National Cancer Institute®
Last Modified: August 1, 2002
UI - 12134704
AU - Kondo T; Wada H; Yata K; Mikami M; Tsujioka T; Suemori S; Suetsugu Y;
TI - Nakanishi H; Otsuki T; Yamada O; Yawata Y; Morioka M; Tanaka H; Sadahira Y; Sugihara T [Seven patients with stage I and II primary testicular lymphoma]
SO - Rinsho Ketsueki 2002 Jun;43(6):473-6
AD - Division of Hematology, Department of Medicine, Kawasaki Medical School.
Seven patients with stage I and II primary testicular lymphoma (PTL) have been treated since 1990 to the present at Kawasaki Medical School. All patients, whose median age was 56 yrs, had initially complained of swelling of the scrotal contents. The lesions were on the right in two patients, on the left in five, and no patient had bilateral lesions. The histological diagnosis was diffuse large B-cell type in all patients. Five patients were classified as Ann Arbor stage I, and two at stage II. After high-orchiectomy for resection of tumor, two patients received chemotherapy alone, with a combination of chemotherapy and irradiation of the contralateral testis in the remaining five. Complete remission was achieved in all seven patients, but relapse occurred later in one. As it is recognized that, even in localized stage or low risk group PTL patients, the relapse rate in the central nervous system (CNS) and contralateral testis is quite high, chemotherapy, prophylactic CNS treatment and radiation of the contralateral testis after tumor resection should be included in the management of PTL.
UI - 12115576
AU - Lajer H; Daugaard G; Andersson AM; Skakkebaek NE
TI - Clinical use of serum TRA-1-60 as tumor marker in patients with germ cell cancer.
SO - Int J Cancer 2002 Jul 10;100(2):244-6
AD - Department of Oncology, Rigshospitalet, Copenhagen, Denmark. H.LAJER@rh.dk
TRA-1-60 antigen has been related to the presence of embryonal germ cell carcinoma (EC) and carcinoma in situ. Our study further investigated the clinical efficacy of TRA-1-60 as a serum tumor marker for germ cell cancer in the testis. Three groups of patients with germ cell tumors were included: Group 1, 34 patients with disseminated disease (24 nonseminomatous germ cell tumors [NSGCT] and 10 seminomatous germ cell tumors [SGCT]); this group of patients were followed during the course of chemotherapy with measurements of TRA-1-60, HCG and AFP; Group 2, 28 patients with Stage I NSGCT (22 with embryonal carcinoma [EC]-component and 6 without EC-component, median follow-up 15 months); and Group 3, 40 patients with Stage I pure SGCT (median follow-up 15 months). Seventy-eight percent of patients with disseminated EC-positive NSGCT had increased levels of TRA-1-60 before chemotherapy. After chemotherapy, levels of TRA-1-60 had dropped significantly (p < 0.01). Levels of TRA-1-60 did not normalize in 15% of NSGCT and 30% of SGCT patients after chemotherapy. This was not associated with recurrent disease. Approximately one-third of patients with Stage I NSGCT had increased values of TRA-1-60 during follow-up without having a relapse. Contrary to earlier reports TRA-1-60 is not at present useful as a tumor marker in patients with germ cell tumors. Although detecting a few early relapses the rate of false positive elevations in the tumor marker makes it unreliable in the clinical setting. Our study did confirm that elevated levels of TRA-1-60 were present in approximately 80% of patients with disseminated EC-positive NSGCT before start of chemotherapy and chemotherapy induced a significant decrease in levels of TRA-1-60. Thus, the TRA-1-60 antigen might still prove clinically useful provided that the reliability of the assay can be increased. Copyright 2002 Wiley-Liss, Inc.
UI - 2321619
AU - Verreault R; Weiss NS; Hollenbach KA; Strader CH; Daling JR
TI - Use of electric blankets and risk of testicular cancer.
SO - Am J Epidemiol 1990 May;131(5):759-62
AD - Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.
Electric blankets are an important domestic source of electromagnetic fields (EMF) because of the relatively high intensity of emission, prolonged exposure, and intimate contact with the source. In a case-control study of testicular cancer in western Washington during 1981 to 1984, the relation between EMF exposure from electric blankets and the occurrence of testicular cancer was examined. The respective proportions of cases and controls who reported the use of an electric blanket were almost identical (age-adjusted rate ratio (RR) = 1.0, 95% confidence interval (CI) 0.7-1.4). Distributions of the duration of use were also very similar in cases and controls. Compared with controls, the frequency of use of an electric blanket was slightly lower in men with seminoma (RR = 0.7, 95% CI 0.5-1.2) and slightly higher among men with nonseminoma germ cell tumors (RR = 1.4, 95% CI 0.9-2.3). Overall, the results of this study suggest that increased exposure to EMF from electric blankets contributes little, if at all, to the risk of testicular cancer in adult white men.
