National Cancer Institute®
Last Modified: July 1, 2002
UI - 12065688
AU - Satie AP; Rajpert-De Meyts E; Spagnoli GC; Henno S; Olivo L; Jacobsen
TI - GK; Rioux-Leclercq N; Jegou B; Samson M The cancer-testis gene, NY-ESO-1, is expressed in normal fetal and adult testes and in spermatocytic seminomas and testicular carcinoma in situ.
SO - Lab Invest 2002 Jun;82(6):775-80
AD - GERM-INSERM U. 435, Universite de Rennes I, Campus de Beaulieu, Rennes, France.
Cancer/testis genes are potential targets for therapeutic genetic and immunologic approaches, and are highly expressed in a large variety of human cancers. However, they are not expressed in normal tissues, with the exception of the testis. The NY-ESO-1 gene is the most recently identified member of the cancer/testis family and its product is one of the most immunogenic tumor antigens. We used immunohistochemistry to investigate the expression of NY-ESO-1 in healthy human prenatal and adult testes and in 59 human testicular tumors of different subtypes. We found that NY-ESO-1 was expressed from 18 weeks until birth in human fetal testes. In the adult testis, NY-ESO-1 was strongly expressed in spermatogonia and in primary spermatocytes, but not in post-meiotic cells or in testicular somatic cells. NY-ESO-1 was not expressed in the Sertoli cells, Leydig cells, classical seminomas, or nonseminomatous germ cells in the 59 testicular tumors. In contrast, NY-ESO-1 was expressed both in carcinomas in situ, which are the earliest stage of testicular tumors (7 of 15 cases), and in spermatocytic seminomas, which are believed to be derived from spermatogonia or primary spermatocytes (8 of 16 cases). We conclude that NY-ESO-1 is a marker that can be used to follow the early progression of testicular tumorigenesis when the tumors present a similar pattern of expression to the cells from which they originated, although the later tumors cease to express NY-ESO-1.
UI - 11786414
AU - Pentikainen V; Suomalainen L; Erkkila K; Martelin E; Parvinen M;
TI - Pentikainen MO; Dunkel L Nuclear factor-kappa B activation in human testicular apoptosis.
SO - Am J Pathol 2002 Jan;160(1):205-18
AD - Program for Developmental and Reproductive Biology, Biomedicum Helsinki, Hospital for Children and Adolescents, University of Helsinki, Finland. firstname.lastname@example.org
Apoptotic cell death plays an important role in limiting testicular germ cell population during spermatogenesis and its dysregulation has been shown to be associated with male infertility. The growing evidence on the role of the transcription factor nuclear factor (NF)-kappa B in controlling apoptosis prompted us to investigate NF-kappa B activity in the normal human testis and its role in testis tissue undergoing excessive apoptosis in vitro. In electrophoretic mobility shift assays, low-level constitutive NF-kappa B DNA-binding activity was found and, by immunostaining of the RelA and p50 NF-kappa B subunits, was localized to Sertoli cell nuclei. During in vitro-induced testicular apoptosis, the Sertoli cell nuclear NF-kappa B levels and whole seminiferous tubule NF-kappa B DNA-binding activity increased previous detection of germ cells undergoing apoptosis. The anti-inflammatory drug sulfasalazine effectively suppressed stress-induced NF-kappa B DNA binding and NF-kappa B-mediated I kappa B alpha gene expression. Importantly, concomitantly with inhibiting NF-kappa B, sulfasalazine blocked germ cell apoptosis. These results suggest that during testicular stress Sertoli cell NF-kappa B proteins exert proapoptotic effects on germ cells, which raises the possibility that pharmacological inhibition of NF-kappa B could be a therapeutic target in transient stress situations involving excessive germ cell death.
UI - 11998529
AU - Fernandez AJ; Papi M; Espuch D; Chillon S; Talavera J
TI - [Cervical metastasis from testicular teratoma]
SO - Acta Otorrinolaringol Esp 2002 Feb;53(2):141-4
AD - Servicio ORL, Hospital General Universitario de Alicante.
The presence of neck metastasis in patients with testicular germ cell neoplasms in a rare but well known phenomenon. The incidence of neck metastasis in testicular carcinoma has been reported to be present in a 5% of cases. When cervical metastasis occurs, surgical resection of the residual disease following chemotherapy and using a specific technique of modified neck dissection results in a surprisingly improvement of the prognosis.
UI - 12050548
AU - Pakzad K; MacLennan GT; Elder JS; Flom LS; Trujillo YP; Sutherland SE;
TI - Meyerson HJ Follicular large cell lymphoma localized to the testis in children.
SO - J Urol 2002 Jul;168(1):225-8
AD - Department of Pathology, University Hospitals of Cleveland, Cleveland, Ohio, USA.
