睾丸生殖细胞肿瘤（GCT）占睾丸恶性肿瘤的大部分。精原细胞瘤和非精原细胞瘤的预后和治疗策略有所不同。虽然基于顺铂的化疗显着提高了生存率，但化疗后残留肿块的识别对于确定进一步的治疗和生存至关重要。对于精原细胞瘤，很大比例的病例会出现残余肿块的自发消退。建议使用氟脱氧葡萄糖正电子发射断层扫描（FDG PET）来评估化疗后的残留肿块。腹膜后淋巴结清扫术（RPLND）具有治疗益处，但由于化疗后结缔组织增生增加而具有挑战性。对于非精原细胞瘤，化疗后残留肿块很常见，大于 1 厘米的肿块需要手术切除。 FDG PET 的实用性有限，及时的手术干预对于获得良好的结果至关重要。畸胎瘤如果不切除，可能会导致严重的并发症，包括畸胎瘤生长综合征、恶变和晚期复发。腹膜外残余肿块，特别是那些含有畸胎瘤的肿块，与较差的预后相关。手术切除仍然是主要治疗方法，与畸胎瘤或存活癌症相比，纤维化/坏死的无进展和无复发生存率显着更高。了解化疗后残留肿块的特征和处理对于优化治疗策略和改善睾丸 GCT 患者的预后至关重要。患者总结：我们回顾了化疗后下腹部仍有肿瘤组织的睾丸癌患者的治疗方案。手术切除肿瘤是主要选择；切除淋巴结也有帮助，但由于组织对化疗的反应可能很困难。生存率因肿瘤类型而异，下腹部以外的肿瘤生存率较低。版权所有 © 2024。由 Elsevier B.V. 出版。

Testicular germ cell tumours (GCTs) account for the majority of testicular malignancies. Seminomas and nonseminomas differ in prognosis and management strategies. While cisplatin-based chemotherapy has significantly improved survival rates, identification of residual masses after chemotherapy is crucial for determining further treatment and survival. For seminomas, spontaneous resolution of residual masses occurs in a significant percentage of cases. Fluorodeoxyglucose positron emission tomography (FDG PET) is recommended for evaluation of residual masses after chemotherapy. Retroperitoneal lymph node dissection (RPLND) offers therapeutic benefits but is challenging because of an increase in desmoplasia after chemotherapy. For nonseminomas, residual masses are common after chemotherapy, with surgical resection necessary for masses larger than 1 cm. FDG PET has limited utility, and timely surgical intervention is crucial for favourable outcomes. Teratoma, if left unresected, can lead to serious complications, including growing teratoma syndrome, malignant transformation, and late relapse. Extraretroperitoneal residual masses, particularly those containing teratoma, are associated with poorer prognosis. Surgical resection remains the mainstay treatment, with significantly higher progression-free and recurrence-free survival rates for fibrosis/necrosis in comparison to teratoma or viable cancer. Understanding the characteristics and management of residual masses after chemotherapy is paramount for optimising treatment strategies and improving patient outcomes in testicular GCT. PATIENT SUMMARY: We reviewed treatment options for patients with testicular cancer who still have tumour tissue in the lower abdomen after chemotherapy. Surgical removal of the tumour is the main option; removal of lymph nodes can also help, but may be difficult because of tissue reactions to chemotherapy. Survival rates differ according to the tumour type and are lower for tumours beyond the lower abdomen.Copyright © 2024. Published by Elsevier B.V.