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1. Brandli DW, Ulbright TM, Foster RS, Cummings OW, Zhang S, Sweeney CJ, Eble JN, Cheng L: Stroma adjacent to metastatic mature teratoma after chemotherapy for testicular germ cell tumors is derived from the same progenitor cells as the teratoma. Cancer Res; 2003 Sep 15;63(18):6063-8
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  • [Title] Stroma adjacent to metastatic mature teratoma after chemotherapy for testicular germ cell tumors is derived from the same progenitor cells as the teratoma.
  • Metastatic mature teratoma is often present in postchemotherapy surgical specimens of lymph nodes from patients with pathological stage II or III testicular germ cell tumors.
  • The stromal cells in these lesions have generally been considered "fibrosis" secondary to the chemotherapy and the necrosis it causes, although the frequent cytological atypia of the stromal cells suggests that they may be neoplastic.
  • We studied 25 patients with pathological stage II or III testicular cancer who were treated with platinum-based chemotherapy followed by surgical resection of retroperitoneal lymph nodes that contained metastatic mature teratoma with "fibrosis" to determine the reactive or neoplastic nature of the stromal cells.
  • We compared the pattern of allelic loss using nine microsatellite DNA markers (D9S177, D9S303, D9S778, D9S171, D12S1015, D1S508, D2S156, D18S46, and D11S903) between the epithelial cells of the teratoma and the cells in the adjacent stroma.
  • A laser capture microdissection technique facilitated preparation of genomic DNA from the epithelial components of teratoma, adjacent stromal cells, and normal lymph node tissue from each patient.
  • Of the 25 patients, loss of heterozygosity was seen at a minimum of one focus in 22 (92%) of the teratoma specimens and 16 (64%) of the adjacent stroma.
  • Of the 16 cases for which the stroma showed loss of heterozygosity, 8 cases showed the identical pattern of allelic loss in the epithelial cells of the adjacent teratoma at all nine DNA loci studied.
  • Interestingly, three cases showed loss of heterozygosity in the stroma that was not seen in the matching teratoma specimens.
  • Our results indicate that the stromal cells adjacent to metastatic mature teratoma in postchemotherapy lymph node specimens frequently have genetic abnormalities similar to the metastatic teratoma.
  • Concordant genetic alterations observed in teratoma and stroma suggest that both are derived from the same element of the original germ cell tumor or the same progenitor cell.
  • [MeSH-major] Neoplastic Stem Cells / pathology. Teratoma / genetics. Teratoma / pathology. Testicular Neoplasms / genetics. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Embryonal Carcinoma Stem Cells. Humans. Loss of Heterozygosity. Male. Neoplasm Metastasis. Stromal Cells / pathology

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  • (PMID = 14522936.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Ehrlich Y, Yossepowitch O, Kedar D, Baniel J: Distribution of nodal metastases after chemotherapy in nonseminomatous testis cancer: a possible indication for limited dissection. BJU Int; 2006 Jun;97(6):1221-4
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  • [Title] Distribution of nodal metastases after chemotherapy in nonseminomatous testis cancer: a possible indication for limited dissection.
  • OBJECTIVE: To assess the clinical and pathological findings of patients treated by bilateral retroperitoneal lymph node dissection (RPLND) after chemotherapy, to identify a subset for whom modified template nodal resection might be contemplated, as bilateral RPLND is the treatment of choice in patients with residual retroperitoneal disease after chemotherapy for nonseminomatous germ-cell tumour (GCT).
  • PATIENTS AND METHODS: The medical records were reviewed of 50 consecutive patients who had RPLND after chemotherapy between 1996 and 2005.
  • The pathological findings were correlated with the side of the primary lesion and the extent of metastatic disease before chemotherapy.
  • RESULTS: Pathological assessment of the resected lymph nodes revealed teratoma in 28 patients (56%), viable carcinoma in three (6%), and necrosis or fibrosis in 19 (38%).
  • CONCLUSION: Bilateral RPLND should be considered as the reference standard in patients with metastatic GCT and residual retroperitoneal mass after completing chemotherapy.
  • However, the present data suggest that a modified template dissection might be considered even after chemotherapy in patients with left-sided primary tumours and limited nodal involvement at presentation.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasm, Residual / surgery. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Combined Modality Therapy. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Retroperitoneal Space. Treatment Outcome

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  • (PMID = 16686715.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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3. Gupta MK, Seam RK, Gurung DS, Kanika S: Familial testicular tumour in two brothers: a case report. Indian J Cancer; 2005 Oct-Dec;42(4):208-10
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  • [Title] Familial testicular tumour in two brothers: a case report.
  • Testicular tumors account for 1% of all cancers in men and it occurs in 1 in 500 men.
  • Incidence of familial testicular tumours is rare.
  • We report a case of two brothers presenting simultaneously with testicular tumours.
  • Histopathologic examination of one revealed embryonal cell carcinoma and other mature teratoma of the testis.
  • Patient with embryonal carcinoma was given adjuvant chemotherapy based on Bleomycin, Etoposide and cisplatinum (BEP) and one with mature teratoma was put on a follow up.
  • [MeSH-major] Genetic Predisposition to Disease. Germinoma / genetics. Germinoma / pathology. Testicular Neoplasms / genetics. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Follow-Up Studies. Humans. Male. Orchiectomy. Pedigree. Risk Assessment. Siblings. Treatment Outcome

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  • (PMID = 16391441.001).
  • [ISSN] 0019-509X
  • [Journal-full-title] Indian journal of cancer
  • [ISO-abbreviation] Indian J Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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4. Minamide M, Hosoi I, Yanagi S: [CA19-9-producing testicular tumor: a case report]. Hinyokika Kiyo; 2000 Jan;46(1):45-7
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  • [Title] [CA19-9-producing testicular tumor: a case report].
  • A rare case of CA19-9-producing testicular tumor is reported.
  • Ultrasonography and computed tomography demonstrated a right testicular tumor with right lung metastasis and aortocaval lymph node metastasis.
  • The histopathological diagnosis was mixed type of teratoma, yolk sac tumor, embryonal carcinoma and seminoma.
  • Immuno-histochemical analysis showed CA19-9 to be expressed in the cancer cells.
  • After 5 courses of combination chemotherapy, the operation for right lung metastasis was performed.
  • [MeSH-major] Biomarkers, Tumor / analysis. CA-19-9 Antigen / analysis. Carcinoma, Embryonal / diagnosis. Endodermal Sinus Tumor / diagnosis. Neoplasms, Multiple Primary. Seminoma / diagnosis. Teratoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Humans. Male. Orchiectomy. Treatment Outcome. Vinblastine / administration & dosage