PURPOSE: Primary follicular lymphoma of the testis in childhood is rare with only 6 cases previously reported. We present 3 additional cases. MATERIALS AND METHODS: We extensively analyzed primary follicular lymphoma of the testis in 3 boys. Clinical data were obtained by reviewing patient charts. RESULTS: The patients were 4, 5 and 11 years old, respectively. Two patients presented with painless unilateral testicular enlargement and 1 presented with unilateral hydrocele. Laboratory findings were within normal limits in all patients. Radical orchiectomy was done in all cases. The excised testes were partially or completely replaced by tumor. In all cases the features were those of follicular, large cell-type malignant lymphoma. Tumor cells in all cases were CD20 and CDw75 positive, focally CD23 positive and bcl-2 negative, while in 2 they were CD10 positive and bcl-6 positive. Surface Ig was absent in the 2 cases studied. Karyotyping in 1 case showed a normal karyotype. Staging revealed no evidence of extratesticular disease. All patients underwent combination chemotherapy and were in complete remission 7 to 59 months after therapy. CONCLUSIONS: We present 3 cases of pediatric primary follicular lymphoma of the testis. Pathological findings and clinical features were similar to those in the 6 previously reported cases and suggest that primary pediatric testicular follicular lymphoma may represent unique subset of follicular lymphoma with a particularly good prognosis.
UI - 12050498
AU - Chang SS; Smith JA Jr; Girasole C; Baumgartner RG; Roth BJ; Cookson MS
TI - Beneficial impact of a clinical care pathway in patients with testicular cancer undergoing retroperitoneal lymph node dissection.
SO - J Urol 2002 Jul;168(1):87-92
AD - Department of Urologic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
PURPOSE: Since 1997, we have used a clinical collaborative care pathway for patients undergoing retroperitoneal lymph node dissection. We examined its impact on perioperative care and outcome. MATERIALS AND METHODS: We examined the records of all patients with germ cell carcinoma who underwent retroperitoneal lymph node dissection from July stage, hospital stay, postoperative care and the complication rate. RESULTS: A total of 118 patients underwent retroperitoneal lymph node dissection for germ cell carcinoma during this period, including 46 (39%) before pathway implementation in 1997 and 72 patients (61%) after pathway implementation. Of the 118 patients 40 (34%) underwent the procedure after chemotherapy. This rate remained fairly constant in the period before and after pathway initiation (31% and 36%, respectively). After pathway implementation fewer patients received a nasogastric tube (94% versus 5%, p <0.001) and had complications (26% versus 16%, p = 0.036). Mean hospital stay decreased after pathway implementation in all primary and post-chemotherapy retroperitoneal lymph node dissection cases (4.2 versus 6.4 days, p <0.005). Although patients who underwent the procedure after chemotherapy were more likely to have complications than those who underwent a primary procedure, the difference was not statistically significant (p = 0.09). CONCLUSIONS: Our collaborative clinical care pathway safely and efficiently outlines routine postoperative care and significantly decreased hospital stay.
UI - 12019150
AU - Mayer F; Gillis AJ; Dinjens W; Oosterhuis JW; Bokemeyer C; Looijenga LH
TI - Microsatellite instability of germ cell tumors is associated with resistance to systemic treatment.
SO - Cancer Res 2002 May 15;62(10):2758-60
AD - Pathology/Laboratory for Exp. Patho-Oncology, University Hospital Rotterdam/Daniel, Josephine Nefkens Institute, Erasmus University Rotterdam, 3000 DR Rotterdam, the Netherlands.
Systemic cisplatin-based chemotherapy cures > or =90% of patients with metastatic germ cell tumors (GCTs). The biological basis of this exquisite chemo-sensitivity and the resistant phenotype encountered in 10-15% of patients with GCT is yet unclear. A defective mismatch repair pathway leading to microsatellite instability (MSI) has been related to resistance to cytotoxic drugs. We investigated 100 unselected GCTs and 11 clinically defined chemotherapy-resistant GCTs for MSI using 8 mono- or dinucleotide markers and the presence of the mismatch repair factors MLH1, MSH2, and MSH6 by immunohistochemistry. The resistant tumors, both chemo-naive (n = 8) and pretreated (n = 3), showed a significantly higher incidence of MSI compared with the unselected series (45 versus 6% in at least one locus and 36 versus 0% in > or =2 of 8 loci, both P < or = 0.001). In 5 of all 11 unstable tumors, MSI correlated with immunohistochemical findings. This study demonstrates for the first time a positive correlation between MSI and treatment resistance in GCT.
UI - 12077918
AU - Kalvin B; Marian T; Galuska L; Szakall S Jr; Geczi L; Esik O; Tron L;
TI - Bodrogi I [Positron emission tomography in the investigation of malignant testicular tumors]
SO - Orv Hetil 2002 May 26;143(21 Suppl 3):1286-9
AD - Debreceni Egyetem, Orvos- es Egeszsegtudomanyi Centrum, PET Centrum, Debrecen. email@example.com
Thirty-three [18F]-FDG and ten [11C]-methionine (altogether 43) PET studies were performed in 37 (24 non-seminoma and 13 seminoma) patients. All results were assessed on the basis of histology (or cytology) or clinical follow-up. PET scan identified metastatic disease in 13 cases while 30 investigations resulted in a negative medical report. There were 3 false-positive cases and no false-negative results were obtained. The false-positive results were likely to occur due to FDG accumulation in benign lesions. There were no false-positive findings with the use of [11C]-methionine. Sensitivity, specificity and accuracy were 100%, 91% and 93%, respectively, using both tracers.
UI - 11824894
AU - Henry AM; Ash DV
TI - Prostate cancer treated with brachytherapy in a group of patients who previously underwent pelvic radiotherapy for testicular cancer.
SO - Clin Oncol (R Coll Radiol) 2001;13(6):490
UI - 11940507
AU - Magagnoli M; Balzarotti M; Castagna L; Bertuzzi A; Nozza A; Santoro A
TI - Combined systemic and intrathecal chemotherapy plus radiotherapy in testicular lymphoma: a report of two cases.
