IGG* Practice Guidelines on Germ Cell Tumor in Adult Male Patients

Giorgi, Ugo De; Nicolai, Nicola; Tana, S.; Tavolini, Ivan Matteo; Palazzi, Silvia; Bracarda, Sergio; Tedeschi, L.; Palmieri, Giovannella; Frassineti, L.; Pozzo, L. Da; Pastorino, Ugo; Emiliani, E; Marangolo, M.; Pizzocaro, Giorgio; Rosti, Giovanni; Salvioni, Roberto

doi:10.1177/030089160809400118

Cited by 12 publications

(12 citation statements)

References 96 publications

(118 reference statements)

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“…, 2010). The Italian guidelines conclude that the low incidence of bilateral testicular tumours in southern Europe and morbidity associated with biopsies do not favour this procedure (De Giorgi et al. , 2008).…”

Section: Who Should Have a Testicular Biopsy?mentioning

confidence: 99%

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Testicular biopsy for early cancer detection – objectives, technique and controversies

et al. 2011

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This review highlights the usefulness of testicular biopsy for early detection of testicular germ cell tumour (GCT). GCT develops through a precursor stage, called testicular intraepithelial neoplasia (TIN; also called intratubular germ cell neoplasia or carcinoma in situ, CIS), which is present many years before invasive malignancy occurs. TIN/CIS is safely detected histologically. TIN is usually widely but non-randomly distributed within the testicle, thus, a biopsy of 3 mm size usually indicates the presence of TIN. Surgically, testicular biopsy should be performed at the cranial pole. Two-site biopsies provide an 18% diagnostic yield over single biopsy. Surgical complications occur in about 2.8%, most of which are managed conservatively. Serial scrotal imaging studies after biopsies revealed significant early changes. Eighteen months thereafter, less than 5% of cases have changes detectable. False-negative biopsies are extremely rare. Biopsy also provides information regarding spermatogenesis. In case of diagnosis of TIN, orchiectomy is rarely required. Low-dose radiotherapy eradicates TIN. In conclusion, testicular biopsy is useful in patients with unilateral GCT to explore the opposite testis, and in patients with retroperitoneal GCT to look for occult testicular primary. Further candidates for biopsy are selected patients with sonographic testicular microlithiasis. Despite its usefulness, the procedure has been implemented in clinical routine only in few countries thus far.

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Section: Who Should Have a Testicular Biopsy?mentioning

confidence: 99%

“…No mention at all regarding biopsies is made in the recent Canadian Consensus Group guidelines (Wood et al, 2010). The Italian guidelines conclude that the low incidence of bilateral testicular tumours in southern Europe and morbidity associated with biopsies do not favour this procedure (De Giorgi et al, 2008).…”

Section: Who Should Have a Testicular Biopsy?mentioning

confidence: 99%

Testicular biopsy for early cancer detection – objectives, technique and controversies

et al. 2011

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Section: Introductionmentioning

confidence: 99%

“…Testicular cancer metastases target various tissues, including lymph nodes, lung, liver and spleen (De Giorgi et al. , 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Although the cure rate is high, presence of metastases reduces survival rates. Interestingly, TGCTs have a disproportionately high number of metastases compared with other tumours, averaging 5.8 metastases per primary tumour (Anant & Davidson, 2001;De Giorgi et al, 2008). Approximately 30% of TGCT patients have metastases at the time of diagnosis (Powles et al, 2005), and 15-20% of patients have subclinical metastases in stage 1 seminoma (Benne et al, 1986), which is the most common presentation (Rodriguez et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous metastasis in mouse models of testicular germ‐cell tumours

et al. 2011

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Summary Testicular germ-cell tumours (TGCTs) are the most common cancer in young men; the incidence is increasing worldwide and they have an unusually high rate of metastasis. Despite significant work on TGCTs and their metastases in humans, absence of a mouse model of spontaneous metastasis has greatly limited our understanding of the mechanisms by which metastatic potential is acquired and on their modes of dissemination. We report a new model of spontaneous TGCT metastasis in the 129 family of mice and provide evidence that these are true metastases derived directly from primary testicular cancers rather than independently from ectopic stem cells. These putative metastases (pMETs) occur at similar frequencies among TGCT-affected males in six genetically distinct TGCT-susceptible strains and were largely found in anatomical sites that are consistent with patterns of TGCT metastasis in humans. Various lines of evidence support their pluripotency and germ-cell origin, including presence of multiple endodermal, mesodermal and ectodermal derivatives as well as cells showing OCT4 and SSEA-1 pluripotency markers. In addition, pMETs were never found in males that did not have a TGCT, suggesting that metastases are derived from primary tumours. Finally, pMETS and primary TGCTs shared several DNA copy number variants suggesting a common cellular and developmental origin. Together, these results provide the first evidence for spontaneous TGCT metastasis in mice and show that these metastases originate from primary TGCTs rather than independently from ectopic stem cells.

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Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference

Nicolai¹,

Biasoni²,

Catanzaro³

et al. 2019

European Journal of Surgical Oncology

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Germ-cell tumours (GCT) of the testis and penile squamous cell carcinoma (PeSCC) are a rare and a very rare uro-genital cancers, respectively. Both tumours are well defined entities in terms of management, where specific recommendations - in the form of continuously up-to-dated guide lines-are provided. Impact of these tumour is relevant. Testicular GCT affects young, healthy men at the beginning of their adult life. PeSCC affects older men, but a proportion of these patients are young and the personal consequences of the disease may be devastating. Deviation from recommended management may be a reason of a significant prognostic worsening, as proper treatment favourably impacts on these tumours, dramatically on GCT and significantly on PeSCC. RARECAREnet data may permit to analyse how survivals may vary according to geographical areas, histology and age, leading to assume that non-homogeneous health-care resources may impact the cure and definitive outcomes. In support of this hypothesis, some epidemiologic datasets and clinical findings would indicate that survival may improve when appropriate treatments are delivered, linked to a different accessibility to the best health institutions, as a consequence of geographical, cultural and economic barriers. Finally, strong clues based on epidemiological and clinical data support the hypothesis that treatment delivered at reference centres or under the aegis of a qualified multi-institutional network is associated with a better prognosis of patients with these malignancies. The ERN EURACAN represents the best current European effort to answer this clinical need.

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IGG* Practice Guidelines on Germ Cell Tumor in Adult Male Patients

Cited by 12 publications

References 96 publications

Testicular biopsy for early cancer detection – objectives, technique and controversies

Testicular biopsy for early cancer detection – objectives, technique and controversies

Spontaneous metastasis in mouse models of testicular germ‐cell tumours

Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference

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