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  • (PMID = 10723665.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; PVB protocol
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5. Matveev VB, Volkova MI, Cherniev VA, Figurin KM, Mitin AV: [Retroperitoneal lymphadenectomy in disseminated non-seminoma germinogenic testicular tumors after chemotherapy in patients with elevated serum tumor markers]. Urologiia; 2010 May-Jun;(3):41-7
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  • [Title] [Retroperitoneal lymphadenectomy in disseminated non-seminoma germinogenic testicular tumors after chemotherapy in patients with elevated serum tumor markers].
  • Postchemotherapy retroperitoneal lymph node dissection (RLND) was performed in 70 testicular non-seminoma patients with elevated serum tumor markers (age median 27.0 +/- 8.1 years) from 1983 to 2008.
  • The prognostic group was not identified in 24 (34.3%) cases which started treatment in other hospitals.
  • All the patients received induction cisplatin-based chemotherapy following orchidectomy (first-line--24 (34.3%), second-line--46 (65.7%) which resulted in tumor shrinkage < 50% in 7 (10.0%), 51-90% in 23 (32.9%), > 90%--in 2 (2.9%) cases.
  • CT scan revealed residual retroperitoneal masses after chemotherapy in all the patients: < 2 cm--5 (7.1%), 2-5 cm--25 (35.7%), > 5 cm--40 (57.1%).
  • Further chemotherapy was not perspective in all 70 patients who further underwent retroperitoneal lymph node dissection (RLND).
  • Postoperative chemotherapy was given to 27 (38.6%) cases.
  • Complications developed in 12.9% (9/70) patients.
  • Histology revealed necrosis in 20 (28.6%), teratoma--in 26 (37.1%), cancer--in 24 (34.3%) specimens.
  • Prognostic factors for cancer in retroperitoneal pathology were the following: S > S1 (p = 0.013), intermediate or poor prognosis group IGCCCG (p = 0.014), absence of embryonal carcinoma (p = 0.003), the presence of choriocarcinoma in the testicular tumor (p = 0.028), second-line chemotherapy (p = 0.001), residual mass > 2 cm (p = 0.006).
  • Univariate analysis revealed an adverse impact on progressive-free survival of category S > S1 (p = 0.015), intermediate or poor prognostic group IGCCCG (p = 0.01), the presence of embryonal carcinoma (p = 0.020) and the absence of choriocarcinoma in the testicular tumor (p = 0.029), tumor shrinkage < 50% (p < 0.0001), incomplete RLND (p = 0.012), an incomplete effect of the combined treatment (p < 0.0001), cancer in the residual mass (p < 0.0001).
  • The multivariate analysis proved predictive value of an incomplete effect of the combined treatment (p < 0.0001).
  • Thus, selected testicular non-seminoma patients with elevated serum tumor markers are curable with surgery.
  • The best candidates for RLND in this group are patients without a tumor markers level increase during chemotherapy, with S1 category, good IGCCCG prognosis, tumor shrinkage > 50% and potentially respectable residual disease.
  • [MeSH-major] Biomarkers, Tumor / blood. Germinoma. Lymph Node Excision. Testicular Neoplasms

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  • (PMID = 20734877.001).
  • [ISSN] 1728-2985
  • [Journal-full-title] Urologii︠a︡ (Moscow, Russia : 1999)
  • [ISO-abbreviation] Urologiia
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia (Federation)
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; Q20Q21Q62J / Cisplatin
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6. Bachmeyer C, Joly H, Jorest R: Early myocardial infarction during chemotherapy for testicular cancer. Tumori; 2000 Sep-Oct;86(5):428-30
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  • [Title] Early myocardial infarction during chemotherapy for testicular cancer.
  • A 36-year-old man with testicular cancer had an acute myocardial infarction during the first course of chemotherapy with bleomycin, etoposide and cisplatin.
  • Since the patient had no significant risk factors for coronary heart disease, the infarction was likely to be attributable to the chemotherapy regimen.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Heart Conduction System / drug effects. Myocardial Infarction / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / adverse effects. Carcinoma, Embryonal / drug therapy. Cisplatin / adverse effects. Electrocardiography / drug effects. Etoposide / adverse effects. Humans. Male. Teratoma / drug therapy

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  • (PMID = 11130576.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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7. Oechsle K, Hartmann M, Brenner W, Venz S, Weissbach L, Franzius C, Kliesch S, Mueller S, Krege S, Heicappell R, Bares R, Bokemeyer C, de Wit M, German Multicenter Positron Emission Tomography Study Group: [18F]Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy: the German multicenter positron emission tomography study group. J Clin Oncol; 2008 Dec 20;26(36):5930-5
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  • [Title] [18F]Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy: the German multicenter positron emission tomography study group.
  • PURPOSE: In patients with metastatic nonseminomatous germ cell cancer (NSGCT), residual masses after chemotherapy (CTX) can consist of vital carcinoma, mature teratoma, or necrosis.
  • This prospective trial has evaluated the accuracy of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) for the prediction of histology compared with computed tomography (CT) and serum tumor markers (STM).
  • Judging only vital carcinoma as a true malignant finding, the negative predictive value increased to 83% for FDG-PET.
  • CONCLUSION: The presence of vital carcinoma and mature teratoma is common (55%) in residual masses in patients with NSGCT, and CT and STM cannot reliably predict absence of disease.
  • [MeSH-major] Neoplasm, Residual / radionuclide imaging. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / radionuclide imaging. Positron-Emission Tomography. Testicular Neoplasms / drug therapy. Testicular Neoplasms / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor / blood. Cell Survival. Cisplatin / therapeutic use. Fluorodeoxyglucose F18. Humans. Male. Middle Aged. Predictive Value of Tests. Prospective Studies. Retroperitoneal Neoplasms / drug therapy. Retroperitoneal Neoplasms / radionuclide imaging. Retroperitoneal Neoplasms / surgery. Sensitivity and Specificity. Tomography, X-Ray Computed

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  • (PMID = 19018083.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0Z5B2CJX4D / Fluorodeoxyglucose F18; Q20Q21Q62J / Cisplatin
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8. Kinebuchi Y, Ogawa T, Kato H, Igawa Y, Nishizawa O, Miyagawa S: Testicular cancer with tumor thrombus extending to the inferior vena cava successfully removed using veno-venous bypass: a case report. Int J Urol; 2007 May;14(5):458-60
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  • [Title] Testicular cancer with tumor thrombus extending to the inferior vena cava successfully removed using veno-venous bypass: a case report.
  • A 33-year-old man with a left testicular tumor was referred to Shinshu University Hospital for advanced therapy.
  • After orchidectomy, a diagnosis of embryonal carcinoma was made with a clinical stage of T1N2M1bS3, which has a poor prognosis, based on the International Germ Cell Cancer Collaborative Group consensus.
  • After eight courses of chemotherapy, the patient's tumor markers normalized and the lung metastases disappeared, but the RPLN and tumor thrombus remained.
  • The pathological examination of the thrombus revealed a mature teratoma.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Neoplastic Cells, Circulating. Testicular Neoplasms / pathology