SO - Haematologica 2002 Apr;87(4):ELT22
AD - Departmenti of Medical Oncology and Hematology, Istituto Clinico Humanitas- Via Manzoni 56, 20089 Rozzano, Italy. firstname.lastname@example.org
UI - 11978722
AU - Khadra A; Oakeshott P
TI - Pilot study of testicular cancer awareness and testicular self-examination in men attending two South London general practices.
SO - Fam Pract 2002 Jun;19(3):294-6
AD - Department of General Practice and Primary Care, St George's Hospital Medical School, London SW17 ORE, UK.
BACKGROUND: Testicular cancer (TC) awareness and testicular self-examination (TSE) have never been evaluated adequately in UK general practice. TC has a 96% cure rate if detected early. OBJECTIVES: Our aim was to estimate awareness of TC and practice of TSE in a general practice population. METHOD: A cross-sectional questionnaire survey was carried out in 250 consecutive male attenders aged 18-50 years in two general practices, one inner city, and one suburban. After obtaining informed consent, male patients in the waiting room were asked to complete a brief confidential questionnaire about TC and TSE. RESULTS: The response rate was 81%. Mean age was 32 years (range 18-50). Seventy-five per cent of responders described themselves as white, 12% Asian, 6% black and 7% other ethnic groups. Ninety-one per cent were aware of TC but only 26% knew both the age group most affected (25-34 years) and that TC can be curable if detected early. Although 49% of responders had carried out TSE in the past year, only 22% were practising according to recommendations: feeling for lumps at least monthly. TSE was associated with age >35 years, white ethnicity, knowing someone with TC, having attended a Men's Health Clinic and having heard of the 'Everyman' TC awareness campaign. CONCLUSION: Although awareness of TC in this GP population was reasonable, less than half were practising TSE. Further public health campaigns may be needed.
UI - 12081209
AU - Schweyer S; Soruri A; Baumhoer D; Peters J; Cattaruzza M; Radzun HJ;
TI - Fayyazi A Expression of CXC chemokine IP-10 in testicular germ cell tumours.
SO - J Pathol 2002 May;197(1):89-97
AD - Department of Pathology, Georg-August-University Gottingen, Germany. email@example.com
Tumour-infiltrating T lymphocytes (TILs) possess discrepant properties ranging from anti- to protumour activities. Understanding precisely which mechanisms navigating T lymphocytes into the tumour site will help to further the anti-tumour or to disrupt the pro-tumour activities of TILs. The present study asked what enables TILs to migrate into testicular germ cell tumours (TGCTs). TILs were characterized and the expression of a large panel of T-lymphocyte-attracting chemokines was investigated in 21 TGCT cases. Flow cytometry revealed that approximately 80% of TGCT-infiltrating T lymphocytes express CXCR3, a receptor for the chemokine interferon-inducible protein-10 (IP-10). RT-PCR and immunohistochemistry indicated that IP-10 was the only chemokine investigated which was constantly expressed in TGCT. As IP-10 was found to be expressed by endothelial cells of TGCT-associated blood vessels, the question arose whether the IP-10-regulating cytokine interferon-gamma (IFNgamma) is produced by tumour cells and if so, whether tumour-derived IFNgamma can induce IP-10 in endothelial cells. Applying in situ hybridization, IFNgamma transcripts were found in neoplastic germ cells. Analyses of two TGCT cell lines indicated that the tumour cells not only express IFNgamma mRNA, but also produce and secrete IFNgamma protein; tumour-derived IFNgamma provokes IP-10 expression and secretion by endothelial cells in vitro, as assessed by PCR and ELISA. Together, the data suggest that neoplastic germ cells secret IFNgamma and thereby stimulate tumour-associated endothelial cells to express IP-10, which contributes to the recruitment of CXCR3+ T lymphocytes to the site of TGCTs.
UI - 11528185
AU - Laguna MP; Pizzocaro G; Klepp O; Algaba F; Kisbenedek L; Leiva O; EAU
TI - Working Group on Oncological Urology EAU guidelines on testicular cancer.
SO - Eur Urol 2001 Aug;40(2):102-10
AD - Department of Urology, UMC St Radboud, Nijmegen, The Netherlands. firstname.lastname@example.org
OBJECTIVES: To establish guidelines for the diagnosis, staging, treatment and follow-up of germ cell testicular cancer. METHODS: A search of published work was conducted using Medline. Highly evidence-based articles were selected and their findings analysed by the members of the Oncological Urology Working Group of the EAU. Testis cancer is rare and affects young men in their 3rd and 4th decades of life. The majority of these tumours are derived from germ cells (seminomatous and non-seminoma germ cell testicular cancer), and more than 50% of patients are diagnosed with stage I disease. Epidemiological, pathological and clinical risk factors are well established. The tumour, node, metastasis (TNM) staging system is endorsed, and for metastatic disease a recently devised prognostic-factor-based staging system has proven to be useful. Staging assessment includes pre- and post-orchiectomy marker levels, pathology of the testis, and nodal and visceral status. Following orchiectomy, treatment depends on the tumour type, pathological risk factors for stage I disease and clinical prognostic factors for advanced disease. The cure rate is excellent for disease stages I and II, irrespective of the treatment adopted. However, the pattern of relapse (rate, timing and site) is highly influenced by therapeutic policy. For metastatic disease, survival depends on clinical prognostic factors and treatment. Follow-up schedules are tailored according to stage, tumour type and post-orchiectomy treatment schedules. CONCLUSIONS: Excellent cure rates are achieved for early-stage germ cell testis tumours following accurate staging at diagnosis. Satisfactory survival rate can be achieved in advanced metastatic disease using a multidisciplinary therapeutic approach. Follow-up schedules vary, depending on the pathology and stage of the primary tumour and on the treatment policy adopted following orchiectomy.
