PT  - JOURNAL ARTICLE
AU  - James E. Montie
TI  - Changing concepts in the management of testis cancer
DP  - 1984 Jun 20
TA  - Cleveland Clinic Journal of Medicine
PG  - 381--385
VI  - 51
IP  - 2
4099  - http://www.ccjm.org/content/51/2/381.short
4100  - http://www.ccjm.org/content/51/2/381.full
SO  - Cleve Clin J Med1984 Jun 20; 51
AB  - The emergence of extremely effective chemotherapy for testis cancer has changed many management concepts. Accurate clinical staging may eliminate the need for a node dissection in carefully selected stage I patients. Early detection of metastases is facilitated by using serum markers. Adjuvant chemotherapy after surgery may virtually eliminate recurrences. High-risk patients that respond poorly to standard treatment can be identified at the time of diagnosis; new protocols for this group are being developed. Chemotherapy is an effective treatment for seminoma and is the preferred initial treatment for a high-stage disease. Postchemotherapy surgery can aggravate the pulmonary fibrosis induced by bleomycin; consequently, appropriate precautions must be taken. All of these changes emphasize the importance of a continuing reappraisal by the practicing urologist of treatment philosophies for testis cancer.