TAILIEUCHUNG - Sách: Guidelines on Testicular Cancer

Adrenal carcinomas are very rare and the real number diagnosed in the United States is not known. It is probably around 300 per year. They are much less common than adrenal adenomas, which are found frequently among middle aged and elderly people. Adrenal tumors (most of which are adenomas) are found in about one in every 10 people who have an imaging test (like a CT or MRI) of the adrenal gland. The average age of patients with adrenal cancer is around 45 to 50, but adrenal cortical cancer can occur in people of any age; even in children | Guidelines on Testicular Cancer P. Albers chairman W. Albrecht F. Algaba C. Bokemeyer G. Cohn-Cedermark K. Fizazi A. Horwich . Laguna European Association of Urology European Association of Urology 2012 TABLE OF CONTENTS PAGE 1. BACKGROUND 4 Methodology 4 2. PATHOLOGICAL CLASSIFICATION 6 3. DIAGNOSIS 6 Clinical examination 6 Imaging of the testis 6 Serum tumour markers at diagnosis 7 Inguinal exploration and orchidectomy 7 Organ-sparing surgery 7 Pathological examination of the testis 8 Diagnosis and treatment of testicular intraepithelial neoplasia TIN 8 Screening 8 4. STAGING 8 Diagnostic tools 8 Serum tumour markers post-orchidectomy half-life kinetics 9 Retroperitoneal mediastinal and supraclavicular lymph nodes and viscera 9 Staging and prognostic classifications 10 Prognostic risk factors 12 Impact on fertility and fertility- associated issues 13 5. GUIDELINES FOR THE DIAGNOSIS AND STAGING OF TESTICULAR CANCER 13 6. TREATMENT STAGE I GERM CELL TUMOURS 13 Stage I seminoma 13 Surveillance 13 Adjuvant chemotherapy 14 Adjuvant radiotherapy 14 Retroperitoneal lymph node dissection RPLND 14 Risk-adapted treatment 14 Guidelines for the treatment of seminoma stage I 15 NSGCT stage I 15 Surveillance 15 Primary chemotherapy 15 Risk-adapted treatment 15 Retroperitoneal lymph node dissection 16 CS1S with persistently elevated serum tumour markers 16 Guidelines for the treatment of NSGCT stage I 17 7. TREATMENT METASTATIC GERM CELL TUMOURS 19 Low-volume metastatic disease stage IIA B 19 Stage IIA B seminoma 19 Stage IIA B non-seminoma 19 Advanced metastatic disease 20 Primary chemotherapy 20 Restaging and further treatment 21 Restaging 21 Residual tumour resection 21 Quality of surgery 22 Consolidation chemotherapy after secondary surgery 22 Systemic salvage treatment for relapse

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