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1. Watanabe M, Kamai T, Masuda A, Huruya N, Yonezawa T, Niakanishi K, Kambara T, Tsujii T, Yoshida K: [A case report: testicular pure seminoma metastasized to costal bone after 2 years post-operatively]. Hinyokika Kiyo; 2004 Jul;50(7):505-9
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  • [Title] [A case report: testicular pure seminoma metastasized to costal bone after 2 years post-operatively].
  • A 32-year-old man underwent orchiectomy for his right testicular tumor (pure seminoma, pT1, stage A(I)).
  • Pelvic and para-aortic lymph nodes were irradiated with 18 Gy as adjuvant therapy.
  • Two years later, he developed low back pain.
  • Computed tomography, magnetic resonance imaging and bone scans showed an enhanced mass at the 10th left costa.
  • Aspiration cytology showed seminoma.
  • After administration of chemotherapy with bleomycin, etoposide and cisplatinum, following high dose chemotherapy with peripheral blood stem cell transplantation, the costal lesion was diminished and symptoms relieved.
  • A histopathological study showed non-viable cells of seminoma.
  • Testicular pure seminoma with bone metastasis is rare, and to our knowledge, only 9 cases have been reported.
  • [MeSH-major] Bone Neoplasms / secondary. Orchiectomy. Ribs. Seminoma / secondary. Testicular Neoplasms / pathology

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  • (PMID = 15334898.001).
  • [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; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] K2I13DR72L / Gadolinium DTPA
  • [Number-of-references] 29
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2. Loriot Y, Fizazi K: [Management of clinical stage I testicular germ cell tumours]. Bull Cancer; 2007 May;94(5):439-48
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  • [Title] [Management of clinical stage I testicular germ cell tumours].
  • [Transliterated title] Prise en charge actuelle des tumeurs germinales du testicule de stade I.
  • Testicular germ-cell cancer is the most frequent malignancy in young men.
  • Orchidectomy is the initial therapeutic intervention.
  • In case of a pure seminoma, three treatment options should be discussed after surgery : radiotherapy with a limited dose and volume, surveillance, and chemotherapy by single-agent carboplatin.
  • In non-seminomatous germ cell tumour three options should also be considered : surveillance, chemotherapy (two cycles of the BEP regimen) or retroperitoneal lymph node dissection.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery
  • [MeSH-minor] Functional Laterality. Humans. Male. Neoplasm Staging. Orchiectomy. Radiotherapy Dosage. Seminoma / pathology. Seminoma / radiotherapy. Seminoma / surgery

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  • (PMID = 17535781.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 68
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3. Nolan L, Wheater M, Kirby J, Simmonds P, Mead G: Late relapse (>2 years) on surveillance in stage I non-seminomatous germ cell tumours; predominant seminoma only histology. BJU Int; 2010 Dec;106(11):1648-51
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  • [Title] Late relapse (>2 years) on surveillance in stage I non-seminomatous germ cell tumours; predominant seminoma only histology.
  • OBJECTIVES: Surveillance is a standard management approach following orchidectomy for stage I non-seminomatous and mixed germ cell tumours.
  • Patients who relapse following this approach are treated with cisplatin-based chemotherapy, with retroperitoneal lymph node dissection considered for patients with post-chemotherapy residual masses.
  • RESULTS: Between 1989 and 2008, 453 patients with a median age of 30 years were entered into our surveillance program for stage I non-seminomatous germ cell tumours (NSGCTs) after orchidectomy alone.
  • We found a high incidence of pure seminoma (56%) at sites of metastatic disease in this group.
  • In those with pure seminoma retroperitoneal lymph node dissection for post chemotherapy residual masses can be avoided.
  • [MeSH-major] Neoplasm Recurrence, Local / pathology. Neoplasms, Germ Cell and Embryonal / pathology. Orchiectomy. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Biopsy. Cisplatin / therapeutic use. Combined Modality Therapy. Disease-Free Survival. Humans. Lymph Node Excision. Male. Middle Aged. Watchful Waiting. alpha-Fetoproteins / metabolism

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  • [Copyright] © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
  • (PMID = 20735393.001).
  • [ISSN] 1464-410X
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / alpha-Fetoproteins; Q20Q21Q62J / Cisplatin
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4. Bauduceau O, Souleau B, Le-Moulec S, Houlgatte A, Bernard O: [Radiotherapy in stage I testicular seminoma: retrospective study and review of literature]. Cancer Radiother; 2003 Dec;7(6):386-94
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  • [Title] [Radiotherapy in stage I testicular seminoma: retrospective study and review of literature].
  • [Transliterated title] Radiothérapie des séminomes testiculaires de stade I : étude rétrospective et revue de la littérature.
  • INTRODUCTION: Seminoma accounts for about 40% of germ cell tumours of the testicle.
  • In this retrospective analysis, we review literature concerning management of stage I seminoma.
  • MATERIALS AND METHODS: Between March 1987 and April 2001, 65 patients with stage I pure testicular seminoma received adjuvant radiotherapy with a 25 MV linear accelerator.
  • Testicular tumour has been found on the right testis in 39 patients and on the left one in 24 patients.
  • Patients have been treated using an anterior-posterior parallel pair and have received 20-25 Gy in 10-14 fractions.
  • Median follow-up time was 37 months.
  • DISCUSSION: Because of good radio-sensitivity of seminoma, radiotherapy is regarded as standard adjuvant treatment (5 years relapse rate: 3-5%).
  • Secondary neoplasia represents one of the worst possible long-term complications of therapy.
  • Waiting for ongoing randomised trials, the modern literature for seminoma reflects a trend toward lower radiation doses (20-25 Gy) and smaller treatment volumes (paraaortic field).
  • Adjuvant chemotherapy with two courses of carboplatin, might be equivalent to radiotherapy but must be investigated in randomised trials.
  • [MeSH-major] Seminoma / radiotherapy. Testicular Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Carboplatin / administration & dosage. Carboplatin / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Dose Fractionation. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Orchiectomy. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Testis / pathology. Time Factors

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  • (PMID = 14725912.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
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5. Yee D, Gabos Z, North S, Moore RB: Malignant spinal cord compression secondary to testicular seminoma at the time of initial presentation and at relapse while on surveillance. Can Urol Assoc J; 2007 Mar;1(1):59-63