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  • (PMID = 17511736.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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9. Stephenson AJ, Bosl GJ, Bajorin DF, Stasi J, Motzer RJ, Sheinfeld J: Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion. J Urol; 2005 Aug;174(2):557-60; discussion 560
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  • [Title] Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion.
  • PURPOSE: The outcome after primary retroperitoneal lymph node dissection (RPLND) was analyzed in patients with clinical stage I-IIA nonseminomatous germ cell testicular cancer with embryonal carcinoma predominance (ECP) or lymphovascular invasion (LVI).
  • MATERIALS AND METHODS: Between 1989 and 2002, 267 patients with clinical stage I-IIA nonseminomatous germ cell testicular cancer, and ECP and/or LVI underwent RPLND.
  • RESULTS: Overall 42% of patients had pathological stage (PS) II disease, of whom 54% had low volume (PN1) disease and 16% had retroperitoneal teratoma.
  • All patients with relapse were continuously free of disease following standard chemotherapy with or without resection of residual masses and the 10-year actuarial overall survival was 100%.
  • When adjuvant chemotherapy was restricted to patients with PN2 disease, the estimated 5-year relapse rate was 9% and an estimated 72% of patients avoided chemotherapy.
  • CONCLUSIONS: The low risk of systemic relapse in patients with PS I and PN1 after RPLND alone combined with the 16% incidence of retroperitoneal teratoma and the favorable morbidity profile supports RPLND over primary chemotherapy for the treatment of patients with low stage disease with ECP and/or LVI who are not candidates for surveillance.
  • An estimated 72% of patients are spared the potential toxicity of chemotherapy if adjuvant therapy is restricted to patients with PN2.
  • After primary RPLND and selective adjuvant chemotherapy late recurrence is distinctly uncommon and long-term cancer control is anticipated in essentially all patients.
  • [MeSH-major] Lymph Node Excision. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease Progression. Humans. Lymphatic Metastasis. Male. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Retroperitoneal Space

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  • [CommentIn] Aktuelle Urol. 2007 Jan;38(1):1-2 [17290323.001]
  • (PMID = 16006891.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 32-CA82088
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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10. Stephenson AJ, Sheinfeld J: Management of patients with low-stage nonseminomatous germ cell testicular cancer. Curr Treat Options Oncol; 2005 Sep;6(5):367-77
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  • [Title] Management of patients with low-stage nonseminomatous germ cell testicular cancer.
  • Management options for patients with clinical stage (CS) I nonseminomatous germ cell testicular cancer (NSGCT) include surveillance, retroperitoneal lymph node dissection (RPLND), or two cycles of bleomycin-etoposide-cisplatin (BEP x 2) chemotherapy.
  • The optimal management of these patients is controversial, as cure rates of 97% or greater are reported with each of these treatment modalities.
  • Patients without evidence of lymphovascular invasion, a predominant component of embryonal carcinoma, or advanced pathologic (p) T stage (pT 2 or greater) are at low risk for occult metastases and are optimal candidates for surveillance.
  • For patients who are not candidates for surveillance, RPLND offers several advantages over chemotherapy.
  • RPLND alone is curative in 50% to 80% of CS I patients with pathologic stage (PS) II, and an estimated 75% of CS I patients avoid chemotherapy (as adjuvant therapy or for treatment of relapse).
  • Virtually all patients are cured following two cycles of adjuvant chemotherapy for PS II disease, which is reserved for patients with high-volume (PN2-3) retroperitoneal disease.
  • The poor outcome of patients with late retroperitoneal recurrence from unresected, chemorefractory germ cell testicular cancer indicates that RPLND is a vital component to the long-term cure of patients with NSGCT.
  • Approximately 20% to 30% of patients with PS II disease have retroperitoneal teratoma (which is chemoresistant), and an estimated 5% of PS II patients have chemoresistant viable cancer following BEP x 2 as primary therapy.
  • Patients who relapse after RPLND are "chemotherapy-naïve" and cured in virtually all cases with good-risk chemotherapy regimens.
  • When nerve-sparing techniques are employed to preserve ejaculation, RPLND is also associated with a more favorable long-term toxicity profile compared with chemotherapy.
  • In the absence of conclusive evidence from a randomized trial, we believe RPLND is the treatment of choice for patients with CS I NSGCT who are not candidates for surveillance, as it offers the greatest likelihood of long-term cure with considerably less morbidity than primary chemotherapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Humans. Laparoscopy. Lymph Node Excision. Lymphatic Metastasis. Male. Neoplasm Staging. Treatment Outcome

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  • (PMID = 16107240.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 68
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11. Subramanian VS, Gilligan T, Klein EA: A case of spermatic cord teratoma in low-stage testicular cancer managed by surveillance. Nat Clin Pract Urol; 2008 Apr;5(4):220-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A case of spermatic cord teratoma in low-stage testicular cancer managed by surveillance.
  • BACKGROUND: A 25-year-old male presented to his local urologist with new-onset right testicular pain and swelling detected on self examination.
  • A scrotal ultrasound scan showed a right testicular mass, suspicious for neoplasm.
  • The patient underwent right inguinal orchiectomy and was diagnosed with nonseminomatous germ cell tumor of the right testis, composed of yolk sac tumor, teratoma, and embryonal carcinoma with no evidence of metastatic disease.
  • He opted to remain under surveillance rather than undergo primary chemotherapy or retroperitoneal lymph node dissection for his clinical stage I disease.
  • Serologic relapse at 4 months after orchiectomy was successfully treated with bleomycin, etoposide and cisplatin (BEP) chemotherapy.
  • Pathology of the testicular mass was reviewed.
  • DIAGNOSIS: A 1.7 cm nodule anterior to the right psoas muscle suspicious for metastatic disease that was seen on CT 16 months after orchiectomy was pathologically confirmed as recurrent mature teratoma in the spermatic cord.
  • Additionally, one of eleven interaortocaval lymph nodes showed evidence of teratoma.
  • [MeSH-major] Genital Neoplasms, Male / therapy. Neoplasms, Germ Cell and Embryonal / surgery. Spermatic Cord / pathology. Teratoma / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chorionic Gonadotropin / blood. Disease Management. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Neoplasm Recurrence, Local / therapy. Orchiectomy. alpha-Fetoproteins / analysis

