[Testicular germ cell tumors late relapses]

Abstract

The late relapses (LR) of germinal cells tumors occur by definition more than two years after a succesful initial care. These rare situations have a poor prognosis with a median survival of 23.9 months after chemotherapy. The LR arise as a general rule at the patient's suffering from an advanced initial stage NSGCT. The risk is increased by the arising of a first relapse in the first two years which follow the initial treatment. The diagnosis is mostly mentioned in front of symptoms, CT scan or rising markers in 40% of the cases. The LR group includes two very different clinical situations: the LR of the initially watched GCT, treatment of which bases on the standards of first-line stage II tumor treatment; and the LR of NSGCT after a first line chemotherapy, treatment of which bases mainly on surgery which allows a long-term complete remission in more than 50%. Other situations (multifocal, non extirpable tumors) require therapeutic associations and impact the prognosis. The knowledge of particular genetic profiles could allow in the future to identify the germinal tumors at risk of RT and to propose adapted watching.