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  • [Title] Malignant spinal cord compression secondary to testicular seminoma at the time of initial presentation and at relapse while on surveillance.
  • We report cases of 2 pure seminoma patients who developed metastatic spinal cord compressions.
  • One patient was diagnosed at age 33 years with stage 1 seminoma and, after undergoing an orchidectomy, chose to be followed on a surveillance protocol.
  • He was treated with urgent surgical decompression and subsequent standard chemotherapy.
  • On physical examination, the patient was found to have a 6-cm left testicular mass.
  • Pathology confirmed a pure classic seminoma.
  • Postoperatively, he received standard chemotherapy and eventually regained neurologic function in his legs.
  • Although it is rare for malignant spinal cord compression to occur in seminoma patients-either as the initial presentation of disease or as a site of disease recurrence in stage 1 patients on surveillance-it is crucial to consider seminoma as a possible etiology in young men diagnosed with malignant spinal cord compression because timely contemporary treatments for seminoma will cure most of these patients and offer them excellent functional recovery.

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  • (PMID = 18542765.001).
  • [ISSN] 1911-6470
  • [Journal-full-title] Canadian Urological Association journal = Journal de l'Association des urologues du Canada
  • [ISO-abbreviation] Can Urol Assoc J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
  • [Other-IDs] NLM/ PMC2422929
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6. Porcaro AB, Antoniolli SZ, Schiavone D, Maffei N, Bassetto MA, Curti P: Management of clinical stage I testicular pure seminoma. Report on 42 patients and review of the literature. Arch Ital Urol Androl; 2002 Jun;74(2):77-80
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  • [Title] Management of clinical stage I testicular pure seminoma. Report on 42 patients and review of the literature.
  • About 20-30% of patients presenting with clinical stage I pure seminoma of the testis, which accounts for 45-50% of all germ cell tumors, present with occult metastases in the retroperitoneal lymph nodes.
  • Currently, treatment options for clinical stage I seminoma include adjuvant radiotherapy (RT) as well as surveillance and adjuvant single agent chemotherapy.
  • Herein, we review our experience in the management of 42 patients with clinical stage I pure seminoma of the testis and review the literature concerning this topic.
  • MATERIALS AND METHODS: Between January 1977 and December 2000, of 56 patients with pure seminoma of the testis 42 (75%) were assessed as clinical stage I disease.
  • A radiation dose of 25 Gy in 20 daily fractions was given.
  • Histopathology assessed classic seminoma in 41 cases (98%) and spermatocytic seminoma in 1 (2%).
  • CONCLUSIONS: Adjuvant radiotherapy (RT) is a safe standard of care in controlling microscopic retroperitoneal disease in patients with clinical stage I seminoma.
  • An alternative optional treatment for compliant patients presenting with low risk factors for relapse is surveillance with recurrences rates ranging between 15% to 20%.
  • Surveillance avoids unnecessary treatment in about 80% of patients, thus it could be offered as a safe alternative option to adjuvant RT since imaging detects relapses at their early stages.
  • Adjuvant chemotherapy with 1 or 2 courses of single-agent carboplatin is being investigated as an alternative adjuvant treatment to RT or surveillance in patients with moderate to high risk factors for relapse.
  • The treatment is well tolerated and recurrence rate is 1%.

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  • (PMID = 12161941.001).
  • [ISSN] 1124-3562
  • [Journal-full-title] Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
  • [ISO-abbreviation] Arch Ital Urol Androl
  • [Language] ENG
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
  • [Number-of-references] 71
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7. Pectasides D, Nikolaou M, Pectasides E, Koumarianou A, Valavanis C, Economopoulos T: Complete response after imatinib mesylate administration in a patient with chemoresistant stage IV seminoma. Anticancer Res; 2008 Jul-Aug;28(4C):2317-20
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  • [Title] Complete response after imatinib mesylate administration in a patient with chemoresistant stage IV seminoma.
  • The case of a young man with stage IV chemoresistant pure seminoma overexpressing KIT, who achieved complete remission (CR) after the administration of imatinib mesylate (400 mg once daily), along with a third-line chemotherapy regimen, consisting of paclitaxel (150 mg/m2), oxaliplatin (100 mg/m2) and gemcitabine (800 mg/m2) every 2 weeks with granulocyte colony-stimulating factor (G-CSF) support is reported.
  • Following treatment with imatinib plus third-line chemotherapy (paclitaxel, oxaliplatin, gemcitabine), the levels of beta-HCG were reduced to within the normal limits during the first month of treatment.
  • Therefore, the patient underwent surgical resection of the residual disease from the retroperitoneum and liver, which proved to be only necrotic tissue.
  • The patient is under close follow-up, with no evidence of disease, 36 months after the completion of chemotherapy and 32 months post surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Benzamides. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Ifosfamide / administration & dosage. Imatinib Mesylate. Male. Organoplatinum Compounds / administration & dosage. Paclitaxel / administration & dosage. Piperazines / administration & dosage. Pyrimidines / administration & dosage

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  • (PMID = 18751412.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Benzamides; 0 / Organoplatinum Compounds; 0 / Piperazines; 0 / Pyrimidines; 04ZR38536J / oxaliplatin; 0W860991D6 / Deoxycytidine; 11056-06-7 / Bleomycin; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 8A1O1M485B / Imatinib Mesylate; 8N3DW7272P / Cyclophosphamide; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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8. Salazar Soler R, Maroto Rey P, Solà Rocabert C, López López JJ: [Rescue chemotherapy in testicular germ cell tumors]. Arch Esp Urol; 2000 Jul-Aug;53(6):554-64
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  • [Title] [Rescue chemotherapy in testicular germ cell tumors].
  • [Transliterated title] Quimioterapia de rescate en tumores de células germinales testiculares.
  • OBJECTIVE: To review the different salvage chemotherapy regimens according to the prognostic factors based on the response to the different therapeutic alternatives.
  • METHODS: The conventional rescue chemotherapy regimens, as well as the role of surgery, new drugs and therapeutic modalities, particularly high dose second and third line chemotherapy, were reviewed.
  • RESULTS/CONCLUSIONS: Germ cell testicular tumor is the paradigm of curable tumors of the adult.
  • Whereas the cure rate for stage I tumors is higher than 98%, patients with advanced stage tumors have a lower cure rate.
  • Approximately 10% of the patients with good-prognosis factors and 30%-50% of those with poor-prognosis factors show tumor progression or recurrence after first line chemotherapy using cisplatin-based combinations.
  • Patients who have recurrence after first line chemotherapy have a 40% probability of achieving second complete remission with second line chemotherapy, but will be sustained in only 20% of the patients, although rare cases of advanced pure seminoma that recurred have shown a cure rate of 55% with second line chemotherapy.
  • New strategies have been developed using new drugs such as taxanes or high doses of well-known chemotherapeutic agents with autologous hematopoietic rescue that have been utilized with success in patients with refractory germ cell testicular tumors.
  • A global analysis of the patients treated with third line chemotherapy shows a sustained complete remission rate of 22%.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Germinoma / drug therapy. Testicular Neoplasms / drug therapy