UI - 8452131
AU - Wertheimer N; Leeper E
TI - Re: "Use of electric blankets and risk of testicular cancer" and "Use of electric blankets and risk of postmenopausal breast cancer".
SO - Am J Epidemiol 1993 Jan 15;137(2):252-7
UI - 12095560
AU - Chan JL; Kabeto MU; Oldread AE; Paisley KL; Bennett JE; Sandler HM;
TI - Smith DC; Hayman JA The use of preferences to measure the benefit of adjuvant radiation therapy for stage I seminoma.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 15;53(4):934-41
AD - Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI, USA. firstname.lastname@example.org
PURPOSE: In Stage I seminoma, treatment with radiation therapy (RT) after radical inguinal orchiectomy reduces the likelihood of relapse by 15%, but does not improve survival, thus making quality of life an important outcome measure. The purpose of this study was to use utilities to assess the quality of life benefits associated with adjuvant RT in this setting. MATERIALS AND METHODS: One hundred healthy men were interviewed using a utility assessment tool. Utilities for five health states were measured using the standard gamble technique: (A) adjuvant RT with 5% recurrence risk; (B) recurrence after RT, salvaged with chemotherapy; (C) orchiectomy alone with 20% recurrence risk; (D) recurrence after orchiectomy alone, salvaged with RT; and (E) recurrence after orchiectomy alone, salvaged with chemotherapy. RESULTS: The median age was 25. Utilities were highest for nonrecurrent health states, and lowest for recurrence salvaged with chemotherapy. All differences in utilities between health states were significant, except between states A and C and B and E. Variability in utilities was not explained by the sociodemographic factors examined. CONCLUSIONS: Our results suggest that healthy males do not value the 15% reduction in recurrence risk achievable with adjuvant RT. However, they do predict that an actual recurrence, especially one requiring salvage chemotherapy, will lead to significant decline in quality of life. We intend to use these utilities to further evaluate the cost-effectiveness of RT in this setting.
UI - 12146015
AU - Kawai K
TI - [Long-term side effects of chemotherapy for testicular cancer]
SO - Gan To Kagaku Ryoho 2002 Jul;29(7):1300-5
AD - Dept. of Urology, Institute of Clinical Medicine, University of Tsukuba.
Since the advent of cisplatin-based chemotherapy in the 1970s, a majority of metastatic testicular cancer patients have been cured with chemotherapy and surgery. The high curability of testicular cancer, along with the young age of afflicted patients, can result in patients living for many years after the chemotherapy. Thus, the assessment of late effects of chemotherapy is clinically important in testicular cancer patients. This article summarizes the literature regarding the long-term side effects, and reviews approaches to the amelioration of these side effects.
UI - 12137835
AU - Steiner H; Holtl L; Wirtenberger W; Berger AP; Bartsch G; Hobisch A
TI - Long-term experience with carboplatin monotherapy for clinical stage I seminoma: a retrospective single-center study.
SO - Urology 2002 Aug;60(2):324-8
AD - Department of Urology, University of Innsbruck, Innsbruck, Austria.
OBJECTIVES: To evaluate the long-term oncologic efficacy and morbidity of carboplatin monotherapy, which was introduced at our department 11 years ago for the treatment of Stage I seminoma. Radiotherapy is the standard treatment of patients with clinical Stage I seminoma. Carboplatin has been advocated as a treatment alternative to avoid the late side effects of radiotherapy and the high recurrence rate of 108 patients received two adjuvant cycles of single-agent carboplatin (400 mg/m2 body surface on days 1 and 22) 2 weeks after high inguinal orchiectomy. To assess for myelosuppression, complete blood counts were performed at least once a week until the nadir occurred after the second treatment cycle. RESULTS: During a mean follow-up period of 59.8 months (range 6 to 134), 2 patients (1.85%) developed a recurrence (retroperitoneal tumor) within the first year. Both patients received cisplatin-based salvage chemotherapy. At last follow-up, all patients were alive without any evidence of disease. Carboplatin treatment was well tolerated by all patients and was associated with only mild gastrointestinal side effects. Leukopenia was noted in 32 patients (29.6%); 21 (19.4%) of these patients had World Health Organization (WHO) grade 1, 8 (7.4%) had grade 2, 3 (2.8%) had grade 3, and none had grade 4. No patient developed neutropenic fever. Thrombocytopenia was observed in 48 patients (44.4%); of these patients, 38 (35.2%) had WHO grade 1, 5 (4.6%) had grade 2, 2 (1.9%) had grade 3, and 3 (2.8%) had grade 4. CONCLUSIONS: From an oncologic standpoint, two cycles of carboplatin monotherapy was highly effective and very well tolerated by all patients.