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  • (PMID = 18268549.001).
  • [ISSN] 1743-4289
  • [Journal-full-title] Nature clinical practice. Urology
  • [ISO-abbreviation] Nat Clin Pract Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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12. Melchior D, Müller SC, Albers P: Extensive surgery in metastatic testicular cancer. Aktuelle Urol; 2003 Jul;34(4):214-22
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  • [Title] Extensive surgery in metastatic testicular cancer.
  • Surgery remains an important component in the multimodal treatment of patients with advanced testicular cancer.
  • Recently, however, the indications for post-chemotherapy residual tumor resection have changed.
  • Patients with advanced seminoma very rarely need surgical resection of the residual disease after standard chemotherapy.
  • In contrast, patients with high stage non-seminomatous testis cancer must undergo post-chemotherapy surgery in most cases.
  • Surgical resection in metastatic disease may also be necessary in patients with recurrent tumors, patients with persisting marker elevation during chemotherapy and patients with late relapses.
  • Post-chemotherapy residual tumor resections, "redo"-retroperitoneal tumor operations and other salvage resections are often technically demanding procedures with unusual surgical approaches that require individualized perioperative planning in order to reduce morbidity.
  • This paper summarizes the current indications for post-chemotherapy surgery and discusses various surgical approaches and techniques, perioperative management recommendations, as well as complications of these extensive resection procedures.
  • [MeSH-major] Carcinoma, Embryonal / surgery. Germinoma / surgery. Seminoma / surgery. Teratoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Combined Modality Therapy. Follow-Up Studies. Humans. Lymph Node Excision. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery. Time Factors. Tomography, X-Ray Computed

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  • (PMID = 14566667.001).
  • [ISSN] 0001-7868
  • [Journal-full-title] Aktuelle Urologie
  • [ISO-abbreviation] Aktuelle Urol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 52
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13. Brandes AA, Pasetto LM, Monfardini S: The treatment of cranial germ cell tumours. Cancer Treat Rev; 2000 Aug;26(4):233-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The treatment of cranial germ cell tumours.
  • Germ cell tumours of the central nervous system (CNS) include many subtypes whose response to treatment varies, even though the symptoms and radiological appearances are similar.
  • Patients with choriocarcinoma, embryonal carcinoma, or yolk sac tumour have the lowest survival rates; patients with germinoma or mature teratoma have longer survival rates.
  • Beside the delayed injury induced by radiotherapy, the late injury induced by chemotherapy is becoming increasingly evident.
  • Cisplatin is considered an indispensable drug, but it may cause renal damage, ototoxicity, peripheral neuropathy and sterility, while etoposide is associated with an excess frequency of second neoplasms.
  • Taking into account all of the published literature, the following therapeutic options are suggested: in pure germinoma tumours (GT) radiotherapy alone will usually ensure adequate control of the disease, and the long-term sequelae may be limited by reducing the dose delivered, as was proposed for germ cell testicular tumours, to 30 Gy to limited fields plus 25-30 Gy to the spinal axis if there is disseminated disease.
  • In cases of recurrence, which should be uncommon, patients may be rescued with both radiotherapy and chemotherapy.
  • In NGGC tumours, the prognosis is more unfavourable and there is often dissemination to the spine at diagnosis; however, the tumour's high chemosensitivity suggests neoadjuvant treatment chemotherapy with cisplatin and etoposide for three cycles followed by consolidation radiotherapy with 40 Gy to the limited fields plus 30 Gy to the spinal axis if disseminated.
  • In our opinion, a higher dose of radiotherapy in cases in which chemotherapy does not achieve a radiological complete remission is not advisable, because very often the residual radiological abnormality does not represent biologically active tumour but differentiated forms such as mature teratoma.
  • The challenge for 2000 is to both cure these patients, and avoid the late and permanent sequelae of radiation and/or chemotherapy that may subsequently impair quality of life.
  • [MeSH-major] Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Combined Modality Therapy. Cranial Irradiation. Drug Therapy. Humans. Neurosurgical Procedures. Prognosis. Radiotherapy Dosage. Survival Rate

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 10913379.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] ENGLAND
  • [Number-of-references] 59
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14. Stang A, Rusner C, Eisinger B, Stegmaier C, Kaatsch P: Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries. Int J Androl; 2009 Aug;32(4):306-16
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  • [Title] Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries.
  • Comparisons of incidence estimates of testicular cancer subtypes beyond seminoma and non-seminoma are virtually missing in the epidemiologic literature.
  • We analysed incidence data from population-based German cancer registries to provide subtype-specific incidences of testicular cancer.
  • We pooled data from nine cancer registries from 1998 to 2003.
  • We estimated incidence and mortality time trends of West and East Germany.
  • In 1998-2003, the seminoma incidence rate was 5.1 per 100,000; among non-seminomas, the rates were the highest for malignant teratoma (1.6 per 100,000), followed by embryonal carcinoma (1.2 per 100,000).
  • Testicular lymphomas were rare (0.1 per 100,000).
  • The incidence of testicular cancer among children aged 0-14 years was nearly constant from 1987 through 2004.
  • In East and West Germany, rates of embryonal carcinoma in the early periods were considerably lower than the rates of malignant teratoma.
  • In the most recent periods, rates of embryonal carcinoma became quite similar to the rates of malignant teratoma.
  • The later start of the mortality decline in East Germany may be because of a later introduction of platinum-based chemotherapy compared to West Germany.
  • [MeSH-major] Testicular Neoplasms / epidemiology
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Aged, 80 and over. Carcinoma, Embryonal / epidemiology. Child. Child, Preschool. Choriocarcinoma / epidemiology. Germany / epidemiology. Humans. Incidence. Infant. Infant, Newborn. Male. Middle Aged. Population Surveillance. Registries. Seminoma / epidemiology. Teratoma / epidemiology. Time Factors. Young Adult