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  • (PMID = 11002524.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] SPAIN
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 88
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9. Giannis M, Aristotelis B, Vassiliki K, Ioannis A, Konstantinos S, Nikolaos A, Georgios P, Georgios P, Pantelis P, Meletios-Athanasios D: Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions. J Cancer Res Clin Oncol; 2009 Nov;135(11):1495-500
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  • [Title] Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions.
  • INTRODUCTION: We evaluated an intensified therapeutic strategy in order to optimize treatment outcomes while maintaining acceptable toxicity in patients with advanced seminoma.
  • PATIENTS AND METHODS: Fifty-two patients with advanced pure seminoma were retrospectively evaluated.
  • Patients with low-risk advanced seminoma, according to the International Germ Cell Cancer Collaborative Group Consensus Classification criteria, had received four cycles of the BEP regimen either in the 5-day or the alternative 3-day schedule, while patients with intermediate-risk advanced seminoma had received four cycles of the IBEP regimen.
  • RESULTS: Forty-two patients (80.7%) had testicular seminoma while ten patients (19.3%) presented with primary extragonadal (mediastinal or retroperitoneal) tumor.
  • Treatment-related toxicity was moderate, with febrile neutropenia being the most prevalent (13.5%).
  • Twenty patients (38.5%) achieved a complete response to chemotherapy.
  • After 69 months of follow-up there were three recurrences that were successfully treated with high-dose or salvage chemotherapy.
  • CONCLUSIONS: Intensified cisplatin-based chemotherapy for patients with advanced seminoma does not confer evidence of superiority over radiotherapy alone or the standard BEP regimen.
  • Patients with low-volume abdominal disease (clinical stage IIA and IIB) can be cured by four cycles of BEP instead of radiotherapy at the cost of a substantial increase in chemotherapy exposure and the resulting toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / therapeutic use. Etoposide / therapeutic use. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Retrospective Studies

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  • (PMID = 19437039.001).
  • [ISSN] 1432-1335
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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10. Bjurlin MA, August CZ, Weldon-Linne M, Totonchi E: Histologically pure stage I seminoma with an elevated beta-hCG of 4497 IU/l. Urology; 2007 Nov;70(5):1007.e13-5
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  • [Title] Histologically pure stage I seminoma with an elevated beta-hCG of 4497 IU/l.
  • Approximately 30% of patients with pure seminoma of the testis have mild elevation of human chorionic gonadotropin (hCG) due to the presence of syncytiotrophoblastic giant cells.
  • We report a case of a man with a stage I histologically pure seminoma, copious syncytiotrophoblast cells, and a serum beta human chorionic gonadotropin (beta-hCG) of 4497 IU/L.
  • To our knowledge this is the third highest value of beta-hCG reported with a stage I pure seminoma.
  • The patient underwent an orchiectomy and chemotherapy.
  • [MeSH-major] Chorionic Gonadotropin, beta Subunit, Human / blood. Seminoma / blood. Seminoma / pathology. Testicular Neoplasms / blood. Testicular Neoplasms / pathology

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  • (PMID = 18068467.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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11. Garcia-del-Muro X, Maroto P, Gumà J, Sastre J, López Brea M, Arranz JA, Lainez N, Soto de Prado D, Aparicio J, Piulats JM, Pérez X, Germá-Lluch JR: Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study. J Clin Oncol; 2008 Nov 20;26(33):5416-21
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish Germ Cell Cancer Group Study.
  • PURPOSE: To assess the long-term efficacy and toxicity of front-line cisplatin-based chemotherapy in patients with stage IIA or IIB testicular seminoma.
  • PATIENTS AND METHODS: Untreated patients with pure seminoma of the testis after orchiectomy, with clinical stage IIA or IIB, were considered eligible for this prospective observational study.
  • Chemotherapy consisted of either four cycles of cisplatin and etoposide or three cycles of cisplatin, etoposide, and bleomycin.
  • Eighteen patients had stage IIA disease, and 54 patients had stage IIB disease.
  • After a median follow-up time of 71.5 months, six patients with stage IIB disease experienced relapse, and one of these patients died as a result of seminoma.
  • Three patients experienced non-seminoma-related deaths (two died from a further esophageal carcinoma, and one died from an upper digestive hemorrhage).
  • The estimated 5-year progression-free survival rates for patients with stage IIA or IIB disease were 100% and 87% (95% CI, 77.5% to 97%), respectively.
  • CONCLUSION: Chemotherapy is a highly effective and well-tolerated treatment for patients with stage IIA or IIB seminoma and represents an available alternative that could avoid some of the serious late effects associated with radiotherapy.
  • Further studies focusing on long-term toxicities of different treatment modalities are needed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Male. Middle Aged. Survival Rate. Young Adult

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  • [CommentIn] J Clin Oncol. 2009 Apr 20;27(12):2101-2; author reply 2102-3 [19289608.001]
  • (PMID = 18936476.001).
  • [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] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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12. Kantzavelos L, Klein EA, Dreicer R: Paracolic recurrence of stage I seminoma. Urology; 2003 Jul;62(1):145
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  • [Title] Paracolic recurrence of stage I seminoma.
  • Paracolic recurrence of testicular germ cell tumors is rare and is usually related to incomplete excision of the ipsilateral spermatic cord.
  • We describe a paracolic recurrence outside of the standard radiation field of a low-stage pure seminoma that was managed by chemotherapy and surgical excision, rendering the patient disease free with short-term follow-up.
  • [MeSH-major] Pelvic Neoplasms / secondary. Seminoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Combined Modality Therapy. Humans. Lymphatic Metastasis. Male. Neoplasm Recurrence, Local. Orchiectomy. Radiotherapy, Adjuvant