UI - 12057104
AU - Foster RS
TI - Early-stage testis cancer.
SO - Curr Treat Options Oncol 2001 Oct;2(5):413-9
AD - Department of Urology, Indiana University Medical Center, 535 North Barnhill Drive, Suite 420, Indianapolis, IN 46224, USA. email@example.com
The treatment of low-stage testis cancer (defined as clinical stage I or low-volume clinical stage II disease) varies, depending on whether or not the orchiectomy specimen reveals seminoma or nonseminoma. Treatments for clinical stage I seminoma include radiotherapy to the retroperitoneum, surveillance, or two courses of carboplatin chemotherapy. Until the results of an ongoing randomized study comparing radiotherapy with two courses of carboplatin are known, standard accepted treatments currently include radiotherapy or surveillance. In nonbulky clinical stage II seminoma, therapeutic options include radiotherapy or cisplatin-based chemotherapy. For clinical stage I nonseminoma, equivalent short-term survival rates are obtained with either nerve-sparing retroperitoneal lymph node dissection (RPLND), surveillance, or two courses of BEP (bleomycin, etoposide, and platinum) chemotherapy. However, minimization of toxicity of treatment would argue that the two preferred treatments in clinical stage I nonseminoma are nerve-sparing RPLND or surveillance. For low- volume clinical stage II nonseminoma, options include three courses of BEP or primary RPLND. The overall chance for cure is essentially the same for either of these options. Therefore, in each clinical stage of early-stage testis cancer, therapeutic options exist that, based upon current data, are therapeutically equivalent in the short term. Therefore, the ultimate choice of therapy is also dependent upon the short- and long-term toxicity of therapy and the likelihood of late recurrence of disease.
UI - 12057105
AU - Droz JP; Rivoire M
TI - Advanced testis cancer.
SO - Curr Treat Options Oncol 2001 Oct;2(5):421-9
AD - Department of Medical Oncology, Centre Leon-Berard, 28 rue Laennec, 68008, Lyon, France. firstname.lastname@example.org
Advanced testis tumors are highly curable. The treatment strategy is chemotherapy followed by the surgical exeresis of residual disease. The standard chemotherapy regimen is BEP (bleomycin, etoposide, and cisplatin); the number of cycles of chemotherapy depends upon prognostic factors, based on the primary site, histology, presence of visceral metastases, and serum tumor marker levels. Patients in the good-risk group receive three cycles of chemotherapy, whereas those in the intermediate- and high-risk groups receive four cycles. Exeresis of all residual disease and systematic postchemotherapy retroperitoneal dissection in bulky disease are mandatory. When complete exeresis of necrotic tissue, teratoma, or active germ-cell cancer has been performed, no further postsurgical treatment is warranted. A multidisciplinary approach, rigorous administration of chemotherapy, and skill in surgery of germ-cell tumors are favored in the treatment of these patients in trained centers.
UI - 11979550
AU - Kraggerud SM; Skotheim RI; Szymanska J; Eknaes M; Fossa SD; Stenwig AE;
TI - Peltomaki P; Lothe RA Genome profiles of familial/bilateral and sporadic testicular germ cell tumors.
SO - Genes Chromosomes Cancer 2002 Jun;34(2):168-74
AD - Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo, Norway.
In order to investigate the genetics of testicular germ cell tumors (TGCTs), we examined 33 TGCTs, including 15 familial/bilateral and 18 sporadic tumors, using comparative genomic hybridization. The frequencies of the histological subtypes were comparable between the two groups. Gains of the whole or parts of chromosome 12 were found in 30 tumors (91%). Furthermore, increased copy number of the whole or parts of chromosomes 7, 8, 17, and X, and decreased copy number of the whole or parts of chromosomes 4, 11, 13, and 18 were observed in > or = 50% of the tumors. Sixteen smallest regions of overlapping changes were delineated on 12 different chromosomes. The chromosomal copy numbers of familial/bilateral and sporadic TGCTs were comparable, suggesting similar genetic pathways to disease in both groups. However, significant differences were observed between the two main histological subgroups. Gains from 15q and 22q were associated with seminomas (P = 0.005 and P = 0.02, respectively), whereas gain of the proximal 17q (17q11.2-21) and high-level amplification from chromosome arm 12p, and losses from 10q were associated with nonseminomas (P < 0.001, P = 0.04, and P = 0.03, respectively). Copyright 2002 Wiley-Liss, Inc.
UI - 12072204
AU - van Echten J; Timmer A; van der Veen AY; Molenaar WM; de Jong B
TI - Infantile and adult testicular germ cell tumors. a different pathogenesis?