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  • (PMID = 18179558.001).
  • [ISSN] 1365-2605
  • [Journal-full-title] International journal of andrology
  • [ISO-abbreviation] Int. J. Androl.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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15. Opot EN, Magoha GA: Testicular cancer at Kenyatta National Hospital, Nairobi. East Afr Med J; 2000 Feb;77(2):80-5
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  • [Title] Testicular cancer at Kenyatta National Hospital, Nairobi.
  • OBJECTIVE: To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital.
  • DESIGN: Retrospective case study of testicular cancer patients over a fifteen year period.
  • PARTICIPANTS: All histologically confirmed testicular cancer patients recorded at the Histopathology Department of Kenyatta National Hospital between 1983 and 1997.
  • Thirty one patients (79.49%) presented with painless testicular swellings, eleven (28.08%) with pain, nine (23.08%) with scrotal heaviness, six (15.38%) with abdominal swellings and one (2.56%) each with gynaecomastia and eye swelling.
  • On examination 32 patients (82.05%) had testicular masses, ten (25.64%) had abdominal masses, seven (17.91%) had supraclavicular and cervical lymphadenopathy, and one each (2.56%) had gynaecomastia and eye mass respectively.
  • More than eighty nine per cent had germ cell cancers with seminoma accounting for 67.35%, teratoma 12.24%, embroyonal carcinoma 8.16%, rhabdomyosarcoma 6.12% and malignant germ cell tumour, orchioblastoma and dysgerminoma each accounted for 2.04%.
  • Three patients (7.7%) had orchidectomy and radiotherapy and chemotherapy, sixteen (41.03%) had orchidectomy and radiotherapy, six (15.38%) had orchidectomy and chemotherapy, ten (25.64%) had radiotherapy and chemotherapy, three (7.7%) and two (5.13%) had only chemotherapy and radiotherapy respectively.
  • No cisplastin based chemotherapy regime was used.
  • Cisplastin based chemotherapy with up to 90% cure rates should be included as a component of testicular cancer management at Kenyatta National Hospital.
  • This retrospective study was undertaken to determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital, Nairobi.
  • All histologically confirmed testicular cancer patients recorded at the Histopathology Department between 1993 and 1997 were analyzed.
  • The clinical symptoms presented were painless testicular swelling (n = 31, 79.49%), testicular pain (n = 11, 28.08%), scrotal heaviness (n = 9, 23.08%), abdominal swelling (n = 6, 15.38%), gynecomastia (n = 1, 2.56%), and eye swelling (n = 1, 2.56%).
  • On examination, 32 patients (82.05%) had testicular masses, 10 (25.64%) had abdominal masses, 7 (17.91%) had supraclavicular and cervical lymphadenopathy, 1 had gynecomastia, and 1 had an orbital mass.
  • More than 89% of patients had germ cell cancers with seminoma accounting for 67.35%, teratoma for 12.24%, embryonal carcinoma for 8.16%, rhabdomyosarcoma for 6.12%, and malignant germ cell tumor, orchioblastoma, and dysgerminoma each accounting for 2.04%.
  • The various methods of treatment include orchidectomy and radiotherapy and chemotherapy in 3 patients (7.7%), orchidectomy and radiotherapy in 16 patients (41.03%), orchidectomy and chemotherapy in 6 patients (15.38%), and radiotherapy and chemotherapy in 10 patients (25.64%).
  • No cisplatin-based chemotherapy was used.
  • Hence, cisplatin-based chemotherapy with up to 90% cure rates should be included in the testicular cancer management in this hospital.
  • [MeSH-major] Testicular Neoplasms / diagnosis. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Child. Child, Preschool. Combined Modality Therapy. Hospitals, Teaching. Humans. Incidence. Kenya / epidemiology. Male. Middle Aged. Orchiectomy. Prognosis. Referral and Consultation. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 10774080.001).
  • [ISSN] 0012-835X
  • [Journal-full-title] East African medical journal
  • [ISO-abbreviation] East Afr Med J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] KENYA
  • [Other-IDs] PIP/ 149564; POP/ 00296083
  • [Keywords] PIP ; Cancer (major topic) / Clinical Research (major topic) / Prevalence (major topic) / Research Report (major topic) / Retrospective Studies (major topic) / Signs And Symptoms (major topic) / Testis (major topic) / Treatment (major topic) / Africa / Africa South Of The Sahara / Biology / Developing Countries / Diseases / Eastern Africa / English Speaking Africa / Genitalia / Genitalia, Male / Kenya / Measurement / Neoplasms / Physiology / Research Methodology / Studies / Urogenital System
  • [General-notes] PIP/ TJ: EAST AFRICAN MEDICAL JOURNAL.
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16. Mann JR, Raafat F, Robinson K, Imeson J, Gornall P, Sokal M, Gray E, McKeever P, Hale J, Bailey S, Oakhill A: The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity. J Clin Oncol; 2000 Nov 15;18(22):3809-18
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  • [Title] The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity.
  • Stage I testicular and some ovarian GCTs were resected and monitored with alpha-fetoprotein (AFP) ("watch-and-wait" approach).
  • Chemotherapy toxicities were assessed using World Health Organization or Brock grading.
  • Eight were excluded because either there was no histologic diagnosis (n = 3) or chemotherapy was given off-study (n = 5).
  • The remaining 184 patients had germinoma (n = 20), malignant teratoma (n = 55), embryonal carcinoma (n = 1), yolk sac tumor (n = 107), or choriocarcinoma (n = 1).
  • The median follow-up after JEB treatment was 53 months (range, 0 to 109 months); the median number of courses was five (range, three to eight).
  • CONCLUSION: Conservative surgery, a watch-and-wait approach after complete excision, and JEB for those requiring chemotherapy produced high cure rates and few serious complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Bleomycin / administration & dosage. Bleomycin / adverse effects. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Chorionic Gonadotropin / blood. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Infant. Infant, Newborn. Male. Prognosis. Survival Analysis. alpha-Fetoproteins / metabolism

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  • (PMID = 11078494.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; JEB protocol
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17. Kusumakumary P, Mathew BS, Hariharan S, Priyakumari T, Rajan B: Testicular germ cell tumors in prepubertal children. Pediatr Hematol Oncol; 2000 Jan-Feb;17(1):105-11
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  • [Title] Testicular germ cell tumors in prepubertal children.
  • Pediatric testicular germ cell tumors are rare.
  • All were staged according to the Pediatric Oncology Group/Children's Cancer Study Group staging system.
  • Histologically, 9 patients had pure endodermal sinus tumor, 1 had endodermal sinus tumor with embryonal carcinoma, 1 had embryonal carcinoma alone, 2 had immature teratoma, and 2 had mature teratoma.
  • All others received chemotherapy with cisplatin, bleomycin, and vinblastine.
  • [MeSH-major] Germinoma. Testicular Neoplasms
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Child, Preschool. Cisplatin / therapeutic use. Humans. Infant. Male. Survival Analysis. Vinblastine / therapeutic use

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  • (PMID = 10689721.001).
  • [ISSN] 0888-0018
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin
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18. Maroto P, García del Muro X, Aparicio J, Paz-Ares L, Arranz JA, Guma J, Terrassa J, Barnadas J, Dorta J, Germà-Lluch JR: Multicentre risk-adapted management for stage I non-seminomatous germ cell tumours. Ann Oncol; 2005 Dec;16(12):1915-20
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  • Other patients (358/589; 61%) were kept on close follow-up (chest X-ray; serum tumour markers: first year every 2 months, second year every 3 months, third year every 4 months; abdominal computed tomography scans at every other outpatient control).
  • In the chemotherapy group, two patients relapsed at 12 and 14.5 months and they are presently free of disease.
  • Five (1.4%) patients died of their cancer.
  • Factors associated with relapse were embryonal carcinoma and vascular invasion in patients who refused chemotherapy.