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  • (PMID = 12837454.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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13. Lo KC, Wong C, Emond J, Aprikian AG: Scrotal orchiectomy for a large testicular seminoma. Can J Urol; 2001 Apr;8(2):1234-6
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  • [Title] Scrotal orchiectomy for a large testicular seminoma.
  • Our patient had neglected a growing left testicular mass over a 5-year period.
  • Pathology showed a 1.6 kg pure classic seminoma.
  • Metastatic work up revealed stage IIC disease and he was treated with primary cisplatin-based chemotherapy and remains free of recurrence after 24 months.
  • [MeSH-major] Orchiectomy / methods. Seminoma / surgery. Testicular Neoplasms / surgery

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  • (PMID = 11375787.001).
  • [ISSN] 1195-9479
  • [Journal-full-title] The Canadian journal of urology
  • [ISO-abbreviation] Can J Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Canada
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14. Palese MA, Su LM, Kavoussi LR: Laparoscopic retroperitoneal lymph node dissection after chemotherapy. Urology; 2002 Jul;60(1):130-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic retroperitoneal lymph node dissection after chemotherapy.
  • OBJECTIVES: To assess the operative feasibility, clinical outcomes, and complications of laparoscopic retroperitoneal lymphadenectomy (RPLND) after chemotherapy.
  • METHODS: A retrospective review of clinical records from 7 patients who underwent laparoscopic RPLND after chemotherapy was performed.
  • One patient was diagnosed with pure seminoma and one with epididymal small cell cancer.
  • All 7 patients received multiagent chemotherapy for clinical Stage IIA or higher disease, followed by laparoscopic RPLND for findings of a residual retroperitoneal mass on computed tomography or a prechemotherapy mass size greater than 3.0 cm.
  • The mean tumor diameter was 3.07 cm before chemotherapy and 1.91 cm after chemotherapy.
  • Of the 5 patients who presented with nonseminomatous germ cell tumor after orchiectomy, 3 were found to have retroperitoneal lymph nodes consistent with mature teratoma, 1 had necrotic tissue, and 1 had residual viable tumor.
  • CONCLUSIONS: Laparoscopic RPLND is a feasible operation in patients after systemic chemotherapy.
  • This technique remains challenging at this time and should be reserved for patients with limited residual disease and should only be performed at institutions with considerable laparoscopic expertise.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymph Node Excision / methods. Retroperitoneal Neoplasms / secondary. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Biomarkers, Tumor. Feasibility Studies. Humans. Laparoscopy / adverse effects. Laparoscopy / methods. Lymphatic Metastasis. Male. Middle Aged. Retrospective Studies. Seminoma / diagnosis. Seminoma / drug therapy

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  • (PMID = 12100938.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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15. Kawasaki M, Satoh Y, Nakashima K, Nishimura K, Kaneko A, Udoh K, Fujiyama C, Uozumi J: [Metachronous testicular seminoma with an interval of 14 years from the first nonseminomatous testicular tumor: a case report]. Nihon Hinyokika Gakkai Zasshi; 2009 Jan;100(1):16-21
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  • [Title] [Metachronous testicular seminoma with an interval of 14 years from the first nonseminomatous testicular tumor: a case report].
  • He had a past history of left testicular nonseminomatous germ cell tumor (NSGCT), stage IIB 14 years ago.
  • He had undergone chemotherapy with 3 courses of PEP and retroperitoneal lymphnode dissection revealing pathological CR.
  • He was diagnosed as having right testicular tumor.
  • Imaging studies and pathological studies revealed pure seminoma with spermatic cord invasion, stage I, pT3N0M0.
  • He underwent chemotherapy with 3 courses of VIP.
  • Herein we present a case of metachronous bilateral testicular germ cell tumor with a review of literatures.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Second Primary. Seminoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Male. Neoplasm Staging. Time Factors

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  • (PMID = 19198225.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 27
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16. Porcaro AB, Antoniolli SZ, Maffei N, Beltrami P, Bassetto MA, Curti P: Management of testicular seminoma advanced disease. Report on 14 cases and review of the literature. Arch Ital Urol Androl; 2002 Jun;74(2):81-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of testicular seminoma advanced disease. Report on 14 cases and review of the literature.
  • INTRODUCTION: About 25% of testicular seminomas present with advanced clinical stage disease.
  • Herein we review our experience in the management of 14 patients with clinical stage II pure seminoma of the testis and review the literature concerning this subject.
  • MATERIALS AND METHODS: Between January 1977 and December 2000, of 56 patients with pure seminoma of the testis 14 (25%) were assessed as clinical stage II disease.
  • RT was performed for clinical substage IIA-IIB and chemotherapy in for IIC disease.
  • Clinical stage IIA-IIB was detected in 12 patients (86%) and IIC in 2 (14%).
  • CONCLUSIONS: Radiation therapy is the standard of care in managing seminoma small bulk retroperitoneal disease including substages IIA and IIB.
  • Overall toxicity of RT is mild and treatment is well tolerated.
  • Chemotherapy is the choice treatment for advanced seminoma presenting with clinical stage IIC-III disease; recently, it has also been advocated for stage IIB when presenting with multiple small lymph nodes.
  • Patients developing progressive disease after first-line chemotherapy undergo combined salvage chemotherapy with cisplatin, ifosfamide and vinblastine with complete response rate of 83%.
  • Patients presenting salvage chemotherapy failure are treated with high-dose chemotherapy associated with autologous bone marrow transplantation.
  • Residual retroperitoneal masses after chemotherapy for advanced seminoma may be assessed by imaging as poorly or well defined.
  • Ongoing clinical trials for testicular germ cell metastatic disease are focused on reducing toxicity without compromising efficacy as well as exploring new salvage strategies and improving the prospect of cures and survival rates.

