NCCN Guidelines updated 10/16/06 V1.2007
Summary of changes in the 1.2007 version of the Testicular Cancer Guidelines from the 1.2006 version include:
• The term "Observe" was changed to "Surveillance" throughout and RPLND was clarified as "open nerve-sparing".
• The recommendation to discuss sperm banking was added to the Primary Treatment section. The biopsy was clarified as an "open inguinal" biopsy and the ultrasound was defined as "suspicious for intratesticular abnormalities" .
• Stage IA, IB, IS: The RT recommendation was modified to include para-aortic ± ipsilateral iliac nodes. Single agent carboplatin was also added as a treatment option with a category 3 designation and supporting reference .
• Stage IIA, IIB: Consider EP x 4 cycles for selected stage IIB pages was added as a treatment option .
• For patients who have recurrence after RT or observation for Stage I or II disease, the recommendation is to treat according to the extent of disease at relapse .
• Stage IIB, IIC, III after primary treatment with chemotherapy: The CT scan was clarified to be of the chest, abdomen and pelvis. Serum tumor markers were added. The categories after the CT scan were modified to include marker status.
Footnote h is new to the page and includes recommendations for persistent, elevated beta-hCG but not rising .
• Footnote j is new throughout to the recommendation of RPLND, "Surgery is recommended within 4 weeks of CT scan, and 7-10 days of markers". This has a category 2B designation.
• aber nt lymphatic The terminology defining landing zone was modified to include "symptomatic" metastatic sites and " ra drainage".
• Footnote m, "There is limited predictive value for PET scan for residual masses" is new to the page .
• A note was added to the BEP regimen on page that some NCCN institutions administer bleomycin on a 2, 9, 16 day schedule.
Last edited by Karen; 10-19-06 at 10:19 AM.
Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.