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  • (PMID = 16126737.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide
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19. van de Geijn GJ, Hersmus R, Looijenga LH: Recent developments in testicular germ cell tumor research. Birth Defects Res C Embryo Today; 2009 Mar;87(1):96-113
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Recent developments in testicular germ cell tumor research.
  • Testicular germ cell tumors of adolescents and adults (TGCTs; the so-called type II variant) are the most frequent malignancies found in Caucasian males between 20 and 40 years of age.
  • TGCTs are divided into seminomas and nonseminomas, the latter consisting of the subgroups embryonal carcinoma, yolk-sac tumor, teratoma, and choriocarcinoma.
  • The pathogenesis starts in utero, involving primordial germ cells/gonocytes that are blocked in their differentiation, and develops via the precursor lesion carcinoma in situ toward invasiveness.
  • Seminoma represents the germ cell lineage, and embryonal carcinoma is the undifferentiated component, being the stem cell population of the nonseminomas.
  • Somatic differentiation is seen in the teratomas (all lineages), whereas yolk-sac tumors and choriocarcinoma represent extra-embryonal differentiation.
  • Seminomas are highly sensitive to irradiation and (DNA damaging) chemotherapy, whereas most nonseminomatous elements are less susceptible to radiation, although still sensitive to chemotherapy, with the exception of teratoma.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Neoplasms, Germ Cell and Embryonal / metabolism. Seminoma / metabolism. Testicular Neoplasms / metabolism

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  • (PMID = 19306344.001).
  • [ISSN] 1542-9768
  • [Journal-full-title] Birth defects research. Part C, Embryo today : reviews
  • [ISO-abbreviation] Birth Defects Res. C Embryo Today
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / MicroRNAs
  • [Number-of-references] 235
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20. Berdjis N, Baldauf A, Kittner T, Manseck A, Wirth M: [Paraneoplastic hyperthyroidism in a patient with metastasizing teratocarcinoma and excessively high HCG]. Aktuelle Urol; 2003 Oct;34(6):407-9
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  • [Title] [Paraneoplastic hyperthyroidism in a patient with metastasizing teratocarcinoma and excessively high HCG].
  • [Transliterated title] Paraneoplastische Hyperthyreose bei metastasiertem Teratokarzinom mit exzessiver HCG-Erhöhung.
  • Clinically manifest hyperthyroidism is a rare paraneoplastic syndrome in patients with excessive HCG production due to testicular cancer.
  • A 40-year-old patient with right testicular cancer (teratoma, embryonal cell carcinoma), diffuse pulmonary metastases and high serum HCG levels presented with symptomatic hyperthyroidism.
  • The patient received immediately thyrostatic therapy and 4 cycles of PEI chemotherapy (Cisplatin, Etoposide, Ifosfamide).
  • Thyroid function had returned to normal by the beginning of the second course of chemotherapy.
  • After right orchiectomy and resection of residual pulmonary masses which revealed vital tumor cells, two additional courses of chemotherapy were performed.
  • The patient is well and without evidence of disease 11 months after therapy.
  • All patients with testicular cancer and excessive HCG production should be evaluated for biochemical and clinical signs of hyperthyroidism and treated accordingly with antithyroidal medication and immediate cytoreductive chemotherapy.
  • [MeSH-major] Chorionic Gonadotropin / blood. Hyperthyroidism / diagnosis. Lung Neoplasms / secondary. Paraneoplastic Syndromes / diagnosis. Teratocarcinoma / secondary. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antithyroid Agents / therapeutic use. Combined Modality Therapy. Humans. Lymphatic Metastasis. Male. Neoadjuvant Therapy. Orchiectomy. Pneumonectomy. Tomography, X-Ray Computed

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  • (PMID = 14579189.001).
  • [ISSN] 0001-7868
  • [Journal-full-title] Aktuelle Urologie
  • [ISO-abbreviation] Aktuelle Urol
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antithyroid Agents; 0 / Chorionic Gonadotropin
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21. Kraggerud SM, Oldenburg J, Alnaes GI, Berg M, Kristensen VN, Fossa SD, Lothe RA: Functional glutathione S-transferase genotypes among testicular germ cell tumor survivors: associations with primary and post-chemotherapy tumor histology. Pharmacogenet Genomics; 2009 Oct;19(10):751-9
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  • [Title] Functional glutathione S-transferase genotypes among testicular germ cell tumor survivors: associations with primary and post-chemotherapy tumor histology.
  • PURPOSE: The pathogenesis of testicular germ cell tumor (TGCT) remains unknown.
  • The aim of this study was to evaluate the pathogenic role of functional polymorphisms in detoxification enzymes among TGCT patients, through association studies of constitutive genotypes and medical parameters before and after chemotherapy.
  • The combined genotype GSTT1positive/GSTP1AA/GSTM1positive was associated with decreased risk of development of pure embryonal carcinoma (P = 0.009, OR: 0.309, 95% CI: 0.122-0.784) and the GSTP1-A-allele (i.e. genotypes GSTP-AA or GSTP-AG) was also associated with decreased risk for development of pure teratoma (P = 0.032, OR: 0.326, 95% CI: 0.122-0.873).
  • The GSTP1-AG genotype was associated with necrosis in the tumor's post-chemotherapy histology (P = 0.001, OR: 16.087, 95% CI: 1.930-134.087).
  • Failure, after platinum-based chemotherapy, was associated with the GSTT1positive/GSTP-AA or GSTP-GG/GSTM1-positive genotype (P = 0.019, OR: 2.168, 95% CI: 1.130-4.160).
  • Combinations of GST genotypes were associated with primary and post-chemotherapy tumor histology, and prognostic group presentation.
  • [MeSH-major] Germinoma / genetics. Glutathione Transferase / genetics. Testicular Neoplasms / drug therapy. Testicular Neoplasms / genetics


