Sabine Kliesch1, Stefanie Schmidt2, Doris Wilborn2, Clemens Aigner3, Walter Albrecht4, Jens Bedke5, Matthias Beintker6, Dirk Beyersdorff7, Carsten Bokemeyer8, Jonas Busch9, Johannes Classen10, Maike de Wit11, Klaus-Peter Dieckmann12, Thorsten Diemer13, Anette Dieing14, Matthias Gockel15, Bernt Göckel-Beining16, Oliver W Hakenberg17, Axel Heidenreich18, Julia Heinzelbecker19, Kathleen Herkommer20, Thomas Hermanns21, Sascha Kaufmann22, Marko Kornmann23, Jörg Kotzerke24, Susanne Krege25, Glen Kristiansen26, Anja Lorch27, Arndt-Christian Müller22, Karin Oechsle8, Timur Ohloff28, Christoph Oing8, Ulrich Otto29, David Pfister18, Renate Pichler30, Heinrich Recken31, Oliver Rick32, Yvonne Rudolph33, Christian Ruf34, Joachim Schirren35, Hans Schmelz36, Heinz Schmidberger37, Mark Schrader38, Stefan Schweyer39, Stefanie Seeling40, Rainer Souchon22, Christian Winter41, Christian Wittekind42, Friedemann Zengerling43, D H Zermann44, Roger Zillmann45, Peter Albers46. 1. Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Münster, Münster, Germany. 2. UroEvidence, Deutsche Gesellschaft für Urologie, Berlin, Germany. 3. Ruhrlandklinik, University Hospital Essen, Essen, Germany. 4. Department of Urology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria. 5. Department of Urology, University Hospital Tübingen, Tübingen, Germany. 6. Südharz Hospital Nordhausen gGmbH, Nordhausen, Germany. 7. Clinic and Polyclinic for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 8. II. Medical Clinic and Polyclinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 9. Department of Urology, Charité University Hospital, Berlin, Germany. 10. Department of Radiotherapy, Radiological Oncology, and Palliative Medicine, St. Vincentius-Kliniken, Karlsruhe, Germany. 11. Clinic for Internal Medicine - Hematology, Oncology, and Palliative Medicine, Vivantes Clinic Neukölln, Berlin, Germany. 12. Department of Urology, Asklepios Klinik Altona, Hamburg, Germany. 13. Clinic and Polyclinic for Urology, Pediatric Urology, and Andrology, University Hospital Gießen, Gießen, Germany. 14. Clinic for Internal Medicine - Hematology and Oncology, Vivantes Clinics Am Urban, Berlin, Germany. 15. HELIOS Clinics Berlin-Buch, Berlin, Germany. 16. Urologist, Horn-Bad Meinberg, Germany. 17. Urological Clinic and Polyclinic, University Hospital Rostock, Rostock, Germany. 18. Department of Urology, University Hospital Cologne, Cologne, Germany. 19. Department of Urology, University Hospital Saarland, Saarbrücken, Germany. 20. Urological Clinic and Polyclinic of the Technical University of Munich, Munich, Germany. 21. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 22. Department for Radiooncology, University Hospital Tübingen, Tübingen, Germany. 23. Clinic for General and Visceral Surgery, University Hospital Ulm, Ulm, Germany. 24. University Hospital Dresden, Dresden, Germany. 25. KEM, Protestant Hospital Essen-Mitte, Clinic for Urology, Pediatric Urology and Urological Oncology, Essen, Germany. 26. Institute of Pathology, University Hospital Bonn, Bonn, Germany. 27. Department of Urology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany. 28. German Foundation for Young Adults with Cancer, Berlin, Germany. 29. Urological Competence Centre for Rehabilitation, Bad Wildungen, Germany. 30. Department of Urology, Medical University Innsbruck, Innsbruck, Austria. 31. Hamburger Fern-Hochschule Studienzentrum Essen, Essen, Germany. 32. Klinik Reinhardshöhe GmbH, Bad Wildungen, Germany. 33. German Cancer Society, Berlin, Germany. 34. Department of Urology, Bundeswehrkrankenhaus, Ulm, Germany. 35. Helios Clinics, Wiesbaden, Germany. 36. Department of Urology, Bundeswehrkrankenhaus, Koblenz, Germany. 37. Clinic and Polyclinic for Radiooncology and Radiotherapy, University Hospital Mainz, Mainz, Germany. 38. Helios Clinics, Berlin, Germany. 39. Clinic for Pathology, Starnberg, Germany. 40. University of Osnabrück, Campus Lingen, Osnabrück, Germany. 41. Urologie Neandertal, Erkrath, Germany. 42. Institute of Pathology, University Hospital Leipzig, Leipzig, Germany. 43. Department of Urology, University Hospital Ulm, Ulm, Germany. 44. Vogtland-Klinik Bad Elster, Bad Elster, Germany. 45. Urology Pankow, Berlin, Germany. 46. Department of Urology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany, p.albers@dkfz-heidelberg.de.