UI - 12131326
AU - Nagarajan M; Marshall RJ; Cook P; O'Rourke S; Mathew J
TI - Symptomatic renal metastasis of a testicular seminoma mimicking pelvicaliceal transitional cell carcinoma.
SO - J Urol 2002 Aug;168(2):634-5
AD - Department of Urology, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom.
UI - 12131327
AU - Kausch I; Galle J; Buttner H; Bohle A; Jocham D
TI - Leiomyo-adenomatoid tumor of the epididymis.
SO - J Urol 2002 Aug;168(2):636
AD - Department of Urology, Medical University of Lubeck, Lubeck, Germany.
UI - 12131337
AU - Steinberg GD; Rinker-Schaeffer CW; Sokoloff MH; Brendler CB
TI - Highlights of the Society of Urologic Oncology meeting, June 2, 2001.
SO - J Urol 2002 Aug;168(2):653-9
AD - Section of Urology, Department of Surgery, Pritzker School of Medicine, University of Chicago Hospitals, Chicago, Illinois, USA.
UI - 12146055
AU - Reis-Filho JS; Schmitt FC; Soares MF; Figueiredo TM; Fillus-Neto J
TI - Fine needle aspiration cytology of paratesticular rhabdomyosarcoma mimicking a testicular germ cell tumor.
SO - Acta Cytol 2002 Jul-Aug;46(4):787-9
UI - 12040227
AU - Rudberg L; Carlsson M; Nilsson S; Wikblad K
TI - Self-perceived physical, psychologic, and general symptoms in survivors of testicular cancer 3 to 13 years after treatment.
SO - Cancer Nurs 2002 Jun;25(3):187-95
AD - Hogskolan Dalarna, Health and Caring Sciences, Falun, Sweden. email@example.com
Due to the large group of patients with advanced testicular cancer now being cured, it is important to identify the men who are at risk of deteriorated health.The purposes of this study were: (1) to delineate and compare frequency of self-perceived physical, psychologic, and general symptoms in men treated for testicular cancer with those of a general population sample and (2) to compare self-perceived physical, psychologic, and general symptoms in relation to secondary Raynaud phenomena, sexual dysfunction, infertility, and self-perceived attractiveness in different treatment modalities. The subjects were 277 survivors of testicular cancer (M = 42.2 years) who had completed a self-reported questionnaire (75.5% response rate). A population survey comprising 392 men was used as a comparison group (M = 45 years).The result demonstrated that although survivors of testicular cancer as a group reported significantly less frequency of backache, leg pain, cough, and eye problems than did the general population sample, they described that they significantly more often felt cold. Men reporting secondary Raynaud phenomena, infertility, and/or feeling less attractive had experienced significantly more self-perceived symptoms. Oncologist nurses could play an important role in psychologic counseling for those men.
UI - 11885998
AU - Fossa SD; Aass N; Winderen M; Bormer OP; Olsen DR
TI - Long-term renal function after treatment for malignant germ-cell tumours.
SO - Ann Oncol 2002 Feb;13(2):222-8
AD - Department of Medical Oncology and Radiotherapy, The Norwegian Radium Hospital, Oslo. firstname.lastname@example.org
OBJECTIVE: To evaluate prospectively renal function in patients with malignant germ-cell tumours (MGCTs) >10 years after retroperitoneal lymph node dissection alone (RPLND), radiotherapy alone (RAD) or different schedules of cisplatin-based chemotherapy with or without surgery/radiotherapy (CHEM). PATIENTS AND METHODS: In 85 patients, three groups were identified: RPLND, 14; RAD, 18; CHEM, 53, with subdivision of the latter group according to the cumulative cisplatin dose or the additional use of radiotherapy. Renal function was determined by 131Iodine Hippuran clearance or 99m DTPA glomerular filtration rate, and was assessed before treatment and four times during 14 years of follow-up. A value of <70% of the upper limit of the normal range identified impaired renal function. RESULTS: Twenty-five patients displayed long-term impaired renal function, 23 of them from the RAD or CHEM group. In the RAD group, renal function decreased by 8%, whereas a 14% reduction of renal function was observed in the CHEM group. In the CHEM group the cumulative dose of cisplatin, and in the RAD group the age at treatment, were associated with impairment of renal function. Combining all patients, age at treatment and the type of treatment were associated with impaired renal function. CONCLUSIONS: In 20-30% of the patients with germ-cell tumour, standard radiotherapy and chemotherapy strategies are followed by long-term subclinical impaired renal function. These findings support current intentions to avoid overtreatment with these treatment modalities.
