Testis Kanseri Tedavisinde Güncel Yaklaşım

Abstract

Testis kanseri 15-44 yaş arası genç erkekleri etkileyen en sık kanserdir. Sıklığı gelişmiş ülkelerde giderek artmaktadır. Testis kanserinin artan insidansına rağmen mortalitesi özellikle gelişmiş ülkelerde on yıllar boyunca düşmektedir. Gelişmiş ülkelerde evre I testis kanseri kür oranı %100’e ulaşmaktadır. Metastatik hastalıkta ise prognostik risk gruplarına göre kür oranı %90 ile %48 arasında değişmektedir. Testiste şüpheli kitlesi olan erkek orşiektomiye gitmeden önce alfa-fetoprotein (AFP), human koryonik gonadotropin (HCG) ve laktat dehidrogenazı (LDH) içeren serum tümör belirteçleri görülmelidir. Tanı için görüntülemede skrotal ultrasonografi yeterlidir. Testis kanserinin primer tedavisi inguinal kesi ile yapılan ve testis ile beraber spermatik kordun internal inguinal ring düzeyine dek tümüyle çıkarılmasından oluşan radikal orşiektomi operasyonudur. Testis kanserinde kemoterapi, özellikle sisplatin bazlı olanlar, testis kanserinin kemo-sensitivitesi nedeniyle mükemmel tedavi oranlarına sahiptir. Testis kanseri tedavisi kanserin evresi ve seminom patolojisinde olup olmamasına göre şekillendirilir.

Keywords

• orşiektomi
• retroperitoneal lenf nodu diseksiyonu
• testis kanseri

Current Approach in Testicular Cancer Treatment

Abstract

Testicular cancer is the most common cancer affecting young men aged 15-44. Its incidence is increasing in developed countries. Despite the increasing incidence of testicular cancer, its mortality has been decreasing for decades, especially in developed countries. In developed countries, the cure rate of stage I testicular cancer reaches 100%. In metastatic disease, the cure rate varies between 90% and 48%, depending on the prognostic risk groups. Serum tumor markers including alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH) should be seen before a man with a suspicious mass in the testis undergoes orchiectomy. Scrotal ultrasonography is sufficient for diagnosis. The primary treatment of testicular cancer is a radical orchiectomy operation, which is performed with an inguinal incision and consists of the complete removal of the testis and the spermatic cord up to the level of the internal inguinal ring. Chemotherapy in testicular cancer, especially those based on cisplatin, has excellent cure rates because of the chemo-sensitivity of testicular cancer. Treatment of testicular cancer is shaped according to the stage of the cancer and whether it is in the pathology of seminoma.

Keywords

• Testicular cancer
• orchiectomy
• retroperitoneal lymph node dissection

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