Abstract

VERA-GIMON, Raúl et al. Management of patients with germinal cell tumors in first relapse. rev.colomb.cancerol. [online]. 2021, vol.25, n.2, pp.79-92.  Epub May 02, 2022. ISSN 0123-9015.  https://doi.org/10.35509/01239015.113.

Germ cell tumors (GCT) are the most common malignant neoplasms affecting young men aged 15 to 35 years. Patients with previous stage 2 and 3 who relapse offer a great challenge to the Medical team. The optimal therapy for these patients with recurrent disease is still poorly defined. Options include second-line chemotherapy regimens at conventional doses which combine cisplatin and ifosfamide, with vinblastine, etoposide or paclitaxel, or alternatively high-dose chemotherapy with stem cell support. As there is still no conclusive evidence from clinical trials, the indications for the use of high-dose chemotherapy remain unclear. Most of the present literature is based in retrospective studies. Second relapse treatment options should be individualized according to the patient and his previous treatment. Surgical resection of residual masses in patients with negative markers after chemotherapy is a key element for successful therapy. Currently, patients in Venezuela who have relapses should receive treatment with any of the established regimens that are used at conventional doses in the second line, however in some cases they should receive treatment in an oncology center with a multidisciplinary team having access to treatment with high dose chemotherapy and to oncologist surgeons who are experts in this area.

Keywords : testicular cancer; germ cell tumor; nonseminomatous; relapse; treatment.

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