UI - 11885999
AU - Strumberg D; Brugge S; Korn MW; Koeppen S; Ranft J; Scheiber G; Reiners
TI - C; Mockel C; Seeber S; Scheulen ME Evaluation of long-term toxicity in patients after cisplatin-based chemotherapy for non-seminomatous testicular cancer.
SO - Ann Oncol 2002 Feb;13(2):229-36
AD - Department of Internal Medicine (Cancer Research), West German Cancer Center, University of Essen. email@example.com
BACKGROUND: Because of the increasing number of long-term survivors of metastatic testicular germ-cell cancer, a general concern has been secondary morbidities, especially cardiovascular risk factors. PATIENTS AND METHODS: Thirty-two patients treated with cisplatin- and doxorubicin-containing chemotherapy > or = 13 years before the time of analyses were evaluated for neuro-, oto-, pulmonary-, vascular- and gonadal toxicity including evaluation of myocardial damage and cardiovascular risk factors and analysis of microcirculation. RESULTS: Thirty percent of the patients showed abnormal left ventricle function. Elevated follicle stimulating hormone (FSH) and luteinising hormone (LH) levels in 75% of patients were often associated with low testosterone levels. Elevated total cholesterol levels were found in 82% and higher triglyceride levels in 44% of patients, most of them were overweight. About 25% of the patients developed diastolic arterial hypertension after chemotherapy. Reduced hearing was confirmed in 23% of patients, especially at frequencies higher than 3000 Hz. Moreover, 53% of patients presented transient evoked otoacoustic emissions. In 38% of patients non-symptomatic neuropathy was detected, in 28% symptomatic neuropathy, and in 6% disabling polyneuropathy. In 80% of patients with neuropathic symptoms additional morphological and functional abnormalities were found by nailfold capillary videomicroscopy, compared to only 57% of the patients without neuropathic symptoms. CONCLUSIONS: Patients cured by cisplatin-based chemotherapy for metastatic testicular cancer have to be cognizant of their unfavorable cardiovascular risk profile, that might be a greater risk than developing a relapse or second malignancy.
UI - 11886000
AU - Harvey ML; Geldart TR; Duell R; Mead GM; Tung K
TI - Routine computerised tomographic scans of the thorax in surveillance of stage I testicular non-seminomatous germ-cell cancer--a necessary risk?
SO - Ann Oncol 2002 Feb;13(2):237-42
AD - Department of Radiology, Royal South Hants Hospital, Southampton, UK.
BACKGROUND: The standard management approach to stage I testicular non-seminomatous germ-cell tumours (NSGCT) in the UK is a surveillance programme with adjuvant bleomycin, etoposide, cisplatin (BEP) chemotherapy being offered to individuals with high risk disease. Conventionally, computed tomography (CT) scanning of the thorax has formed part of the surveillance programme. This paper evaluates the contribution of routine thoracic CT imaging in the management of this disease. PATIENTS AND METHODS: We retrospectively reviewed the case notes of 168 patients with stage I NSGCT referred to the Wessex Medical Oncology Unit over a period of 13 years (1986-1998). These patients entered onto a surveillance programme that included serial chest X-ray follow up rather than thoracic CT. RESULTS: Forty-two out of 168 patients (25%) evaluated suffered relapse during the follow up period. Eight of 42 patients (19%) relapsed with intrathoracic disease. Seven out of eight of these patients (87.5%) had at least one other indicator of disease recurrence (elevated serum marker, abnormal abdominal CT). One of 42 patients (2.4%) relapsed with isolated intrathoracic disease with no other indicator of relapse. All patients with intrathoracic relapse had evidence of disease on chest X-ray. Of the 42 relapsing patients, 93% could be categorised as having good prognosis metastatic disease. Seven per cent relapsed with intermediate or poor prognostic disease; relapse in these patients would not have been detected earlier with the inclusion of routine thoracic CT. Only one patient has died giving a cure rate of 98% for relapsing patients. CONCLUSIONS: The elimination of chest CT did not compromise outcome but significantly reduced radiation exposure thereby minimising the risk of radiation-induced secondary malignancy. Continued review of surveillance programmes is essential if we are to optimise management of this disease.
UI - 11885847
AU - Horvath LG; McCaughan BC; Stockle M; Boyer MJ
TI - Resection of residual pulmonary masses after chemotherapy in patients with metastatic non-seminomatous germ cell tumours.
SO - Intern Med J 2002 Mar;32(3):79-83
AD - Department of Medical Oncology, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney University, New South Wales, Australia.