SO - Cancer Genet Cytogenet 2002 May;135(1):57-62
AD - Department of Clinical Genetics University Hospital Groningen, The Netherlands. email@example.com
Most adult testicular germ cell tumors have a characteristic chromosomal abnormality that is an isochromosome 12p [i(12p)]. Furthermore, these tumors are characterized by a chromosome number in the triploid range and gains and losses of (parts of) specific chromosomes. Cytogenetic investigation of three cases of infantile testicular germ cell tumors, all diagnosed as yolk sac tumors, revealed highly abnormal karyotypes. We found one case to be diploid; the other two cases were in the hypertriploid/hypotetraploid range. Structural abnormalities of chromosomes 1, 3, and 6 were recurrent and no i(12p) was found. Our results, together with data from the literature, suggest that infantile and adult testicular germ cell tumors have a different origin and pathogenetic pathway. Aberrations of chromosomes 1, 3, and 6 may play an important role in the pathogenesis of infantile testicular yolk sac tumors.
UI - 12099588
AU - Hampel U; Schleicher E; Freyer R
TI - Volume image reconstruction for diffuse optical tomography.
SO - Appl Opt 2002 Jul 1;41(19):3816-26
AD - Institut fur Biomedizinische Technik, Technische Universitat Dresden, Germany. firstname.lastname@example.org
Optical tomography is a potential diagnostic method for visualizing optical properties of tissues in vivo. We present an optical tomography method that has been designed for imaging of the human testes, particularly for spectroscopic tumor differentiation. In this application we need to compute three-dimensional distributions of the optical contrast (absorption coefficient) in the tissue in real time. Thus we have given special care to elaborate an efficient inverse algorithm that takes the limitations of spatial resolution and data space point density into account. Our inverse solution is based on a linearization approach and a dedicated object space discretization. Furthermore, we introduce the concept of fuzzy voxels, which enables a reconstruction-inherent image smoothing.
UI - 11458101
AU - Classen J; Dieckmann KP
TI - Re: Malignant germ cell tumor of the contralateral testis after radiotherapy for testicular intraepithelial neoplasia.
SO - J Urol 2001 Aug;166(2):630-1
UI - 11982910
AU - Kurosawa K; Fukutani K; Masuno M; Kawame H; Ochiai Y
TI - Gonadal sex cord stromal tumor in a patient with Rubinstein-Taybi syndrome.
SO - Pediatr Int 2002 Jun;44(3):330-2
AD - Department of Pediatric,Tokyo Metropolitan Kita Medical Rehabilitation Center for The Handicapped, Tokyo, Japan. email@example.com
UI - 12010324
AU - Koshida K; Kato H; Mizokami A; Morishita H; Seto C; Komatsu K; Kou E;
TI - Uchibayashi T; Shiobara S; Namiki M High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer.
SO - Int J Urol 2002 Mar;9(3):146-53
AD - Department of Urology, Division of Transfusion Medicine, School of Medicine, Kanazawa University, 13-12 Takaramachi, Kanazawa 920-8640, Japan. firstname.lastname@example.org
BACKGROUND: The aim of this study was to investigate the efficacy and safety of high-dose chemotherapy (HDCT) for the treatment of patients with advanced testicular cancer. METHODS: Fourteen patients were treated with high-dose carboplatin, etoposide and cyclophosphamide (with or without THP-adriamycin) followed by peripheral blood stem cell transplantation. The treatment was used for two refractory cases, a second relapse, and for consolidation after the first relapse in one case each. It was also used for nine cases as part of the first-line treatment following primary conventional-dose chemotherapy, and for one case as the first salvage for a late recurrent tumor of teratoma with malignant transformation. RESULTS: The first two patients who received intensive pretreatment with cisplatin-based chemotherapy did not respond to HDCT. The two patients who were treated with HDCT as the first or second salvage therapy achieved successful outcomes. The results for the subsequent nine patients (consisting of two with stage IIIC, five with IIIB2, one with IIB, and one extragonadal seminoma) were two progressive disease, three no change and four partial remission. Only three are alive with NED following salvage surgery. Finally, a case of teratoma with malignant transformation did not respond well to two cycles of HDCT. There were no marked adverse reactions except one episode of severe neutropenic colitis. CONCLUSIONS: The results demonstrated the limited efficacy of HDCT even in cases with a good to intermediate risk rating according to classification by the International Germ Cell Cancer Collaborative Group. Because treatment for relapse after HDCT is extremely difficult, new HDCT regimens consisting of drugs that are not used in induction chemotherapy need to be established.
UI - 12010325
AU - Kakehi Y; Kamoto T; Kawakita M; Ogawa O
TI - Follow-up of clinical stage I testicular cancer patients: cost and risk benefit considerations.
SO - Int J Urol 2002 Mar;9(3):154-60; discussion 160-1
AD - Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. email@example.com
BACKGROUND: Regardless of the way it is managed, a high cure rate has been achieved for recurrent low-stage testicular cancer. Achieving a balance between survival and the patient's inconvenience and expense during follow-up, has therefore become an important issue. METHODS: Prognoses and recurrence patterns were investigated in 39 patients with stage I non-seminomatous germ cell tumor of the testis (NSGCT), and 82 patients with stage I seminomatous germ cell tumor of the testis (SGCT), who underwent high orchiectomy between 1970 and 1997 at our institution. We considered the cost benefits and the risks by reviewing our results together with other reported results. RESULTS: Patients with clinical stage I NSGCT under surveillance showed no progression later than 4 years after orchiectomy. The ability to detect progression using chest X-ray alone appeared very low. There was no infradiaphragmatic recurrence after adjuvant radiotherapy for patients with stage I SGCT. Only two of 204 patients showed progression, which included eight of our patients who underwent two cycles of adjuvant carboplatin therapy. CONCLUSIONS: Four years of intensive follow-up is probably sufficient for patients with stage I NSGCT under surveillance, and routine chest X-rays may be required only during the first year of surveillance. The benefit of using adjuvant radiotherapy for patients with stage I SGCT is that we could remove abdominal and pelvic CT scans from the routine follow-up protocol. Randomized trials will clarify whether the adjuvant carboplatin therapy is less toxic, provides better prognosis and is more cost-effective than adjuvant radiotherapy.