22. Beck SD, Foster RS, Bihrle R, Cheng L, Donohue JP: Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors? J Urol; 2005 Oct;174(4 Pt 1):1287-90; discussion 1290
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • MATERIALS AND METHODS: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease.
  • No patient received adjuvant chemotherapy and minimal followup was 24 months.
  • Embryonal cell carcinoma was identified in 92 of 118 (77%) surgical specimens, which was significantly greater than the presence of teratoma (22%), seminoma (16%) and yolk sac (14.4%, p < or = 0.001) with no difference in 5-year DFS comparing the presence or absence of each histology.
  • Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73%), with the incidence of seminoma, teratoma and yolk sac being 12.5%, 9.0% and 5.5%, respectively (p < or = 0.001).
  • Recurrence rates were similar for pure embryonal cell carcinoma (69%), mixed embryonal cell carcinoma (63%) and no embryonal cell carcinoma (73%) in the retroperitoneum (p=0.63).
  • [MeSH-major] Lymph Node Excision. Lymphatic Metastasis. Neoplasm Recurrence, Local / pathology. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Carcinoma, Embryonal / pathology. Humans. Male. Prognosis. Retrospective Studies. Seminoma / pathology. Teratoma / pathology

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  • (PMID = 16145394.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Porcaro AB, Antoniolli SZ, Martignoni G, Brunelli M, Curti P: Adult primary teratoma of the testis--report on 5 cases in clinical stage I disease. Int Urol Nephrol; 2001;33(4):657-9
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  • [Title] Adult primary teratoma of the testis--report on 5 cases in clinical stage I disease.
  • OBJECTIVES: Testis pure teratoma accounts for 2.7% to 3% of all germ cell tumors in adult where it behaves as a malignant neoplasm.
  • Pure teratoma of the testis presents in clinical stage I disease in 44% of the patients whose risk of having pathological stage II disease is 16.7% to 19.2%.
  • Herein we report on 5 cases of adult pure teratoma of the testis presenting itself in clinical stage I disease.
  • MATERIALS AND METHODS: From September 1976 to February 2000, 75 patients underwent orchidectomy for clinical stage I nonseminomatous germ cell cancer of the testis.
  • Testis pure teratoma was detected in 5 patients (7%).
  • Testis tumor markers were evaluated in all cases.
  • Treatment options after orchidectomy included retroperitoneal lymph node dissection (RPLND) in 4 patients and surveillance in 1.
  • Histopathology detected the following subtypes: mature teratoma in 3 cases (60%), immature teratoma in 1 (20%) and teratoma with malignant transformation in (20%).
  • Germ cell cancer microscopic metastatic disease including embryonal carcinoma was detected in I dissected lymph node of 1/4 patients (25%).
  • CONCLUSIONS: Primary pure teratoma of the testis does not respond to chemotherapy nor does it to radiation therapy.
  • The disease treatment options after orchidectomy for patients with clinical stage I disease include RPLND or surveillance with their relative risks and benefits.
  • RPLND is the chosen treatment because it is both staging and treating.
  • A close a long term follow up is required since pure teratoma metastatic disease may clinically develop after more than 10 years.
  • [MeSH-major] Orchiectomy. Teratoma / surgery. Testicular Neoplasms / surgery

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  • (PMID = 12452623.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
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24. Roeleveld TA, Horenblas S, Meinhardt W, van de Vijver M, Kooi M, ten Bokkel Huinink WW: Surveillance can be the standard of care for stage I nonseminomatous testicular tumors and even high risk patients. J Urol; 2001 Dec;166(6):2166-70
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  • [Title] Surveillance can be the standard of care for stage I nonseminomatous testicular tumors and even high risk patients.
  • Patients with relapse were treated with cisplatin based chemotherapy.
  • Computerized tomography located all but 1 relapse.
  • Vascular invasion (p = 0.0001), tumor size (p = 0.0341) and presence of immature teratoma (p = 0.0154) were significantly predictive of relapse with the multivariate analysis, percentage embryonal carcinoma only by univariate analysis (p = 0.032).
  • CONCLUSIONS: With surveillance for stage I nonseminomatous germ cell tumors, excellent treatment results can be achieved that are comparable to primary retroperitoneal lymph node dissection.
  • Tumor markers and computerized tomography are highly reliable for detecting relapse.
  • Pathological factors may influence the choice of adjuvant treatment.
  • However, relapse risks of 50% to 60% are maximally achieved with presently available prognostic factors, and so sparing morbidity of adjuvant treatment by a surveillance protocol remains a feasible option even in these patients.
  • [MeSH-major] Germinoma / pathology. Testicular Neoplasms / pathology

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  • (PMID = 11696728.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Guney S, Guney N, Sonmez NC, Ergenekon E: Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis. Med Oncol; 2009;26(2):136-42
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  • [Title] Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis.
  • Testis cancer is the most common cancer in young men and its incidence continues to rise.
  • We aimed to evaluate whether two courses of chemotherapy after orchiectomy in patients with clinical stage I, non-seminomatous germ cell testicular tumour at high risk of relapse, will spare patients additional chemotherapy or surgery.
  • High-risk patients had one or more of the following: preorchiectomy alpha-fetoprotein level of 80 ng/dl, 80% embryonal cell carcinoma or greater, vessel invasion in the primary tumour and tumour stage pT2 or greater.
  • Low-risk patients had none of these factors or had 50% teratoma or more without vessel invasion.
  • High-risk patients were offered two 21-day courses of outpatient chemotherapy consisting cisplatin, etoposide and bleomycin (BEP).
  • All of the high-risk patients received two courses of BEP chemotherapy.
  • Of the 71 patients in high-risk group, 3 relapsed with viable cancer and required additional chemotherapy and 1 patient with normal biomarkers and a late-appearing mass underwent retroperitoneal lympadenectomy for mature teratoma.
  • None of the 37 patients at low risk of recurrences developed relapse.
  • We recommend two courses of adjuvant chemotherapy after postorchiectomy for high-risk patients with stage I non-seminomatous germ cell tumour of the testis.
  • Adjuvant chemotherapy for these patients results in a low relapse and morbidity, wich compares favourably with the results of surveillance or RPLND.
  • This well-tolerated approach may spare patients additional surgery or protracted chemotherapy, reduce the cost and eliminate the compliance problems associated with intensive follow up of high-risk patients.
  • [MeSH-major] Germinoma / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Combined Modality Therapy. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local / prevention & control. Orchiectomy. Risk Factors. Young Adult