BACKGROUND: Resection of residual post-chemotherapy pulmonary masses in patients with non-seminomatous germ cell tumours gives therapeutic benefit and prognostic information. AIM: This study was undertaken to review the experience of this intervention in a single teaching hospital. METHODS: The Germ Cell Database of the Sydney Cancer Centre was searched for all patients who had undergone excision of pulmonary metastases. These patient records were subsequently reviewed. RESULTS: Between 1976 and 1999, 15 patients underwent a combined total of 19 thoracotomies for resection of residual tumour mass after cisplatin-based chemotherapy. The primary tumour histology included mature teratoma in 47% (7 of 15) of patients. Prior to chemotherapy, 73% (11 of 15) of patients had elevated serum levels of alpha-fetoprotein (median 180 ng/mL) and 60% (9 of 15) of patients had elevated beta-human chorionic gonadotropin (median 672 IU/L). The median length of hospital stay related to thoracotomy was 7 days. There were two surgical complications, a prolonged air leak and a residual pleural effusion. Pathology of residual pulmonary masses revealed necrosis alone in 37% (7 of 19) of procedures, mature teratoma alone in 32% (6 of 19) of procedures and viable tumour in 32% (6 of 19) of procedures. Of those with viable tumour, three achieved long-term complete response (CR), two died of progressive disease (PD) and one is alive with PD. Of those with teratoma, two achieved CR and one relapsed. The long-term CR rate was 80% (12 of 15 patients).The median follow up was 10 years (range 0.75-17.5 years). Four patients died, two of PD and two of cardiovascular disease while in CR. CONCLUSION: At this institution, thoracotomy for residual pulmonary masses was well tolerated, with a high cure rate.
UI - 12052503
AU - Bianchi NO; Richard SM; Peltomaki P; Bianchi MS
TI - Mosaic AZF deletions and susceptibility to testicular tumors.
SO - Mutat Res 2002 Jun 19;503(1-2):51-62
AD - Instituto Multidisciplinario de Biologia Celular (IMBICE), La Plata, Argentina. firstname.lastname@example.org
We tested for azoospermia factor (AZF) deletions 17 loci corresponding to AZF subintervals a-d in 17 cases of testicular tumors occurring in Finns. While DNA samples from 48 CEPH and 32 Finnish males showed no deletions, patients with testicular cancer displayed AZF deletion mosaicisms in various non-tumor tissues (13 cases) and specific deletion haplotypes in tumor tissues (10 cases). Two of the cases with AZF deletions were testicular non-Hodgkin lymphomas indicating that Y-microdeletions appear also in malignancies other than seminoma and non-seminoma tumors. In good agreement with this assumption, we detected one AZF deletion in normal cells from 1 of 5 HNPCC cases, heterozygous for an MLH1 mutation. We propose that AZF deletions occur in early embryogenesis due to mutations of TSPY, mismatch repair (MMR), or X-specific genes. Since fathers of testicular, tumor cases did not exhibit AZF deletions, we assumed they were not carriers of the mutation inducing AZF deletion-mosaicisms. Therefore, tumor cases should have received the MMR gene or X mutations via the maternal lineage, or for the case of TSPY and MMR genes via a sperm carrying a mutation occurred in the paternal germ-cell line. We consider AZF microdeletions in non-tumor cells to be part of a broader pattern of chromosome instability producing susceptibility to testicular tumors. Clonal transformation and expansion of one of these tumor-susceptible cell lineages give rise to testicular tumors showing genome anomalies characteristic of testicular cancers (i12p, LOH and genetic imbalance for various autosomal regions, Y- and autosomal MSI, specific AZF deletion haplotypes).
UI - 12128117
AU - Incrocci L; Hop WC; Wijnmaalen A; Slob AK
TI - Treatment outcome, body image, and sexual functioning after orchiectomy and radiotherapy for Stage I-II testicular seminoma.
SO - Int J Radiat Oncol Biol Phys 2002 Aug 1;53(5):1165-73
AD - Department of Radiation Oncology, Erasmus MC-Daniel den Hoed, Rotterdam, The Netherlands. email@example.com
PURPOSE: Orchiectomy followed by infradiaphragmatic irradiation is the standard treatment for Stage I-II testicular seminoma in The Netherlands. Because body image and sexual functioning can be affected by treatment, a retrospective study was carried out to assess treatment outcome, body image, and changes in sexuality after orchiectomy and radiotherapy. METHODS AND MATERIALS: The medical charts of 166 patients with Stage I-II testicular seminoma were reviewed. A questionnaire on body image and current sexual functioning regarding the frequency and quality of erections, sexual activity, significance of sex, and changes in sexuality was sent to 157 patients (at a mean of 51 months after treatment). RESULTS: Seventy-eight percent (n = 123, mean age 42 years) completed the questionnaire. During irradiation, almost half of patients experienced nausea and 19% nausea and vomiting. Only 3 patients had disease relapse. After treatment, about 20% reported less interest and pleasure in sex and less sexual activity. Interest in sex, erectile difficulties, and satisfaction with sexual life did not differ from age-matched healthy controls. At the time of the survey, 17% of patients had erectile difficulties, a figure that was significantly higher than before treatment, but which correlated also with age. Twenty percent expressed concerns about fertility, and 52% found their body had changed after treatment. Cancer treatment had negatively influenced sexual life in 32% of the patients. CONCLUSIONS: Orchiectomy with radiotherapy is an effective and well-tolerated treatment for Stage I-II testicular seminoma. Treatment-induced changes in body image and concerns about fertility were detected, but the sexual problems encountered did not seem to differ from those of healthy controls, although baseline data are lacking.