UI - 12010330
AU - Ohyama C; Kyan A; Satoh M; Saito S; Nishimura Y; Imai Y; Oikawa K;
TI - Yokoyama J; Suzuki K; Takeuchi M; Hoshi S; Orikasa S Bilateral testicular tumors: a report of nine cases with long-term follow-up.
SO - Int J Urol 2002 Mar;9(3):173-7
AD - Department of Urology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. firstname.lastname@example.org
BACKGROUND: The incidence and clinical features of bilateral germ cell testicular tumor (GCTT) in the Japanese population are not fully characterized. We examined the incidence, clinical features, management and outcome, sexual status, hormonal environment, implication of androgen replacement, and human leukocyte antigen (HLA) typing of bilateral GCTT. METHODS: We treated nine consecutive patients with bilateral GCTT from 1980 through to 1999, and reviewed their hospital and clinic charts. Testosterone, luteinizing hormone, follicle stimulating hormone, dehydroepiandrosterone, and dehydroepiandrosterone-sulfate were measured in bilateral orchiectomized patients. Human leukocyte antigen typing was assessed with peripheral lymphocyte. RESULTS: The incidence of bilateral GCTT against the total number of patients with GCTT was 9/274 (3.3%). The median age of the first tumor was 29 (range 21-75) years. Three cases were synchronous and the remaining six cases were metachronous. In the case of metachronous tumor, the median interval between first and contralateral tumor was 8 (range 2-25) years. Standard treatment was defined as surveillance policy in stage I, chemotherapy for higher stages of non-seminoma, and radiotherapy for stage II seminoma. Human leukocyte antigen typing was examined for seven cases. Five cases were positive for HLA-A24. The incidence of HLA-A24 in bilateral GCTT was identical to that of the Japanese population. The relapsing incidence of stage I disease with surveillance policy was almost identical to unilateral GCTT. A 74-year-old patient with stage II seminoma died of the disease at 1.3 years. The other eight patients remained well without any evidence of recurrence at a median follow-up period of 78 (range 12-204) months. Four patients with bilateral orchiectomy did not require androgen replacement without easy fatigability. Sexual status was conserved using androgen replacement. CONCLUSIONS: Long-term follow-up, as long as 25 years, is recommended for contralateral relapse. Some patients with bilateral orchiectomy do not require androgen replacement. The significance of HLA-A24 for bilateral testicular tumor is equivocal in the Japanese population.
UI - 12102165
AU - Nowak R; Grzybowska EA; Wilczynska A; Pykalo R; Siedlecki JA
TI - Low expression of DNA polymerase beta in human testicular germ cell tumours--impact on foetal gonocytic origin theory.
SO - Acta Oncol 2002;41(2):188-91
AD - Department of Molecular Biology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland. email@example.com
Different models of pathogenesis of adult testicular germ cell tumours (TGCTs) are presented. Analysis of telomeric length and DNA polymerase beta expression suggests that seminoma and nonseminoma, two main histological types of TGCTs, derive independently from transformed foetal primordial cells.
UI - 12107935
AU - Eschwege P; Benoit G
TI - [Testicular tumors]
SO - Rev Prat 2002 May 15;52(10):1119-24
AD - Service d'urologie, centre hospitalier universitaire de Bicetre, 94275 Le Kremlin-Bicetre.
UI - 12115319
AU - Schmelz HU; Abend M; Kraft K; Hauck EW; Weidner W; Van Beuningen D;
TI - Sparwasser C Fas/Fas ligand system and apoptosis induction in testicular carcinoma.
SO - Cancer 2002 Jul 1;95(1):73-81
AD - Department of Urology, Federal Armed Forces Hospital, Ulm, Germany. firstname.lastname@example.org
BACKGROUND: Tumor-infiltrating, Fas ligand (FasL)-expressing lymphocytes are able to eliminate Fas-bearing tumor cells by apoptosis induction. Activated cytotoxic T-cells that express Fas may enter apoptosis in the presence of FasL tumor cells. To date, no studies of patients with testicular carcinoma have correlated the differential expression of Fas and FasL in both cell types with the corresponding apoptotic index (AI). METHODS: Fas and FasL were investigated immunohistochemically in paraffin embedded tissue sections from 25 patients with nonseminomatous testicular tumors. The percentages of positive cells and the ratios of Fas cells to FasL cells were correlated with the AI of tumor cells and lymphocytes, respectively, using Spearman correlations. RESULTS: No association was found between the rate of FasL positive cells and AI of the other cell type or between the rate of Fas positive cells and the AI of the same cell type. Ratios between Fas positive cells and FasL positive cells were not correlated with the AI; however, a significant positive correlation was found between the AI of tumor cells and the AI of lymphocytes. CONCLUSIONS: It seems unlikely that the Fas/FasL system is responsible for immune escape of the tumor in testicular carcinoma. Rather, the significant positive correlation between the AIs of tumor cells and lymphocytes implicate a previously unknown mechanism of apoptosis induction in both cell types. Copyright 2002 American Cancer Society.
