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Clinical prognostic factors and investigation of chemoresistance in testicular cancer

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  • Biology
  • Medicine


Microsoft Word - Geczi-THESRTF 1 Clinical prognostic factors and investigation of chemoresistance in testicular cancer Lajos Géczi M.D. Ph. D. Thesis DDeeppaarrttmmeenntt ooff MMeeddiiccaall MMiiccrroobbiioollooggyy Faculty of Medicine University of Szeged 22000033 2 1. INTRODUCTION 1.1. Testicular tumors are rare, making up only 1 per cent of all cancers in men, however this tumor has become an extremely important oncological disease. 1. Testicular germ cell tumor is the most common carcinoma in young men aged 15-35 years and thus has the potential to greatly shorten productive years of life. 2. Available serum markers (alfafetoprotein, AFP and human chorionic gonadotropin, HCG) allow the clinician to make important and accurate treatment related decisions. 3. Testicular cancer has been a model for multidisciplinary care, as surgical resection of postchemotherapy radiographically persistent disease can improve the cure rate. 4. Germ cell tumors have become an excellent testing ground for active experimental drugs (i.e., cisplatin, etoposide, and ifosfamide), all of which were approved primarily on the basis of data from studies of testicular cancer. The prognosis of germ cell tumor cases has improved markedly following the introduction of cisplatin-based chemotherapy. In parallel with advances in the management of testicular cancer, growing concern about late adverse effects of treatment has been expressed. The risk-adapted treatment strategy focuses on reducing toxicity in good-risk patients, while preserving treatment efficacy. However, more intensive chemotherapy regimens and treatment policies used in poor risk and relapsed patients. The goal of chemotherapy for patients with germ cell tumors is never merely palliation or prolongation of survival, but cure. The chance of cure for patients with poor prognosis - those with relapse or resistance to cisplatin based chemotherapy - is low because no standa

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