UI - 12128133
AU - Campostrini F; Gregianin M; Rampin L; Lonardi F; De Lucchi A; Coeli M;
TI - Gioga G; Prina M; Ferretti G; Povolato M How iliopelvic lymphoscintigraphy can affect the definition of planning target volume in radiation therapy of pelvic and testicular tumors.
SO - Int J Radiat Oncol Biol Phys 2002 Aug 1;53(5):1303-13
AD - Department of Radiation Oncology, ASL 21, Legnago General Hospital, Legnago, Verona, Italy. firstname.lastname@example.org
PURPOSE: External beam radiation therapy (EBRT) of most intrapelvic and testicular tumors has been generally performed with large fields encompassing both the primary disease and lymphatic drainage. This study was carried out to map the pelvic and periaortic lymphatics by means of iliopelvic lymphoscintigraphy (IPL) in preparation for radiotherapy 70 patients scheduled for EBRT (61 operated on, 52 females, 18 males, mean age 61, range, 24-80), affected with uterine (43), rectal (11), testicular (8), anal (4), penile (2), and vulvar (2) cancers were enrolled in the study. IPL was performed by injection of 99mtechnetium-nanocolloids in the bipedal (70 cases) or bipedal plus perianal (20 cases) sites. The sensitivity of IPL in mapping the lymphatic anatomy was evaluated first. Then three radiation oncologists scored the modifications induced by IPL on the planning target volume (PTV) which had been previously delineated only on the basis of bony landmarks. The original fields were classified "inadequate" if they failed to match the new PTV by more than 1 cm. RESULTS: IPL sensitivity in showing the inguinal, external iliac, common, and periaortic lymphatics was 100%, 90%, 80%, and 70% in anterior-posterior (A-P) projections, and 100%, 80%, 70%, and 60% in lateral projections respectively. For the presacral and hypogastric ones the sensitivity was 40%. When compared with bony landmarks, IPL changed the delineation of PTV in 24 of 70 A-P P-A fields (34%) and 22 of 58 (38%) lateral fields. Furthermore, 8/12 (67%) lymphadenectomies resulted in being incomplete. No IPL-related toxicity was observed. CONCLUSION: IPL is a safe, inexpensive (cost: 100 Euros), and effective method to map the lymphatic chains. In the A-P scintigrams these structures were detected in 85% (70-100%) of the patients referred for total pelvis irradiation, and this figure could be higher in subjects not operated on. IPL can also give a reliable evaluation of the lymphadenectomies in order to schedule the proper treatments after surgery. Finally, IPL may change the conventional PTV for pelvic irradiation in about 36% (34-38%) of the cases; therefore, the fields should be tailored more around the lymphatic landmarks than the bony landmarks.
UI - 12010239
AU - Sanchez D; Zudaire JJ; Fernandez JM; Lopez J; Arocena J; Sanz G; Gimenez
TI - M; Rosell D; Robles JE; Berian JM 18F-fluoro-2-deoxyglucose-positron emission tomography in the evaluation of nonseminomatous germ cell tumours at relapse.
SO - BJU Int 2002 Jun;89(9):912-6
AD - Department of Urology, Facultad di Medicina, Clinica Universitaria, Universidad de Navarra, Pamplona, Spain.
OBJECTIVES: To compare the performance of 18F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) in the follow-up of nonseminomatous germ cell tumours (NSGCT) in the retroperitoneum. PATIENTS AND METHODS: FDG-PET was used 25 times in 15 patients diagnosed with NSGCT. At the time of diagnosis five patients each were in stage I, II and III. Five patients had pure embryonal carcinoma, two had yolk sac tumours, one choriocarcinoma and seven had mixed tumours. RESULTS: Eleven patients either presented with retroperitoneal disease or this did not disappear after chemotherapy. The results of both examinations coincided in 18 cases and were contradictory in the other seven, the difference being statistically significant (P=0.042). CONCLUSION: In these patients FDG-PET detected the retroperitoneal relapse of NSGCT, in advanced stages treated with surgery plus chemotherapy, earlier than did CT; it also detected the presence of mature teratoma in residual retroperitoneal masses more accurately than CT. More extensive trials are needed before making conclusions about FDG-PET imaging as a routine method for NSGCT.