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  • (PMID = 12161942.001).
  • [ISSN] 1124-3562
  • [Journal-full-title] Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
  • [ISO-abbreviation] Arch Ital Urol Androl
  • [Language] ENG
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 85
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17. Quek ML, Simma-Chiang V, Stein JP, Pinski J, Quinn DI, Skinner DG: Postchemotherapy residual masses in advanced seminoma: current management and outcomes. Expert Rev Anticancer Ther; 2005 Oct;5(5):869-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Postchemotherapy residual masses in advanced seminoma: current management and outcomes.
  • Although pure testicular seminoma is most often confined to the testis, it can present with advanced-stage bulky retroperitoneal metastases in nearly a quarter of cases.
  • While highly treatable with cisplatin-based chemotherapy, up to 80% of patients with advanced disease are found to have a radiographically detectable residual mass after chemotherapy.
  • Surgical resection is technically challenging due to a desmoplastic reaction resulting from seminoma treatment and regression.
  • Despite the highly radiosensitive nature of seminoma, radiation therapy in this setting has not been shown to provide significant benefit, and may limit the tolerability of subsequent salvage chemotherapy.
  • The incorporation of noninvasive imaging modalities, such as positron emission tomography, into the management algorithm may better delineate the presence of viable residual tumor and thus allow better risk stratification.
  • [MeSH-major] Retroperitoneal Neoplasms / secondary. Seminoma / drug therapy. Seminoma / pathology. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology
  • [MeSH-minor] Algorithms. Humans. Male. Neoplasm, Residual / surgery. Positron-Emission Tomography. Risk Assessment. Salvage Therapy. Survival

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  • (PMID = 16221056.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 41
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18. Durand X, Vedrine L, Deligne E, Desfemmes FR, Ceccaldi B, Houlgatte A: [Management of testicular seminoma with elevation of alpha fetoprotein. A case report]. Prog Urol; 2008 Mar;18(3):190-2
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  • [Title] [Management of testicular seminoma with elevation of alpha fetoprotein. A case report].
  • [Transliterated title] Prise en charge d'un séminome testiculaire avec élévation de l'alpha-foetoprotéine. A propos d'un cas.
  • The authors report a case of stage N3 pure testicular seminoma associated with paradoxical elevation of alphafoetoprotein (AFP).
  • Despite the absence of histological arguments after review of the slides, this lesion was considered to be a stage pT1 N3 M0 S3 non seminomatous germ cell tumour with a poor prognosis.
  • Laboratory and then clinical relapse at three months was treated by salvage chemotherapy followed by retroperitoneal lymph node dissection.
  • [MeSH-major] Seminoma / pathology. Testicular Neoplasms / pathology. alpha-Fetoproteins / analysis

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  • (PMID = 18472076.001).
  • [ISSN] 1166-7087
  • [Journal-full-title] Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie
  • [ISO-abbreviation] Prog. Urol.
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins
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19. Tavolini IM, Mazzariol C, Dal Bianco M, Bassi P: Late recurrence of clinical stage I seminoma of the testis after 12 years despite adjuvant infradiaphragmatic irradiation. Urol Int; 2004;73(1):84-6
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  • [Title] Late recurrence of clinical stage I seminoma of the testis after 12 years despite adjuvant infradiaphragmatic irradiation.
  • A patient treated with prophylactic infradiaphragmatic radiation therapy for clinical stage I left testicular pure seminoma developed a large mass of the chest wall 12 years after primary treatment.
  • An incisional biopsy confirmed pure seminoma.
  • After chemotherapy, surgical removal of the residual mass and second-line chemoradiation therapy for persistent seminoma, the patient had a vertebral relapse.
  • He died of progression 24 months after the first relapse despite further therapy.
  • [MeSH-major] Neoplasm Recurrence, Local. Seminoma / radiotherapy. Testicular Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Diaphragm. Fatal Outcome. Humans. Male. Neoplasm Staging. Radiotherapy, Adjuvant. Time Factors

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  • [Copyright] Copyright 2004 S. Karger AG, Basel
  • (PMID = 15263799.001).
  • [ISSN] 0042-1138
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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20. Dieckmann KP, Brüggeboes B, Pichlmeier U, Küster J, Müllerleile U, Bartels H: Adjuvant treatment of clinical stage I seminoma: is a single course of carboplatin sufficient? Urology; 2000 Jan;55(1):102-6
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  • [Title] Adjuvant treatment of clinical stage I seminoma: is a single course of carboplatin sufficient?
  • OBJECTIVES: Adjuvant radiotherapy produces excellent disease-free rates in clinical Stage I seminoma.
  • However, concern is growing about side effects and late hazards of this treatment.
  • To date, there is little experience with this drug in the adjuvant treatment of seminoma.
  • METHODS: In a nonrandomized study, 125 patients with pure clinical Stage I seminoma were given adjuvant carboplatin treatment (400 mg/m2).
  • The median follow-up time was 48 months.
  • To assess myelotoxicity, platelet counts at 3 and 4 weeks after treatment were monitored.
  • All the relapses were located in the para-aortic region, and all the patients were rescued with cisplatin-based chemotherapy.
  • The median time to recurrence was 16 months.
  • The median FSH level increased immediately after treatment, reaching a peak of 13.6 U/L.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carboplatin / administration & dosage. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • (PMID = 10654903.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
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21. Tan A, Gilligan T: Controversies in the management of early-stage germ cell tumors. Curr Oncol Rep; 2009 May;11(3):235-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in the management of early-stage germ cell tumors.
  • The optimal management of clinical stage I testicular germ cell tumors remains controversial despite a cure rate of 99%.
  • Alternatives for stage I nonseminomas include close surveillance, retroperitoneal lymph node dissection, and chemotherapy.
  • For pure seminomas, the options are surveillance, chemotherapy, and radiation.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy. Testicular Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Humans. Male. Neoplasm Recurrence, Local. Neoplasm Staging. Risk Factors. Seminoma / drug therapy. Seminoma / prevention & control. Seminoma / radiotherapy

