Abstract：
Testicular germ cell tumors are the most common tumors in adolescent and young men. They are curable malignancies that should be treated with curative intent, minimizing acute and long-term side effects. Inguinal orchiectomy is the main diagnostic procedure, and is also curative for most localized tumors, while patients with unfavorable risk factors for recurrence, or those who are unable or unwilling to undergo close follow-up, may require adjuvant treatment. Patients with persistent markers after orchiectomy or advanced disease at diagnosis should be staged and classified according to the IGCCCG prognostic classification. BEP is the most recommended chemotherapy, but other schedules such as EP or VIP may be used to avoid bleomycin in some patients. Efforts should be made to avoid unnecessary delays and dose reductions wherever possible. Insufficient marker decline after each cycle is associated with poor prognosis. Management of residual masses after chemotherapy differs between patients with seminoma and non-seminoma tumors. Patients at high risk of relapse, those with refractory tumors, or those who relapse after chemotherapy should be managed by multidisciplinary teams in experienced centers. Salvage treatment for these patients includes conventional-dose chemotherapy (TIP) and/or high-dose chemotherapy, although the best regimen and strategy for each subgroup of patients is not yet well established. In late recurrences, early complete surgical resection should be performed when feasible. Given the high cure rate of TGCT, oncologists should work with patients to prevent and identify potential long-term side effects of the treatment. The above recommendations also apply to extragonadal retroperitoneal and mediastinal tumors.
摘要：
睾丸生殖细胞肿瘤是青少年和年轻男性中最常见的肿瘤。它们是可以治愈的恶性肿瘤，应该有治愈的意图，最大限度地减少急性和长期副作用。腹股沟睾丸切除术是主要的诊断程序，也可以治愈大多数局部肿瘤，而有不良复发危险因素的患者,或那些不能或不愿意接受密切随访的人，可能需要辅助治疗。睾丸切除术后有持续性标志物或诊断为晚期疾病的患者应根据IGCCCG预后分类进行分期和分类。BEP是最推荐的化疗方案,但其他方案如EP或VIP可用于在某些患者中避免博来霉素。应努力尽可能避免不必要的延误和剂量减少。每个周期后标记物下降不足与不良预后相关。精原细胞瘤和非精原细胞瘤患者化疗后残留肿块的管理不同。复发风险高的患者，那些患有难治性肿瘤的人，或化疗后复发的患者应由经验丰富的中心的多学科团队进行管理.这些患者的挽救治疗包括常规剂量化疗（TIP）和/或高剂量化疗，尽管每个亚组患者的最佳治疗方案和策略尚未得到很好的确立.在晚期复发中，可行时，应进行早期完整的手术切除。鉴于TGCT的高治愈率，肿瘤学家应与患者合作，以预防和确定治疗的潜在长期副作用。上述建议也适用于性腺外腹膜后和纵隔肿瘤。
