How do you decide between RPLND vs. chemotherapy in patients with Stage IIA mixed germ cell tumor as primary treatment?

Topics: Genitourinary Cancers • Pediatric Oncology • Medical Oncology • Testicular Cancer • Germ Cell Tumors • AYA • AYA Cancers

Answer from: Medical Oncologist at Community Practice

CSIIA nonseminoma is not as straightforward as many people think although it is a common clinical scenario in the days of active surveillance in CSI GCTs. A very germane aspect is that probably 20% of clinical IIA GCTs are false positive (when confirmed by pathologic assessments) which means if you ...

Comments

Medical Oncologist at Tennessee Onc/Sarah Cannon Rsrch Inst
Agree with the answer.

Answer from: Medical Oncologist at Academic Institution

I agree but would add a few comments: If there is a rising hCG or AFP above normal values, we prefer BEP X 3 rather than RPLND. If the patient > age 50, EP X 4. Also, we consider any AFP < 25 to be “ normal” despite many labs listing 0-8 as their normal range. Our group r...

Answer from: Medical Oncologist at Academic Institution

If there is teratoma in primary testis cancer and markers are not elevated then prefer RPLND.

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