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  • (PMID = 18821067.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Williams SB, Steele GS, Richie JP: Primary retroperitoneal lymph node dissection in patients with clinical stage IS testis cancer. J Urol; 2009 Dec;182(6):2716-20
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  • [Title] Primary retroperitoneal lymph node dissection in patients with clinical stage IS testis cancer.
  • PURPOSE: Initial management for clinical stage IS (persistently increased tumor markers) nonseminomatous germ cell tumor has evolved from primary retroperitoneal lymph node dissection to induction chemotherapy at most medical centers.
  • MATERIALS AND METHODS: We reviewed the charts of patients who underwent retroperitoneal lymph node dissection at Brigham and Women's Hospital, and Dana Farber Cancer Center from 1993 to 2008.
  • Histopathology revealed an embryonal carcinoma component in 24 orchiectomy specimens (100%) with associated teratoma in 15 (63%).
  • Positive lymph nodes were identified at retroperitoneal lymph node dissection in 9 patients (38%), including pure embryonal carcinoma in 6 (67%), combined embryonal carcinoma and teratoma in 1, embryonal carcinoma, choriocarcinoma and teratoma in 1, and only teratoma in 1.
  • Of the patients who underwent primary retroperitoneal lymph node dissection 5 (21%) also received chemotherapy postoperatively, which was due to persistently increased tumor markers in 3 (13%).
  • At surgery estimated blood loss was 175 cc, operative time was 3.1 hours and hospital stay was 3.9 days.
  • CONCLUSIONS: Patients with clinical stage IS are at significant risk for metastatic disease and can be successfully treated with primary retroperitoneal lymph node dissection, thereby sparing chemotherapy in most of them.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery

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  • [CommentIn] J Urol. 2009 Dec;182(6):2720 [19836765.001]
  • (PMID = 19836777.001).
  • [ISSN] 1527-3792
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Berney DM, Shamash J, Gaffney J, Jordan S, Oliver RT: DNA topoisomerase I and II expression in drug resistant germ cell tumours. Br J Cancer; 2002 Sep 9;87(6):624-9
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  • [Title] DNA topoisomerase I and II expression in drug resistant germ cell tumours.
  • A small number of testicular germ cell tumours are refractory to current chemotherapy regimens.
  • DNA topoisomerase I is the target for several new drugs and a potential candidate treatment for chemorefractory germ cell tumours.
  • DNA topoisomerase II alpha is the target for etoposide, which is currently used regularly in germ cell tumour treatment.
  • The expression of DNA topoisomerase I and II alpha were therefore assessed immunohistochemically in a range of testicular tumours, especially those with persistent malignant elements on retroperitoneal lymph node dissection.
  • Pre-chemotherapy orchidectomy specimens were matched with post-chemotherapy retroperitoneal lymph node dissections to examine changes in expression.
  • There was considerable variation in the expression of topoisomerase I in different tumour types.
  • Both yolk sac tumours and teratoma, mature showed universal expression of topoisomerase I, while 38% of seminomas and 30% of embryonal carcinomas were positive.
  • Strong topoisomerase II alpha expression was found in embryonal carcinoma.
  • There was a negative correlation between topoisomerase I and II alpha expression (P=0.004) and downregulation of topoisomerase II alpha after chemotherapy (P=0.02).
  • Topoisomerase I expression appears to increase in those cases with residual teratoma, mature, but is largely unchanged in those cases remaining as embryonal carcinoma.
  • These results suggest that topoisomerase I inhibitors may be useful in chemorefractory germ cell tumours, especially yolk sac tumours and where there are unresectable residual teratoma, mature deposits.
  • [MeSH-major] Carcinoma, Embryonal / metabolism. DNA Topoisomerases, Type I / metabolism. DNA Topoisomerases, Type II / metabolism. Drug Resistance, Neoplasm. Seminoma / metabolism. Teratoma / metabolism. Testicular Neoplasms / metabolism
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Cisplatin / administration & dosage. Down-Regulation. Etoposide / administration & dosage. Humans. Immunoenzyme Techniques. Ki-67 Antigen / metabolism. Male. Testis / chemistry. Testis / pathology

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  • (PMID = 12237772.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 6PLQ3CP4P3 / Etoposide; EC 5.99.1.2 / DNA Topoisomerases, Type I; EC 5.99.1.3 / DNA Topoisomerases, Type II; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2364243
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28. Basu S, Rubello D: PET imaging in the management of tumors of testis and ovary: current thinking and future directions. Minerva Endocrinol; 2008 Sep;33(3):229-56
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] PET imaging in the management of tumors of testis and ovary: current thinking and future directions.
  • The role of fluoro-D-deoxyglucose positron-emission tomography (FDG-PET) in testicular malignancies has been examined in various studies primarily in three specific settings:.
  • 1) differentiation of active disease from fibrosis/mature teratoma in patients with residual mass following chemotherapy and evaluation of the response to treatment;.
  • 2) initial staging and disease assessment after orchidectomy identification of suspected recurrences in the context of elevated circulating serum markers; and 3) predicting response to treatment.
  • Of these, the area where FDG-PET imaging has been examined the most in testicular tumors is the evaluation of postchemotherapy residual mass in both seminoma and nonseminomatous germ cell tumors (NSGCT) of the testis, a critical step in determining the subsequent management approach of these tumors that vary amongst various centers.
  • From the available data, this should be the test of choice for the assessment of a computed tomography (CT)-visualized residual mass following chemotherapy.
  • In patients with residual masses or raised marker levels following therapy, positron-emission tomography (PET) appears sensitive and specific for detecting recurrent disease, at suspected and unsuspected sites.
  • With regard to its role in ovarian carcinoma, it appears to be particularly useful for the diagnosis of recurrence when CA125 levels are rising and conventional imaging is inconclusive or negative.
  • The role of fluoro-D-deoxyglucose (FDG)-PET/CT for the detection of recurrent ovarian cancer appears very promising and has the potential to replace the current surveillance techniques in detecting recurrent disease.
  • [MeSH-major] Ovarian Neoplasms / radionuclide imaging. Positron-Emission Tomography. Testicular Neoplasms / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Cost-Benefit Analysis. Female. Follow-Up Studies. Forecasting. Humans. Lymphoma, Non-Hodgkin / radionuclide imaging. Lymphoma, Non-Hodgkin / therapy. Male. Middle Aged. Neoplasm Staging / methods. Neoplasms, Germ Cell and Embryonal / radionuclide imaging. Neoplasms, Germ Cell and Embryonal / therapy. Paraneoplastic Cerebellar Degeneration / radionuclide imaging. Prognosis. Prospective Studies. Radiopharmaceuticals. Retrospective Studies

  • MedlinePlus Health Information. consumer health - Ovarian Cancer.
  • MedlinePlus Health Information. consumer health - Testicular Cancer.
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  • (PMID = 18846028.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Radiopharmaceuticals
  • [Number-of-references] 83
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