Effect of Chemotherapy on Carcinoma In Situ of the Testis

Christensen, Thomas Broe; Daugaard, Gedske; Geertsen, Poul F.; Maase, Hans von der

doi:10.1097/00005392-199906000-00090

Cited by 17 publications

(29 citation statements)

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“…Relapses in this cohort occurred when radiotherapy was not performed in two cases of associated TIN, which was consistent with the findings of Heidenreich et al [10]. Several studies have reported the possibility of recurrence after [16][17][18]12,20,21], indicating that a 20-Gy irradiation of the remaining parenchyma might be more effective in eradicating TIN; without increasing the Leydig cell toxicity compared with 16 Gy [20,21].…”

Section: Discussionsupporting

confidence: 90%

Testicular‐sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long‐term oncological and functional results

et al. 2014

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ObjectiveTo review long-term oncological and functional outcomes of testicular-sparing surgery (TSS) in men presenting with bilateral or monorchide testicular tumours at one of five reference centres for testicular neoplasm and infertility. Patients and MethodsWe review 25 cases of bilateral synchrone and metachrone testicular tumours treated in five academic centres between 1984 and 2013.Clinical, biological, ultrasonography and pathological tumour findings, overall survival (OS) times, local or metastatic recurrence, pre-and postoperative hormonal profile, paternity and the need for androgen substitution were assessed.

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Section: Discussionsupporting

confidence: 90%

Testicular‐sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long‐term oncological and functional results

et al. 2014

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“…It is accepted that in excess of 90% of testis tumours have detectable carcinoma in situ (CIS) in the rim of normal testis surrounding the tumour (25). The data from the study reported confirms our initial report (4) and those from Christensen et al (26) and Geldart et al (27), i.e. that chemotherapy is capable of eliminating CIS and this is complete in a substantial proportion of patients though not 100%.…”

Section: Discussionsupporting

confidence: 89%

“…Although it is possible to invoke the question of a blood testis barrier, evidence for this is limited to early reports using non‐etoposide containing regimens (28, 29). More recent data (30) including that in this series and those of Christensen et al (26) suggests that since the advent of etoposide regimens, evidence for a blood testis barrier is less clear cut (Table 2).…”

Section: Discussionmentioning

confidence: 62%

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Testis conserving chemotherapy in germ cell cancer: its potential to increase understanding of the biology and treatment of carcinoma‐in‐situ

Oliver¹,

Ong²,

Berney³

et al. 2003

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Prompted by recognition of the potential of chemotherapy to increase the success of testis conserving surgery in patients with germ cell cancer, background and outcome data are reviewed and their contribution to the ongoing debate about how germ cell cancer develops discussed. The review is based on three previous studies of: a) time trends in tumour size in 578 personal series of all stages of testis cancer treated since 1978; b) impact of chemotherapy on actuarial risk of tumours in contralateral testis examined on 1221 patients treated in trials through the Anglian Germ Cell Cancer Consortium; and c) testes conservation attempted using chemotherapy in 78 patients. Since 1978 tumour size has decreased from 4.8 to 3.0 cms while cure has gone from 77 to 97%. There was no overall long term reduction in second cancers beyond 10 years in stage 1 patients after orchidectomy alone compared to stage 1 or metastatic disease patients receiving chemotherapy though the incidence was non significantly lower up to 10 years particularly in those patients receiving etoposide based combination. Testis conservation was initially successful in 28 of 78 (36%). An additional 25 (32%) had no viable cancer in orchidectomy specimen. In the 28 primary tumours cured by chemotherapy there was a 26% late relapse rate between 5 and 10 years (all cured by orchidectomy) compared to less than 5% in those cured with established metastases. In conclusion, testis conservation with chemotherapy is safe and feasible, though relapse is too frequent for routine service use. Confirmation of the high frequency of late relapse by others has raised the question whether these recurrences are due to post pubertal events reinducing CIS in intrauterine oestrogen primed germ cells and highlights the potential of testes conservation studies to better understand germ cell cancer development.

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“…However, TIN may recurr after several years and close follow‐up for relapse is necessary. Usually, a control biopsy is recommended 6 months after the end of chemotherapy (21, 23, 31).…”

Section: Discussionmentioning

confidence: 99%

Update on the diagnostic safety for detection of testicular intraepithelial neoplasia (TIN)

Kliesch

Thomaidis

Schütte³

et al. 2003

APMIS

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Testicular intraepithelial neoplasia (TIN) of the testis is the noninvasive precursor of testicular germ cell tumours (GCT) and can be detected by a single random biopsy in 5% of patients with GCT in the contralateral testes. Although it is generally presumed that TIN is dispersed throughout the testis, we realize in about 60% of TIN bearing tissue close to testis tumours that its distribution is not homogenously diffuse, but may be focal. Thus we tested whether we can improve diagnostic safety in detecting TIN by increasing the number of biopsies. We could finally evaluate 295 men with proven testicular tumours. Three biopsies of contralateral testes were taken (each 5 mm length) from one surgical incision site and fixed in Bouin's solution or glutaraldehyde. TIN cells were histologically identified by their typical morphological characteristics and additionally by placental alkaline phophatase (PlAP) immunohistochemistry. Patients revealed testicular tumour without contralateral TIN in 271 cases and with contralateral TIN in 24 cases (8.1%). In 6 of these 24 men with contralateral TIN the cells could be detected in only one (n=5) or two (n=1) of the three specimen investigated. That means in these six patients TIN could have been missed if only one single random biopsy was taken. By increasing the number of biopsies (=increasing the number of investigated seminiferous tubules) the detection rate of contralateral TIN may be increased up to 8.1%. Thus we recommend multiple testicular biopsies to increase the diagnostic safety in detection of TIN. Biopsies may be taken from one randomly chosen surgical incision site.

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Effect of Chemotherapy on Carcinoma In Situ of the Testis

Cited by 17 publications

References 1 publication

Testicular‐sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long‐term oncological and functional results

Testicular‐sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long‐term oncological and functional results

Testis conserving chemotherapy in germ cell cancer: its potential to increase understanding of the biology and treatment of carcinoma‐in‐situ

Update on the diagnostic safety for detection of testicular intraepithelial neoplasia (TIN)

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