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  • (PMID = 19336016.001).
  • [ISSN] 1534-6269
  • [Journal-full-title] Current oncology reports
  • [ISO-abbreviation] Curr Oncol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
  • [Number-of-references] 49
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22. Michael H, Lucia J, Foster RS, Ulbright TM: The pathology of late recurrence of testicular germ cell tumors. Am J Surg Pathol; 2000 Feb;24(2):257-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The pathology of late recurrence of testicular germ cell tumors.
  • A total of 91 men had histologically documented late recurrences of testicular germ cell tumors characterized by a complete response to treatment with a subsequent disease-free interval of at least 2 years and no evidence of a second primary lesion.
  • Ninety percent of the patients for whom information was available received chemotherapy shortly after their initial diagnosis of testicular germ cell tumors; most of the other patients were known to have stage I disease initially.
  • Thus, teratoma was the most common type of neoplasm in late recurrences.
  • Excluding teratoma coexisting with other types of neoplasms, yolk sac tumor was the most frequent type of tumor in patients with late recurrence.
  • It occurred in 47% of patients, either alone or with teratoma, another nonteratomatous germ cell tumor type, or a "nongerm cell malignant tumor."
  • Unusual types of yolk sac tumor, including glandular, parietal, clear cell, and pleomorphic patterns, were seen frequently in late recurrences and often raised differential diagnostic problems with "nongerm cell" carcinomas.
  • A smaller number of late recurrences consisted of other types of neoplasms.
  • Most of these nonteratomatous germ cell tumors other than yolk sac tumor were embryonal carcinoma, although rarely seminoma and choriocarcinoma were encountered.
  • "Nongerm cell malignant tumors," including both sarcomas and carcinomas of various types, occurred in 23% of late-recurrence patients, either alone or with a nonteratomatous germ cell tumor.
  • Patients whose late recurrences consisted of pure "nongerm cell malignant tumor" or pure germ cell tumor (yolk sac tumor or other types) had a much worse prognosis: Only 36% to 37% were alive with no evidence of disease.
  • Patients with two different types of nonteratomatous malignancies in their late recurrences had a dismal clinical course: Only 17% with both yolk sac tumor and other nonteratomatous germ cell tumor had no evidence of disease, whereas no patient with both nonteratomatous germ cell tumor and "nongerm cell malignant tumor" was disease free.
  • Furthermore, late recurrence is not likely to respond to chemotherapy and is best treated by surgical excision when possible.
  • [MeSH-major] Germinoma / pathology. Neoplasm Recurrence, Local / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Carcinoma, Embryonal / complications. Carcinoma, Embryonal / pathology. Carcinoma, Embryonal / therapy. Choriocarcinoma / complications. Choriocarcinoma / pathology. Choriocarcinoma / therapy. Endodermal Sinus Tumor / complications. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / therapy. Fluorescent Antibody Technique, Direct. Humans. Male. Neoplasm Staging. Neoplasms, Second Primary / pathology. Neoplasms, Second Primary / therapy. Sarcoma / complications. Sarcoma / pathology. Sarcoma / therapy. Seminoma / complications. Seminoma / pathology. Seminoma / therapy. Teratoma / complications. Teratoma / pathology. Teratoma / therapy

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  • (PMID = 10680894.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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23. Kawai K, Kojima T, Miyanaga N, Hattori K, Hinotsu S, Shimazui T, Akaza H: Lectin-reactive alpha-fetoprotein as a marker for testicular tumor activity. Int J Urol; 2005 Mar;12(3):284-9
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  • [Title] Lectin-reactive alpha-fetoprotein as a marker for testicular tumor activity.
  • In the present study, we used the subfraction profile of LCA-binding AFP to diagnose and monitor testicular tumor activity.
  • METHODS: Serum samples were collected from 21 testicular tumor patients, and the LCA-reactive fractions were determined by LCA-affinity electrophoresis coupled with antibody-affinity blotting.
  • The histological diagnosis was non-seminomatous germ cell tumor (NSGCT) in 15 patients and pure seminoma in six patients.
  • One NSGCT patient and two seminoma patients showed borderline AFP levels between 10 and 20 ng/mL.
  • LCA-reactive AFP was detected in all 11 NSGCT patients with serum AFP levels above 10 ng/mL, but not in the two seminoma patients with serum AFP levels above 10 ng/mL.
  • In testicular tumor patients, the broad band of AFP-L2 could not be completely separated from AFP-L3.
  • They included five patients who received chemotherapy, and three patients who underwent orchiectomy for stage I NSGCT.
  • CONCLUSION: Determination of LCA-reactive AFP might be a useful marker for testicular tumor activity in patients with lower AFP levels.
  • [MeSH-major] Germinoma / diagnosis. Seminoma / diagnosis. Testicular Neoplasms / diagnosis. alpha-Fetoproteins / analysis
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Feasibility Studies. Humans. Lectins / metabolism. Male. Neoplasm Staging. Orchiectomy. Protein Isoforms

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  • (PMID = 15828957.001).
  • [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] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Lectins; 0 / Protein Isoforms; 0 / alpha-Fetoproteins
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24. 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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  • [Title] Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors?
  • PURPOSE: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT).
  • 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).
  • CONCLUSIONS: Retroperitoneal histology does not appear to predict outcome in patients with pathological stage B1 NSGCT.
  • [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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25. Ondrus D, Hornák M, Mat'oska J: Bilateral testicular germ-cell tumors--a single centre long-term experience. Int Urol Nephrol; 2001;33(3):521-4
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  • [Title] Bilateral testicular germ-cell tumors--a single centre long-term experience.
  • OBJECTIVES: The incidence of bilateral testicular tumors (BTT) had increased over the preceding decade.
  • MATERIAL AND METHODS: 27 (2.8%) out of 960 patients with germ-cell testicular tumors (GCTT), treated between 4/1977 and 8/2001, developed bilateral disease.
  • All of them underwent radical orchiectomy (in one patient was done delayed orchiectomy after primary chemotherapy due to advanced disease).
  • Additional treatment was planned according to the histologic type and clinical stage of the disease, and previous treatment as well.
  • RESULTS: 24 out of 27 patients (88.9%) developed the 2nd tumor metachronously (median interval 66 months, range, 4-197 months) and three (11.1%) had synchronous BTT.
  • Only 7 patients (25.9%) had identical histological types on both sides (6 of them with pure seminomas, one with embryonal carcinoma).
  • Two of three synchronously developed BTT had different histologic types on both sides.
  • GCTT of one histologic type were observed in respect of the first tumor: 11 seminomas, three embryonal carcinomas, in respect of the 2nd tumor: 10 seminomas, three embryonal carcinomas, in respect of the 2nd tumor: 10 seminomas, three embryonal carcinomas and one mature teratoma.
  • GCTT of more than one histologic type were observed in respect of the first and the 2nd tumors: 6 mixed GCTT with seminoma component and 7 without seminoma component.
  • Majority of BTT was presented in clinical stage I (in respect of the first tumor in 70.4%, in respect of the 2nd tumor in 62.9%).
  • CONCLUSIONS: All patients with unilateral GCTT have an increased risk of developing a contralateral testicular tumor, even decades after diagnosis.
  • [MeSH-major] Germinoma / surgery. Neoplasms, Second Primary / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Humans. Male. Orchiectomy. Treatment Outcome

