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Germ-Cell Cancer of the Testis and Related Neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Surveillance studies in stage I seminoma have demonstrated that in the absence of adjuvant therapy, it will recur in 15–20% of the patients.52–54 Retrospective analyses of pooled series of patients managed by surveillance suggest that the risk factors for relapse are increasing size of the primary tumor (with those >4 cm in diameter at most increased risk) along with tumor involvement of the rete testis.52,55 There is evidence that patients with both of these features have a 31.5% risk of relapse, patients with either feature are at approximately 15% chance of relapse, and patients with neither feature are at a 12% risk of relapse.52
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
What are the long-term chances of malignancy in undescended testes?The undescended testes are 5–10 times more likely to develop a malignancy. Inguinal UDT − 1:80 riskIntra-abdominal testis 1:20 risk(lifetime risk of developing testicular CA = 1:190) Seminoma is the commonest tumour related to UDTTesticular self-examination should be promoted for early diagnosis.Effect of age at orchidopexy (based on a Swedish 35 year study in NEJM 2007, UDT post-orchidopexy versus population, if orchidopexy done before 13 years carries lower relative risk of cancer than done after 13 years (RR 2.2 vs. 5.4).
Testicular cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Lymph node metastases can range from a single enlarged node measuring 1 cm in diameter to huge intra-abdominal retroperitoneal masses. Seminoma metastases are usually of soft tissue density with occasional low-density areas due to necrosis. On the other hand, non-seminomatous metastases are frequently heterogeneous in density and may have multiloculated cystic areas, as well as soft tissue elements.
Promising novel therapies for relapsed and refractory testicular germ cell tumors
Published in Expert Review of Anticancer Therapy, 2021
Kristyna Kozakova, Michal Mego, Liang Cheng, Michal Chovanec
Within the management of metastatic GCT, postchemotherapy surgery – retroperitoneal lymph-node dissection (RPLND) is essential. In case of seminoma patients with positive PET scan 6–8 weeks after chemotherapy, the chance of finding residual disease stays within the range of 20%. Therefore false-positive results are common and repetition of PET scan is advised [42–44]. Moreover, in the majority of seminoma patients undergoing surgery, only necrosis or fibrosis is found in the specimens [45]. Nonseminoma patients should also be examined for residual disease by CT or MRI scan and tumor marker levels in serum up to 6 weeks after the initiation of the last chemotherapy cycle [44]. If the nonseminoma patient has residual lesions in retroperitoneum (RP) of size ≥ 1 cm, the RPLND is indicated [29,44–49]. Despite the fact that small lesions may continue to diminish spontaneously, in circa 30–40% of patients the removed lymph nodes may contain mature teratoma and vital cancer in about 10–20% [29,48,50–52]. According to retrospective studies, the necessity of RPLND should be assessed individually by the presence of residual RP lesions and their size in the presence of normal serum tumor marker levels [53–56].
Multiparametric ultrasonographic analysis of testicular tumors: a single-center experience in a collective of 49 patients
Published in Scandinavian Journal of Urology, 2020
Vincent Schwarze, Constantin Marschner, Bastian Sabel, Giovanna Negrão de Figueiredo, Julian Marcon, Michael Ingrisch, Thomas Knösel, Johannes Rübenthaler, Dirk-André Clevert
Multiparametric ultrasonographic examination was performed in all patients without the occurrence of any adverse effects. The mean age of the patients at the time of CEUS performance was 46 years (min = 7; max = 80). In one patient bilateral lesions as manifestations of diffuse large b-cell lymphoma were found. In 34 patients, lesions were located in the left testicle (27 malignant vs 7 benign lesions, 79% vs 21%) and, in 14 patients, lesions were located in the right testicle (8 malignant vs 6 benign lesions, 57% vs 43%). The mean size of testicular tumors was 1.2 cm (min = 0.2; max = 8.0 cm). The mean size of benign and malignant tumors was 0.9 cm (min = 0.3; max = 3.0 cm) and 1.4 cm (min = 0.3 cm; max = 8.0 cm), respectively. There was no significant difference in mean diameters of malignant vs benign tumors and in age between patients with malignant lesions and in patients with benign lesions. The underlying histopathological subtypes of the included malignant (n = 36) and benign (n = 13) testicular lesions are illustrated in Table 1, with seminoma and Leydig cell tumors being the most frequent malignant and benign tumors, respectively.
Longitudinal kidney function outcome in aging testicular cancer survivors
Published in Acta Oncologica, 2020
Ragnhild V. Nome, Milada Cvancarova Småstuen, Trine Bjøro, Cecilie E. Kiserud, Sophie D. Fosså
Of the 1,813 invited TCSs, 1,436 participated in S1. In 1,273 of these, eGFR could be calculated with N = 670 also evaluable at S3 (Supplementary Figure 1). About half of the responders to S1 were diagnosed with seminoma and half had non-seminoma. Median age at diagnosis was 31 years with seminoma patients being slightly older (median 35 years) than those with non-seminoma (median age 28 years). At S3, TCSs had been followed for median 26 years (range 21–36 years) since diagnosis (Table 1), the interval between S1 and S3 being median 15 years. Initially non-metastatic disease was diagnosed in 71% of the patients. CBCT was administered to 39%, 42% received RT only and 19% surgery only. The treatment type distribution was similar at all three assessment time points (Table 1).