UI - 12151969
AU - Sarid DL; Ron IG; Avinoach I; Sperber F; Inbar MJ
TI - Spontaneous regression of retroperitoneal metastases from a primary pure anaplastic seminoma: a case report.
SO - Am J Clin Oncol 2002 Aug;25(4):380-2
AD - Department of Oncology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Spontaneous regression of pure seminoma metastases is a rare phenomenon, with only a few cases reported to date. To the best of our knowledge, this is the first report of regression of anaplastic pure seminoma metastases located in the retroperitoneum. We present a 27-year-old man, a marihuana smoker, with metastatic pure anaplastic seminoma in the high retroperitoneal lymph nodes. After orchiectomy, his metastases regressed with no medication. Several mechanisms are suggested to explain this phenomenon, which still remains elusive.
UI - 12163388
AU - Takayama H; Takakuwa T; Tsujimoto Y; Tani Y; Nonomura N; Okuyama A;
TI - Nagata S; Aozasa K Frequent Fas gene mutations in testicular germ cell tumors.
SO - Am J Pathol 2002 Aug;161(2):635-41
AD - Department of Pathology, Osaka University Medical School, Suita, Osaka, Japan.
The Fas (Apo-1/CD95)/Fas ligand (L) system is involved in cell death signaling, and has been suggested to be important for the regulation of germ cell apoptosis in the testis. Mutations of the Fas gene may result in accumulation of germ cells and thus might contribute to testicular carcinogenesis. The open reading frame of Fas cDNA was examined in 24 cases of testicular germ cell tumors (TGCTs), comprised of 19 pure histological type (15 seminomas, 3 embryonal carcinomas, 1 immature teratoma) and 5 mixed-type tumors. Mutations of the Fas gene were found in nine (37.5%) of these cases. Each lesion with a homogeneous histological picture was selectively microdissected using a laser capture microdissection method: samples consisted of 18 lesions from seminomas, 7 embryonal carcinomas, 4 immature teratomas, 2 choriocarcinomas, and 1 from a yolk sac tumor. Microdissected genomic DNA was examined to determine which mutations were derived from which kind of histological lesion. Eleven mutations were detected in 10 TGCT lesions from nine cases, but none were found in benign lesions. All were point mutations, and eight missense mutations occurred in exon 9 encoding the core protein of the death domain essential for apoptotic signal transduction. Three were silent mutations. Mutations were found in the seminoma (27.8%) and embryonal carcinoma lesions (62.5%), but none were found in the one yolk sac tumor, two choriocarcinomas, or four immature teratoma lesions. Each seminoma and embryonal carcinoma lesion found in the same case had a different type of Fas mutation from the others. Mouse T-cell lymphoma cells transfected with missense mutated genes were resistant to apoptosis induced by anti-Fas antibody, indicating these to be loss-of-function mutations. These findings suggested a role of Fas gene mutations in the pathogenesis of TGCTs.
UI - 11888046
AU - Lechner L; Oenema A; de NJ
TI - Testicular self-examination (TSE) among Dutch young men aged 15-19: determinants of the intention to practice TSE.
SO - Health Educ Res 2002 Feb;17(1):73-84
AD - Department of Social Science, Open University The Netherlands.
The present study analyzed what determinants are important to describe and explain the intention of testicular self-examination (TSE) for young men aged 15-19 attending senior high school (response rate 80%, n = 274). The questionnaire assessed determinants, including knowledge, attitude (positive and negative consequences, anticipated regret, and moral obligation), social influence (social norm, social support and modeling) and self-efficacy. Knowledge of testicular cancer and TSE was very low. Only 2% of the subjects reported regularly performing TSE. After hearing of TSE (through the questionnaire), 41% of all young men had a positive intention to start performing TSE regularly. The various intention groups (positive, neutral and negative) differed significantly on almost all of the determinants. Multiple regression analysis showed that young men who where anxious about TSE and those who were not anxious had different determinants explaining the variance in the intention to perform TSE regularly (R2 = 41-57%). Differences in determinants of intention between young men who are anxious about TSE and young men who are not can be used to design health education interventions that may therefore be more effective for these different subgroups.
UI - 12063007
AU - Classen J; Souchon R; Hehr T; Bamberg M
TI - Radiotherapy for early stages testicular seminoma: patterns of care study in Germany.