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  • (PMID = 12230287.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
  • [ISO-abbreviation] Int Urol Nephrol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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26. Khouni H, Ghozzi S, Ramzi K, Smaali CH, Majed H, Ben Rais N: Surgery for testicular cancer: indication, results and technical aspects. Tunis Med; 2005 Dec;83 Suppl 12:78-83
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  • [Title] Surgery for testicular cancer: indication, results and technical aspects.
  • The standard therapeutique approach to patients with advanced germ cell tumors of the testis is a combination of systemic chemotherapy with surgical removal of the residual disease.
  • Sugery is not longer recommended after chemotherapy of pure seminoma and surveillance of the residual tumor is the favored option.
  • RPLND is a critical component of the treatment armentarium in low-stage nonseminomatous germ cell.
  • RPLND is an accurate staging tool prviding important information to dtermine the need for chemotherapy.
  • In advanced nonseminomatous tumours, surgery after chemotherapy is recommended in most of the cases since large studies have shown that a considerable proportion of patients with complete radiological remission after chemotherapy harbor vital carcinoma or teratoma.
  • Prediction models of necrosis after chemotherapy in order to avoid RTR are generally accepted since the accuracy of most models is too low.
  • RTR is indicated in patients with elevated markers after two different chemotherapy regimens (including salvage chemotherapy) either to resect teratoma or cystic residual disease or to remove chemorefractory disease.
  • [MeSH-major] Germinoma / surgery. Lymph Node Excision. Orchiectomy. Testicular Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor. Chemotherapy, Adjuvant. Humans. Laparoscopy. Male. Neoplasm Invasiveness. Neoplasm Staging. Neoplasm, Residual. Patient Selection. Prognosis. Remission Induction. Risk Factors. Salvage Therapy / methods. Survival Rate. Treatment Outcome

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  • (PMID = 16430075.001).
  • [ISSN] 0041-4131
  • [Journal-full-title] La Tunisie médicale
  • [ISO-abbreviation] Tunis Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Tunisia
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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27. Dieckmann KP, Albers P, Classen J, De Wit M, Pichlmeier U, Rick O, Müllerleile U, Kuczyk M: Late relapse of testicular germ cell neoplasms: a descriptive analysis of 122 cases. J Urol; 2005 Mar;173(3):824-9
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  • [Title] Late relapse of testicular germ cell neoplasms: a descriptive analysis of 122 cases.
  • PURPOSE: The problem of late relapse of testicular germ cell tumor (GCT) is poorly understood.
  • MATERIALS AND METHODS: Late relapse was defined as recurrence of disease more than 2 years after completion of primary treatment.
  • A total of 122 patients (50 with pure seminoma and 72 with nonseminoma) were retrospectively studied.
  • Several parameters were analyzed including age, clinical stage, treatment at primary presentation, occurrence of prior early relapse, interval to L/R, tumor markers, site of relapse, and mode and outcome of L/R treatment.
  • Possible effects of various clinical parameters on treatment results were studied by multivariate statistical analysis.
  • RESULTS: Median age at first presentation was 34 years and 26.5 years in patients with seminoma and nonseminoma, respectively.
  • The intervals to L/R were 42 months (range 25 to 276) in seminoma and 64.5 months (range 28 to 216) in nonseminoma.
  • A total of 75% of nonseminomas but only 20% of seminomas had disseminated disease at first presentation, while 51 patients with nonseminoma had initially received chemotherapy. alpha-Fetoprotein was increased in 45 patients (of 59 eligible) with nonseminoma at L/R, human chorionic gonadotropin in 12 cases. alpha-Fetoprotein levels greater than 100 U/l indicated poor prognosis.
  • Of 72 patients with nonseminoma cure failed in 37 in contrast to only 6 patients with seminoma (of 48 eligible).
  • These events occur in nonseminoma and seminoma, but clinical features are quite different in the 2 groups.
  • Treatment should include surgery in nonseminoma.
  • Seminomas and otherwise chemotherapy naive cases might respond to chemotherapy only.
  • Particular risk groups for late relapse are nonseminoma with prior early relapse, patients receiving chemotherapy for disseminated disease at first presentation and those with pure teratoma.
  • [MeSH-major] Germinoma / epidemiology. Neoplasm Recurrence, Local / epidemiology. Testicular Neoplasms / epidemiology
  • [MeSH-minor] Adolescent. Adult. Humans. Male. Middle Aged. Retrospective Studies. Time Factors

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  • (PMID = 15711278.001).
  • [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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28. Loriot Y, Fizazi K: [Management of localized germ-cell tumours of the testis]. Rev Prat; 2007 Feb 28;57(4):379-84
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  • [Transliterated title] Tumeurs germinales du testicule: prise en charge des formes localisées.
  • Stage 1 is currently the most frequent pattern at diagnosis of germ-cell tumours.
  • The therapeutic choice should be taken after fair and extensive information regarding the limitations of each option therefore taking into account both predictive factors of relapse and patient individual willing.
  • In case of pure seminoma, prophylactic radiotherapy directed to the retroperitoneal lymph nodes, chemotherapy by single-agent carboplatin and surveillance with differed treatment at relapse are the three currently available attitudes.
  • In non-seminomatous germ cell tumours three options should also be considered: surveillance (watchful waiting), chemotherapy by two cycles of BEP, or retroperitoneal lymph node dissection.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Bleomycin / therapeutic use. Carboplatin / administration & dosage. Carboplatin / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Clinical Protocols. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / therapeutic use. Follow-Up Studies. Humans. Lymph Node Excision. Male. Neoplasm Metastasis. Neoplasm Staging. Orchiectomy. Practice Guidelines as Topic. Prognosis. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Seminoma / drug therapy. Seminoma / pathology. Seminoma / radiotherapy. Seminoma / therapy. Testis / pathology. Time. Time Factors

