Bilateral Testicular Germ Cell Tumours: an Increasing Incidence and Prevention by Chemotherapy

Thompson, J. F.; Williams, Christopher J.; Whitehouse, J. M. A.; Mead, G. M.

doi:10.1111/j.1464-410x.1988.tb04368.x

Cited by 30 publications

(18 citation statements)

References 10 publications

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“…No case of contralateral testicular cancer was observed among 656 patients treated with chemotherapy (median follow-up 7.7 years) [2], In 3 smaller series, also no patient was iden tified who developed a second testicular cancer after cisplatin-based chemotherapy [1,10,11]. Considering only patients who had their first tumor in the testis, we observed 3 cases (0.8%) of metachronous testicular germ cell cancer after cisplatin-containing chemotherapy.…”

Section: Resultsmentioning

confidence: 90%

Testicular T umor after Cisplatin-Based Chemotherapy for Germ Cell Malignancy

Gerl¹,

Clemm²,

Kohl³

et al. 1994

Eur Urol

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Section: Resultsmentioning

confidence: 90%

Testicular T umor after Cisplatin-Based Chemotherapy for Germ Cell Malignancy

Gerl¹,

Clemm²,

Kohl³

et al. 1994

Eur Urol

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“…Publications have suggested a decreased incidence as well as a delay in the appearance of metachronous GCTT after chemotherapy (Van Basten 1997) and an increased incidence of asynchronous seminoma (Sokal 1980;Thompson 1988); however, the data are controversial. The given explanation is that the results depend on selection bias in studies based on data from large single institutions.…”

Section: Discussionmentioning

confidence: 99%

The incidence, prognosis, clinical and histological characteristics, treatment, and outcome of patients with bilateral germ cell testicular cancer in Hungary

Gergely

Gómez

Bak

et al. 2003

J Cancer Res Clin Oncol

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Purpose: To examine the incidence, prognosis, clinical and histological characteristics, treatment, and outcome of patients with bilateral testicular cancer in the referral center in Hungary, to determine which parameters might predict a second testicular tumor. Methods: Clinical parameters-such as time of original surgery, histology of primary tumor, extent of the disease, serum marker concentrations, history of testicular abnormalities, treatment, response to treatment, followup period, data on second carcinoma-of bilateral testicular tumors among the 2,386 patients with testicular cancer treated between November 1988 and November 1998 were analyzed. Results: The incidence of patients with synchronous testicular tumor was 0.8% (19 of 2,386 patients). The clinical stages were 8 I/A, 5 I/B, 1 II/A, 2 II/ B, 1 III/A, and 2 III/B. Median follow-up time was 93 months and the 5-year overall survival was 84%. The incidence of patients with metachronous testicular cancer (median age 28 years and 35 years at first and second tumor diagnosis) was 2.2% (53 of 2,386 patients) and the median time to second tumor was 76 months (range 18-203 months). The clinical stages at the first and second tumor diagnosis were: 14 I/A, 21 I/B, 15 II/A, 2 II/B, and 1 III/B, and 26 I/A, 16 I/B, 3 II/A, 1 II/B, 7 III/B, respectively. The median follow-up time was 42 months and the 5-year overall survival was 93%. In thirteen patients with metachronous cancers, two family histories of testicular cancer, five cases of undescended testicles, seven cases of testicular atrophy, and one case of azoospermia were detected. There was a non-significant trend to a longer cancer interval after chemotherapy and radiotherapy and a tendency to a greater incidence of asynchronous seminoma after chemotherapy. Clinical stage I tumors were more frequent in the surveyed group than among patients not followed up according to the institutional protocol (P = 0.01), but the survival rate was good in both groups. Seminoma as a second tumor was diagnosed in an older age group (median 38 years, range 25-49 years) than nonseminoma (median 32 years, range 21-51 years, P < 0.045).The interval till the appearance of a metachronous testicular cancer depended on tumor histology: in seminoma cases it was longer than in nonseminoma cases (median time: 121 months versus 50 months, P = 0.002). Conclusions: The overall incidence of bilateral testicular cancer in the referral center in Hungary was 3%. We could not identify clinical factors which predicted a higher risk for metachronous testicular cancer. With regular follow-up the early diagnosis of second testicular tumors is probable; therefore education, self-examination of the remaining testicle, and long-term follow-up are important in early detection.

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“…Nevertheless, several authors have documented a second carcinoma in the contralateral testis following chemotherapy associated with the initial tumor. Although the frequency of meta chronous germ cell tumors following chemotherapy seems to be reduced [ 1,15], Fossa and Aass [7] as well as Dieck mann [5] have described residual CIS after chemothera py. In case of a strong desire for keeping fertility and the diagnosis of carcinoma in situ in the contralateral testis, for patients receiving chemotherapy surveillance of the opposite testis seems acceptable.…”

Section: Discussionmentioning

confidence: 99%

“…Extensive retrospective studies have shown the preva lence of bilateral testicular tumors to range between 2.6 and 5% [1,4,13,15]. Human testicular germ cell tumors result from the malignant transformation of primordial germ cells.…”

Section: Introductionmentioning

confidence: 99%