Samenvatting
Testicular cancer is a rare malignancy, however the most common malignancy in young men. Today, due to new chemotherapy schedules and improved surgical techniques, 90% of these patients can be cured. Is further improvement in diagnostic and treatment of testicular cancer possible?
Patient and doctor delay are associated with more advanced disease requiring a more intensive treatment. The most important cause for patient delay is patient's embarrassment and doctor's delay ‘not suspecting a malignant tumor’. There is a need for continuous public and medical education to prevent delay in the diagnosis of testicular cancer.
With the use of new computer techniques, reliable volumetric measurement of metastases in the abdomen can be performed, before and after chemotherapy, by non-radiologists. Volumetric measurement is as reliable as the standard radiological measurement by radiologists for determining response after chemotherapy treatment. Automatic and semiautomatic segmentation tools will play an important, cost-effective role in the evaluation of tumor response in cancer treatment in the near future.
If residual tumor is still present in the abdomen after chemotherapy treatment, the tumor can be removed by laparoscopy in about half of these patients. In the remaining patients a standard laparotomy is necessary, but sometimes a posterior retroperitoneoscopy can be considered.
The study showed that laparoscopic removal of residual testicular metastases in the abdomen after chemotherapy is oncological safe, results in a postoperative hospital stay of only one day, in contrast to the five days after a standard laparotomy, and is accompanied by a very nice cosmetic result; only three small scars instead of a big midline laparotomy scar.
Patient and doctor delay are associated with more advanced disease requiring a more intensive treatment. The most important cause for patient delay is patient's embarrassment and doctor's delay ‘not suspecting a malignant tumor’. There is a need for continuous public and medical education to prevent delay in the diagnosis of testicular cancer.
With the use of new computer techniques, reliable volumetric measurement of metastases in the abdomen can be performed, before and after chemotherapy, by non-radiologists. Volumetric measurement is as reliable as the standard radiological measurement by radiologists for determining response after chemotherapy treatment. Automatic and semiautomatic segmentation tools will play an important, cost-effective role in the evaluation of tumor response in cancer treatment in the near future.
If residual tumor is still present in the abdomen after chemotherapy treatment, the tumor can be removed by laparoscopy in about half of these patients. In the remaining patients a standard laparotomy is necessary, but sometimes a posterior retroperitoneoscopy can be considered.
The study showed that laparoscopic removal of residual testicular metastases in the abdomen after chemotherapy is oncological safe, results in a postoperative hospital stay of only one day, in contrast to the five days after a standard laparotomy, and is accompanied by a very nice cosmetic result; only three small scars instead of a big midline laparotomy scar.
| Originele taal-2 | English |
|---|---|
| Kwalificatie | Doctor of Philosophy |
| Toekennende instantie |
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| Begeleider(s)/adviseur |
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| Datum van toekenning | 26-nov.-2018 |
| Plaats van publicatie | [Groningen] |
| Uitgever | |
| Gedrukte ISBN's | 978-94-034-0895-8 |
| Elektronische ISBN's | 978-94-034-0894-1 |
| Status | Published - 2018 |