGCTT. Cieľom súčasnej štúdie bolo analyzovať dlhoročné skúsenosti s liečebnými postupmi založenými na prítomnosti rizikových faktorov (prísny dohľad a adjuvantná chemoterapia). V období 1/ 1992– 2/ 2015 bolo celkovo 454 pacientov s CSI NSGCTT zaradených do štúdie. Stratifikovali sa do dvoch skupín podľa použitých liečebných postupov v závislosti na prítomnosti rizikových faktorov. Skupina A (CSI NSGCTT s nízkym rizikom) pozostávala z 287 pacientov ktorí podstúpili prísny dohľad, progresia ochorenia sa zistila u 48 (16,7 %) pacientov po mediáne sledovania 7,0 mesiacov. Šesť pacientov (2,1 %) v tejto skupine zomrelo po mediáne sledovania 34,3 mesiacov. Skupina B (CSI NSGCTT s vysokým rizikom) pozostávala z 167 pacientov, ktorí boli dostávali adjuvantnú chemoterapiu, progresia ochorenia sa zistila u dvoch pacientov (1,2 %) s mediánom sledovania 56,2 mesiacov. Jeden pacient (0,6 %) zomrel 139,4 mesiacov po orchiektómii. Štatisticky významný rozdiel medzi oboma skupinami sa zistil v prežívaní bez progresie ochorenia, avšak nevýznamný bol rozdiel v celkovom prežívaní.

Klúčové slová:
testikulárne nádory – prísny dohľad – adjuvantná chemoterapia – progresia ochorenia

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Obdrženo:
4. 3. 2015

Přijato:
8. 3. 2015

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