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  • (PMID = 17455739.001).
  • [ISSN] 0035-2640
  • [Journal-full-title] La Revue du praticien
  • [ISO-abbreviation] Rev Prat
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; BEP protocol
  • [Number-of-references] 26
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29. Fléchon A, Droz JP: [Germ cell tumors of the testes: state of the art]. Cancer Radiother; 2000 Jan-Feb;4(1):27-31
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  • The treatment of stage I seminoma is lomboaortic radiotherapy, and that of stage I non-seminomatous tumors is either surveillance, retroperitoneal lymph node dissection or adjuvant chemotherapy according to the risk factors of extra-testicular involvement (pure embryonal carcinoma, vascular invasion).
  • For advanced diseases, the standard treatment is three cycles of bleomycin, etoposide, cisplatin (BEP regimen) or four cycles of the same association without bleomycin (EP regimen) and four cycles of the BEP regimen for patients with good risk and poor risk prognostic characteristics, respectively.
  • It is recommended to resect all residual masses after chemotherapy.
  • The standard salvage treatment is four cycles of vinblastin, ifosfamide, cisplatin (VelP regimen).
  • New associations of drugs are under study in order to improve the overall survival rate for the poor-risk and relapsed-tumors patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Incidence. Male. Middle Aged. Prognosis. Risk Factors. Salvage Therapy. Vinblastine / administration & dosage

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  • (PMID = 10742806.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] FRANCE
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; BEP protocol; VeIP protocol
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30. Géczi L, Biron P, Droz JP: [Treatment of germ cell tumors at the threshold of the third millennium]. Orv Hetil; 2001 Aug 5;142(31):1673-9
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  • [Title] [Treatment of germ cell tumors at the threshold of the third millennium].
  • The aim of the authors is to present the risk factors and the risk factors based treatment strategy of germ cell tumors.
  • They review the risk adapted treatment strategy of germ cell tumors using the treatment policy of the Léon Bérard Oncological Center and the current findings published.
  • More than of 80% germ cell tumors may be cured by standard treatment.
  • The treatment of stage I seminoma is lumboaortic radiotherapy and that of stage I non seminoma is either surveillance, retroperitoneal lymph node dissection or chemotherapy depending on the risk factors of extratesticular involvement (pure embryonal carcinoma, vascular invasion).
  • The treatment of metastatic cases is chemotherapy: three cycles of bleomycin, etoposid, cisplatin of four cycles of the similar components without bleomycin for good risk patients, and four cycles bleomycin, etoposid and cisplatin in poor risk cases.
  • The indication of retroperitoneal lymph node dissection depends on the size of retroperitoneal spreading prior to chemotherapy and on the efficacy of chemotherapy.
  • The second line salvage treatment is four cycles of a combination of vinblastin, ifosfamide and cisplatin.
  • After salvage chemotherapy the resection of all residual masses is recommended.
  • New drugs, such as gemcitabine, taxotere, oxaliplatin and high dose chemotherapy may bring further success, however these new treatment modalities are not available for clinical practice in Hungary.
  • Risk adapted treatment for germ cell tumors decreasing the early and late toxicity's of conventional treatment may improve the patients quality of life, and may decrease the cost of standard treatment in Hungary.
  • The said new medication and the use of high dose chemotherapy may further improve the chances of patients with poor and intermediate prognosis and of those who are resistant to the cisplatin based standard therapy.
  • [MeSH-major] Germinoma / etiology. Germinoma / therapy. Testicular Neoplasms / etiology. Testicular Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Prognosis. Radiotherapy, Adjuvant. Retroperitoneal Neoplasms / secondary. Retroperitoneal Neoplasms / therapy. Risk Assessment. Risk Factors. Salvage Therapy

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  • (PMID = 11556261.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Hungary
  • [Number-of-references] 50
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31. Stamatiou K, Papadopoulos P, Perlepes G, Galariotis N, Olympitis M, Moschouris H, Vasilakaki T: Mixed germ cell tumor of the testicle with ravdomuosarcomatous component: a case report. Cases J; 2009;2:9299

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  • INTRODUCTION: Testicular tumors can be classified as seminomatous and non-seminomatous germ-cell tumor (NSGCT) types.
  • Mixed germ cell tumors contain more than one germ cell component and are much more common than any of the pure histologic forms representing 32%-60% of all germ cell tumors.
  • Here we present a rare case of a mixed germ cell tumor composed of seminoma, Yolk sack tumor and teratoma containing a sarcoma component of somatic type malignancy.
  • The patient underwent right-sided high orchidectomy and was given chemotherapy of the BEP regimen.
  • After the 2nd cycle the patient discontinued the chemotherapy and when he came for follow-up after a gap of 3 months, despite the normalisation in tumor markers values, the retroperitoneal mass was relapsed.
  • CONCLUSION: More than 50% of germ-cell tumors include more than 2 basic germ-cell tumor types, with the exception of spermatocytic seminoma.
  • About 90% of the patients with nonseminomatous tumors can achieve complete cure with aggressive chemotherapy and most of them can be cured.
  • Although prognosis of testicular tumors depends largely on clinical stage, histological type and adhesion to the treatment influence the prognosis as well.

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  • (PMID = 20062623.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2803963
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32. Malagón HD, Valdez AM, Moran CA, Suster S: Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol; 2007 Sep;31(9):1356-62
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  • The germ cell component consisted of pure mature or immature teratoma (23 cases), teratoma mixed with other seminomatous or nonseminomatous components (17), pure seminoma (2), intratubular germ cell neoplasia (1), and yolk sac tumor (1).
  • All patients were treated by cisplatinum-based chemotherapy plus other agents followed by surgery.
  • Comparison of these patients with an age-matched and stage-matched control group of patients with GCT without SC showed statistically significant differences in survival between the 2 cohorts (P <or=0.001).
  • [MeSH-major] Immunohistochemistry. Mediastinal Neoplasms / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Ovarian Neoplasms / diagnosis. Retroperitoneal Neoplasms / diagnosis. Sarcoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Orchiectomy. Ovariectomy. Time Factors. Treatment Outcome

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  • (PMID = 17721191.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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