Bilateral testicular germ cell tumours in patients with initial stage I disease: prevalence and prognosis—a single centre’s 30 years’ experience

Sonneveld, D.J.A.; Koops, H. Schraffordt; Sleijfer, Dirk; Hoekstra, HJ

doi:10.1016/s0959-8049(98)00055-0

Cited by 30 publications

(17 citation statements)

References 22 publications

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“…This contradicts some previous reports that suggest surveillance after 1 st tumor leads to earlier diagnosis of 2 nd tumor, with stage I representing roughly 70-75% of metachronous cases in pooled analysis, 17 and closer to 90% in smaller studies. 16 We noted a slightly higher prevalence of Stage II and Stage III disease at 2 nd TGCT; however this was not statistically significant. We postulated that a late presentation of metachronous TGCT might be associated with advanced disease; although stages II/III tended to present later in our series, this was not a statistically significant relationship (logistic regression p=0.09).…”

Section: Commentcontrasting

confidence: 56%

“…The current interval for metachronous diagnosis is also longer than previously reported in a series where 16 of 445 Stage I TGCT followed without chemotherapy developed metachronous TGCT. 16 Patients were discharged from routine follow-up after a 10-year disease free interval; median interval between TGCT was 4.7 years, but 3 of 16 developed metachronous tumors after 10 years and up to a maximum of 18 years. Fossa and colleagues analyzed SEER data including roughly 29,000 patients with TGCT between 1973 and 2001 and determined 1% had metachronous TGCT at a median interval of 63 months (range 3-223).…”

Section: Commentmentioning

confidence: 99%

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Bilateral Testicular Germ Cell Tumors in the Era of Multimodal Therapy

Kopp

Chevinsky

Bernstein

et al. 2017

Urology

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Objectives To characterize the incidence, presentation, management, and relapse of a large population of bilateral testicular germ cell tumors (TGCT) from a single institution. Methods We identified bilateral TGCT diagnosed between 1/1989 and 2/2014. We categorized synchronous and metachronous TGCT, noting time between 1st and 2nd TGCT, histology [seminoma vs. nonseminoma (NSGCT)], stage and treatments. Kaplan Meier survival estimates characterized relapse. Results Of 5,132 TGCT patients, 128 (2.5%) had bilateral TGCT. Bilateral TGCT increased over time--1.7% in 1989-1994 up to 3.8% in 2010-2/2014. The 35 (27%) synchronous TGCT had 20 (57%) concordant seminoma, 5 (14%) concordant NSGCT, and 10 (29%) discordant. The 93 (73%) metachronous cases had median time interval to 2nd TGCT of 73 months (range 5 months to 28.6 years). Compared to 1st TGCT, 39 (42%) had discordant histology, 29 (31%) concordant seminoma, and 25 (27%) concordant NSGCT. Stage at 1st tumor was statistically similar to second TGCT (2nd stage I/II/II in 69%/22%/10%). Increasing duration between 1st and 2nd TGCT was not associated with higher stage (II/III) at second TGCT (p=0.09). Treatment at 1st tumor was not associated with stage at 2nd tumor. Relapse following bilateral diagnosis was 16.8% (95%CI 10.5-26.2%) at 5 years. Conclusions Incidence of bilateral TGCT increased with >25% of metachronous TGCT presenting ≥10 years after 1st TGCT; possible causes include increased survivorship and/or referral bias. Stage was statistically similar at 1st and 2nd tumor; stage at 2nd tumor was not associated with time interval between tumors or prior treatment modality at 1st tumor.

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Section: Commentcontrasting

confidence: 56%

Section: Commentmentioning

confidence: 99%

Bilateral Testicular Germ Cell Tumors in the Era of Multimodal Therapy

Kopp

Chevinsky

Bernstein

et al. 2017

Urology

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“…Four hundred and eighty-nine of 24 524 patients (2.0%) developed a metachronous TGCT and 33 of 489 patients (6.8%) were dead of disease at time of publication. However, looking at these patients in detail, only some died of the second TGCT provided that appropriate treatment was applied: 13 died before introduction of cisplatin [25,29,37], 1 patient refused chemotherapy [27], 4 died of their first TGCT [1,25,28, this series], and in one patient non germ cell tumor histology (primitive neuroectodermal tumor) was found at post-chemotherapy retroperitoneal lymph node dissection [5]. It is therefore assumed that only 14 of 24 524 patients (0.06%) retrospectively investigated died of the second TGCT while on appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Management and outcome of bilateral testicular germ cell tumors: Twenty-five year experience in Munich

Hentrich

Weber²,

Bergsdorf

et al. 2005

Acta Oncologica

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“…The average, annual age-adjusted incidence rate of germ cell testis neoplasms is 3.7 per 100,000 males [1], and among these, bilateral testis tumour occurs in up to 5% [2,3], whether simultaneously or after an interval. That incidence depends on the countries being only 1.2% at 15 years in the only series published in Spain [4].…”

Section: Discussionmentioning

confidence: 99%

Young male patient with bilateral synchronous testicular germ cell tumour. Considerations for partial orchiectomy

et al. 2008

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Bilateral synchronous testicular cancer is a rare disease and is usually associated with similar histological findings in each testicle. The standard therapy of bilateral testis cancer is generally considered to be inguinal orchiectomy. We present a case of synchronous bilateral testicular germ cell tumour, with different histology, initially treated with testis-sparing surgery. After pathology review, the margin of the partial orchiectomy was considered affected, and an inguinal orchiectomy was planned. Options for testis-sparing surgery are discussed.

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Bilateral testicular germ cell tumours in patients with initial stage I disease: prevalence and prognosis—a single centre’s 30 years’ experience

Cited by 30 publications

References 22 publications

Bilateral Testicular Germ Cell Tumors in the Era of Multimodal Therapy

Bilateral Testicular Germ Cell Tumors in the Era of Multimodal Therapy

Management and outcome of bilateral testicular germ cell tumors: Twenty-five year experience in Munich

Young male patient with bilateral synchronous testicular germ cell tumour. Considerations for partial orchiectomy

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