Abstract
OBJECTIVES: We developed the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes therecommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. MATERIALS AND METHODS: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. RESULTS: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. CONCLUSION: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.
OBJECTIVES: We developed the first German evidence- and consensus-based clinical guideline on diagnosis, treatment, and follow-up of germ cell tumours (GCT) of the testes in adult patients. We present the guideline content in 2 separate publications. The present second part summarizes therecommendations for the treatment of advanced disease stages and for the management of follow-up and late effects. MATERIALS AND METHODS: An interdisciplinary panel of 42 experts including 1 patient representative developed the guideline content. Clinical recommendations and statements were based on scientific evidence and expert consensus. For this purpose, evidence tables for several review questions, which were based on systematic literature searches (last search in March 2018), were provided. Thirty-one experts, who were entitled to vote, rated the final clinical recommendations and statements. RESULTS: Here we present the treatment recommendations separately for patients with metastatic seminoma and non-seminomatous GCT (stages IIA/B and IIC/III), for restaging and treatment of residual masses, and for relapsed and refractory disease stages. The recommendations also cover extragonadal and sex cord/stromal tumours, the management of follow-up and toxicity, quality-of-life aspects, palliative care, and supportive therapy. CONCLUSION: Physicians and other medical service providers who are involved in the diagnostics, treatment, and follow-up of GCT (all stages, outpatient and inpatient care as well as rehabilitation) are the users of the present guideline. The guideline also comprises quality indicators for measuring the implementation of the guideline recommendations in routine clinical care; these data will be presented in a future publication.
Authors: Sabine Kliesch; Stefanie Schmidt; Doris Wilborn; Clemens Aigner; Walter Albrecht; Jens Bedke; Matthias Beintker; Dirk Beyersdorff; Carsten Bokemeyer; Jonas Busch; Johannes Classen; Maike de Wit; Klaus-Peter Dieckmann; Thorsten Diemer; Anette Dieing; Matthias Gockel; Bernt Göckel-Beining; Oliver W Hakenberg; Axel Heidenreich; Julia Heinzelbecker; Kathleen Herkommer; Thomas Hermanns; Sascha Kaufmann; Marko Kornmann; Jörg Kotzerke; Susanne Krege; Glen Kristiansen; Anja Lorch; Arndt-Christian Müller; Karin Oechsle; Timur Ohloff; Christoph Oing; Ulrich Otto; David Pfister; Renate Pichler; Heinrich Recken; Oliver Rick; Yvonne Rudolph; Christian Ruf; Joachim Schirren; Hans Schmelz; Heinz Schmidberger; Mark Schrader; Stefan Schweyer; Stefanie Seeling; Rainer Souchon; Christian Winter; Christian Wittekind; Friedemann Zengerling; Dirk-Henrik Zermann; Roger Zillmann; Peter Albers Journal: Urol Int Date: 2021-01-07 Impact factor: 2.089
Authors: Stefanie Schmidt; Carsten Bokemeyer; Christian Winter; Friedemann Zengerling; Jonas Busch; Julia Heinzelbecker; David Pfister; Christian Ruf; Julia Lackner; Peter Albers; Sabine Kliesch Journal: World J Urol Date: 2022-05-12 Impact factor: 4.226
Authors: Jonas Busch; Stefanie Schmidt; Peter Albers; Julia Heinzelbecker; Sabine Kliesch; Julia Lackner; David Pfister; Christian Ruf; Christian Winter; Friedemann Zengerling; Dirk Beyersdorff Journal: World J Urol Date: 2022-01-17 Impact factor: 4.226
Authors: David Pfister; Karin Oechsle; Stefanie Schmidt; Jonas Busch; Carsten Bokemeyer; Axel Heidenreich; Julia Heinzelbecker; Christian Ruf; Christian Winter; Friedemann Zengerling; Sabine Kliesch; Peter Albers; Christoph Oing Journal: World J Urol Date: 2022-02-28 Impact factor: 4.226
Authors: Friedemann Zengerling; Dirk Beyersdorff; Jonas Busch; Julia Heinzelbecker; David Pfister; Christian Ruf; Christian Winter; Peter Albers; Sabine Kliesch; Stefanie Schmidt Journal: World J Urol Date: 2022-07-29 Impact factor: 3.661
Authors: Gamal Anton Wakileh; Christian Ruf; Axel Heidenreich; Klaus-Peter Dieckmann; Catharina Lisson; Vikas Prasad; Christian Bolenz; Friedemann Zengerling Journal: World J Urol Date: 2021-11-15 Impact factor: 4.226
Authors: Ramin Madanchi; Nils W Engel; Winfried Alsdorf; Christoph Oing; Christian Frenzel; Finn-Ole Paulsen; Carsten Bokemeyer; Christoph Seidel Journal: Bone Marrow Transplant Date: 2022-02-21 Impact factor: 5.174