UI - 11816610
AU - Cuesta Alcala JA; Arrondo Arrondo JL; Pascual Piedrola I; Zozaya Alvarez
TI - E; Aldave Villanueva J; Solchaga Martinez A; Ripa Saldias L; Grasa Lanau V; Ponz Gonzalez M; Ipiens Aznar A [Differential diagnosis of epididymal leiomyoma. Report of a new case]
SO - Arch Esp Urol 2001 Oct;54(8):823-5
AD - Servicio de Urologia Hospital de Navarra C/Irunlarrea s/n 31008 Pamplona, Espana.
OBJECTIVE: A case of epididymal leiomyoma is presented. This lesion is uncommon and sometimes misdiagnosed. The literature is briefly reviewed. METHODS/RESULTS: A 29-year-old patient presented with a tumor in the tail of the right epididymis that was initially diagnosed as scrotal hematoma or complex cyst in the tail of the epididymis. RESULTS/CONCLUSIONS: Ultrasound has an important role in distinguishing testicular from epididymal tumors. However, if the diagnosis is unclear, surgical resection and subsequent anatomopathological analysis must be performed.
UI - 11774771
AU - Debbagh A; Bennani S; Jouhadi H; Joual A; el Mrini M; Kahlain A;
TI - Benjelloun S [Yolk sac tumor. Report of a case]
SO - Ann Urol (Paris) 2001 Nov;35(6):356-8
AD - Service d'urologie, hopital Ibn Rochd, quartier des Hopitaux, 20000 Casablanca, Maroc.
Yolk sac tumor is rare in adult. We report a case in a young man aged of 23 years treated by orchiectomy, chemotherapy and retroperitoneal lymphadenectomy. Diagnosis is based on pathology who shows other cellular contingents. Treatment is based on orchiectomy and chemotherapy is indicated for residula masses. The prognosis is bad because metastasis is frequent.
UI - 11822063
AU - Porcaro AB; Zecchini Antoniolli S; Novella G; Martignoni G; Bassetto MA;
TI - Poli A; Schiavone D; Tallarigo C; D'Amico A; Ficarra V; Curti P [Histopathologic risk factors in patients with non-seminomatous germ tumors of the testis in clinical stage 1. Retrospective study of 75 patients]
SO - Arch Ital Urol Androl 2001 Dec;73(4):177-80
AD - Divisione Clinicizzata di Urologia, Ospedale Policlinico G. Rossi, Verona, Italia.
OBJECTIVES: This retrospective study was performed to evaluate histopathologic prognostic risk factors in 75 patients on clinical stage 1 nonseminomatous germ cell cancer of the testis (NSGCTT). METHODS: From clinical stage 1 disease. Average age was 29.5 years (range 16-71). After orchiectomy, therapeutic options included retroperitoneal lymph node dissection (RLND) for 44 patients (58.6%), surveillance for 26 (34.6%) and neoadjuvant chemotherapy for 5 (6.6%). Testis primary tumor samples were assessed for studying prognostic risk factors that included vascular and/or lymphatic invasion (IV/IL+), percentage of embryonal carcinoma (%EC) and absence of yolk sac tumor (YS-). RESULTS: All patients were alive and disease-free. The average age follow-up was 84.5 months (range 1-254). Relapses occurred in 11 (14.6%) patients after an average follow-up of 9.09 months (range 3-24). Prognostic risk factors were detected as follows: IV/IL+ in 17 cases (22.7%), (50-80%) EC in 23 (30.6%), CE% > 80 in 23 (30.6%), YS- in 55 (72%). In 8 (10.6%) patients there was not any prognostic risk factor. Disease relapse related to prognostic risk factors was detected as follows: 18.1% for VI/LI, 90.9% for EC% > 50 (27.2% for 50-80% EC and 63.6% for CE% > 80) and 90.9% for YS-. Relapsing rates between patients with EC% > 80 and 50-80% EC resulted statistically significant (p = 0.02, odds ratio = 12.25). Relapsing rates between patients on surveillance and those who underwent RLND was next to be significant (p = 0.05, odds ratio 3.68). CONCLUSIONS: EC% > 80 is a prognostic risk factor for disease relapse in patients with clinical stage 1 NSGCT who are selected in a high risk group requiring RPLND or neoadjuvant chemotherapy as therapeutical option.
UI - 11981629
AU - Lee JK; Kim SH; Kim JH; Kim IY; Kim TS; Jung S; Kang SS; Lee JH; Lee MC
TI - Metastatic spinal cord compression of testicular yolk sac tumor.