SO - Radiother Oncol 2002 May;63(2):179-86
AD - Department of Radiation Oncology, Tubingen University, Hoppe-Seyler-Strasse 3, D-72076, Tubingen, Germany.
BACKGROUND AND PURPOSE: To evaluate compliance of radiotherapeutic departments with 1997 German consensus guidelines for staging and treatment of testicular cancer patients. MATERIAL AND METHODS: A questionnaire was mailed to all departments of radiotherapy in Germany as identified by the data-base of the German Society for Radiation Oncology (DEGRO). The questionnaire was analysed with particular respect to institutional characteristics, frequency of seminoma patients treated per year, treatment techniques, and institutional compliance with consensus guidelines. RESULTS: Fifty-six institutions (39%) returned the questionnaire, 46% of which fully complied with consensus guidelines concerning staging requirements. A minimum workup with computed tomography (CT) of abdomen and pelvis, X-ray or CT of the chest and tumour markers was mandatory in 87.5% of the departments. Compliance with the recommended treatment schedule was high in stage I with less than 5% major violations of recommended dose prescription or target volume definition. In stage IIA/B, however, 22.6 and 10.2% of the departments showed major deviations from either standardised treatment target volumes or total doses of irradiation, respectively. CONCLUSIONS: Compliance with consensus recommendations in German departments for radiotherapy is satisfactory in many institutions. However, major deviations from treatment guidelines were observed in stage II disease indicating the need for continuous improvement in the quality of testicular cancer patient management.
UI - 12125389
AU - Nori F; Settimi L; Figa-Talamanca I
TI - [Testicular tumors in Italy: historical trends, geographic differences, and etiological hypotheses]
SO - Epidemiol Prev 2002 Mar-Apr;26(2):76-81
AD - Dipartimento di biologia animale e dell'uomo, Universita degli studi La Sapienza, Roma.
Testicular cancer is a rare tumour. Its incidence has been increasing in many parts of the world during the last decades. This cancer has an unusual age distribution with one peak in incidence in young adults (aged 20-39) and a second peak in over 60. On the basis of the Italian Bureau of Statistics, mortality rate was higher in northern regions of the country compared to southern ones, up to the beginning of the 1980's. However, the progressive decline in mortality in all regions eliminated the geographical differences in recent years. Incidence rates obtained from the existing cancer Registries, confirm a strong geographical gradient, with higher rates in the North (ex. 5.1/100,000 in Parma in 1988-92) than in the South (ex. 1.1/100,000 in Ragusa in 1988-92). The comparison between incidence rates of two recent periods (1983-87 and 1988-92), showed an increase in most of the provinces for which data were available. The age distribution curve showed that testicular cancer occurs after puberty, with a peak in incidence among 30-34 year olds, and after the age of 60. These observations suggest the possible causative role of some environmental exposures. Epidemiological studies have found an association between some occupational exposures in industrial and agricultural settings and testicular cancer. Moreover some studies have found an association between parental occupation and testicular cancer in the offspring. However, the aetiology of testicular cancer is still poorly understood.
UI - 12173328
AU - Tu SM; Reyes A; Maa A; Bhowmick D; Pisters LL; Pettaway CA; Lin SH;
TI - Troncoso P; Logothetis CJ Prostate carcinoma with testicular or penile metastases. Clinical, pathologic, and immunohistochemical features.
SO - Cancer 2002 May 15;94(10):2610-7
AD - Department of Genitourinary Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. email@example.com
BACKGROUND: Despite the proximity, prostate carcinoma seldom metastasizes to the penis or testis. METHODS: In the current study, the authors retrospectively examined the clinical history of 12 patients with prostate carcinoma and testicular or penile metastases. Pathologic review and immunohistochemical staining were performed on tumors from eight of these patients. RESULTS: Patients with prostate carcinoma and testicular or penile metastasis responded to androgen ablative therapy (median duration, 33 months). They were predisposed to developing persistent or recurrent urinary symptoms and visceral metastases. Six of 9 evaluable patients had elevated serum carcinoembryonic antigen levels (> 6 ng/mL), whereas 2 of 10 patients had low or undetectable serum prostate specific antigen levels (< 4 ng/mL). In seven of the eight patients for whom specimens were available, the tumors were found to contain histologic features that were compatible with a diagnosis of ductal or endometrioid adenocarcinoma of the prostate. CONCLUSIONS: Patients with prostate carcinoma and testicular or penile metastases have unique clinical and pathologic characteristics. Many of these patients' tumors are compatible with a subtype of prostate carcinoma known as ductal adenocarcinoma. Further studies need to be performed to elucidate the biologic basis of the various histologic subtypes of prostate carcinoma.
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