SO - Childs Nerv Syst 2002 Apr;18(3-4):171-4
AD - Department of Neurosurgery, Chonnam National University Hospital and Medical School, 8 Hak-dong, Dong-ku, Gwangju, 501-757, South Korea. email@example.com
INTRODUCTION: Pediatric testicular tumors are rare. Spinal metastasis of testicular yolk sac tumor (YST) is extremely rare, with only one reported case. CASE REPORT: We report a rare case of metastatic spinal cord compression of testicular YST in a 14-month-old boy who presented with progressive paraparesis and neurological bladder dysfunction. Two months prior to admission, he underwent a left radical orchiectomy for YST of the testis. Magnetic resonance imaging revealed severe spinal cord compression by the ventral epidural mass from T-9 to T-11 and at S-3. Emergency surgical resection was performed for tissue diagnosis and spinal decompression. Histopathological features of the epidural mass indicated metastasis of the testicular YST. CONCLUSION: Although spinal involvement with metastatic YST is rare, it must be considered in children with testicular YST exhibiting evidence of pain or weakness, and surgical decompression followed by adjuvant chemotherapy should not be delayed.
UI - 12037681
AU - Qiao D; Zeeman AM; Deng W; Looijenga LH; Lin H
TI - Molecular characterization of hiwi, a human member of the piwi gene family whose overexpression is correlated to seminomas.
SO - Oncogene 2002 Jun 6;21(25):3988-99
AD - Department of Cell Biology, Duke University Medical Center, PO Box 3709, DUMC, Durham, North Carolina, NC 27710, USA.
The piwi family genes are highly conserved during evolution and play essential roles in stem cell self-renewal, gametogenesis, and RNA interference in diverse organisms ranging from Drosophila melanogaster and C. elegans to Arabidopsis. Here we report the molecular characterization of hiwi, a human member of the piwi gene family. hiwi maps to the long arm of chromosome 12, band 12q24.33, a genomic region that displays genetic linkage to the development of testicular germ cell tumors of adolescents and adults (TGCTs), i.e., seminomas and nonseminomas. In addition, gain of this chromosomal region has been found in some TGCTs. hiwi encodes a 3.6 kb mRNA that is expressed abundantly in the adult testis. It encodes a highly basic 861-amino-acid protein that shares significant homology throughout its entire length with other members of the PIWI family proteins in Drosophila, C. elegans and mammals. In normal human testes, hiwi is specifically expressed in germline cells, with its expression detectable in spermatocytes and round spermatids during spermatogenesis. No expresssion was observed in testicular tumors of somatic origin, such as Sertoli cell and Leydig cell tumors. Enhanced expression was found in 12 out of 19 sampled testicular seminomas-tumors originating from embryonic germ cells with retention of germ cell phenotype. In contrast, no enhanced expression was detected in 10 nonseminomas-testicular tumors that originate from the same precursor cells as seminomas yet have lost their germ cell characteristics. Finally, no enhanced expression was detected in four spermatocytic seminomas-testicular tumors that most likely originate from germ cells capable of partial meiosis. Thus, hiwi is specifically expressed in both normal and malignant spermatogenic cells in a maturation stage-dependent pattern, in which it might function in germ cell proliferation.
UI - 12085204
AU - Fizazi K; Prow DM; Do KA; Wang X; Finn L; Kim J; Daliani D; Papandreou
TI - CN; Tu SM; Millikan RE; Pagliaro LC; Logothetis CJ; Amato RJ Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours.
SO - Br J Cancer 2002 May 20;86(10):1555-60
AD - Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. firstname.lastname@example.org
Only about half of patients with a poor-prognosis non-seminomatous germ-cell tumours can achieve a cure. The aim of this phase II study was to assess the efficacy and toxicity of a dose-dense alternating chemotherapy regimen in this subset of patients. High volume non-seminomatous germ-cell tumours was defined as follows: at least two sites of non pulmonary metastases, an extragonadal primary tumour, a serum human chorionic gonadotropin level higher than 10 000 mIU x ml(-1), or a alpha-foetoprotein level higher than 2000 mIU ml(-1). Patients who fulfilled these criteria were treated with the so-called BOP-CISCA-POMB-ACE regimen (bleomycin, vincristine, and cisplatin; cisplatin, cyclophosphamide, and doxorubicin; cisplatin, vincristine, methotrexate, and bleomycin; etoposide, dactinomycin, and cyclophosphamide) plus granulocyte colony-stimulating factor. A total of 58 patients were enrolled. Patients were retrospectively classified according to the International Germ-Cell Cancer Consensus Group classification; 38 patients (66%) had poor-prognosis disease and 19 patients (33%) had intermediate-prognosis. Patients received a median of 2.5 courses (range 0.25 to five courses) of the BOP-CISCA-POMB-ACE regimen. Forty-two patients (72.4%) had a complete response to therapy. With a median follow-up time of 31 months, the 3-year progression-free survival rate was 71% (95% confidence interval, 60 to 84%) and the 3-year overall survival rate was 73% (95% confidence interval: 62 to 86%). The 3-year PFS rates were 83% (95% confidence interval: 68 to 100%) in the intermediate-prognosis group and 65% (95% confidence interval: 51 to 82%) in the poor-prognosis group. Early side effects included mainly grade 4 haematologic toxicity (neutropaenia in 79% of patients, thrombocytopaenia in 69%, anaemia in 22%), grade 4 stomatitis (19%), and four early deaths (7% of patients), at least partially related to toxicity. The dose-dense BOP-CISCA-POMB-ACE regimen is highly active in patients with non-seminomatous germ-cell tumours classified as intermediate-prognosis or poor-prognosis according to the International Germ-Cell Cancer Consensus Group. Because outcomes with this regimen compare favourably with outcome after standard therapy, dose-dense chemotherapy should be further investigated in this subset of patients. comCopyright 2002 Cancer Research UK
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