690 patients were treated for testicular tumour in the course of 18 years. The histology of 7 cases showed Leydig cell tumour. In 4 of the 7 cases, a metastatic process leading to death was observed. At the time of diagnosis, 5 patients were found to have low stage, whereas 2 of the patients had advanced lymphatic involvement. The hematogenous and lymphatic metastases proved to be resistant to chemotherapy. Contrary to the major part of the literature, retroperitoneal lymphadenectomy should be performed with this histological type for the exact pathological staging immediately following orchiectomy.

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This manuscript captures the discussion and recommendations that came out of a special Afro Asian symposium involving 13 countries. Unmet needs and cost-effective solutions with special emphasis on training form the backbone of practical next steps.

One hundred fifty children of 113 fathers with testicular tumour treated from 1979 on the National Institute of Oncology, Budapest, were studied. Three groups were formed on the basis of the time of conception; 69 children were born before the illness of the fathers, 40 during the 12 pretreatment months, and 41 during or after combined chemotherapy. One hundred fifty control children underwent tonsillectomy/appendectomy, but were otherwise healthy. They were matched according to age, sex, and place of inhabitance with index children. Family anamnesis, perinatal, and gestational data were listed; thereafter, physical, laboratory, immunological, and, if required, radiological examinations were made. No difference was detectable in the somatic and psychiatric status of the three groups, and development was well balanced, corresponding to age. Protocols of the combined chemotherapy applied, and the incidence of anomalies, abnormalities, malignancies, and other diseases was recorded. Incidence was similar in all three groups. Incidence of congenital malformations was not increased in children conceived before and after therapy; however, a complex congenital abnormality, an atrial septal defect with horseshoe kidney, occurred in one young girl, conceived after the end of her father's treatment. The interval between conception and the end of therapy was established in the case of children conceived either during or after therapy. This was shorter in the case of healthy children; the number of healthy children conceived during cytostatic treatment was also remarkable. Further detailed analysis of data and individual evaluation of case reports are recommended.

The outlook for patients with testicular germ cell cancer was dramatically improved by the introduction of cisplatin. Well-known side effects of cisplatin (nausea, vomiting, nephrotoxicity, myelosuppression) can be managed with preventive methods. The long life expectancy after this therapy draws attention to long-term side effects. The ototoxic side effects were scarcely studied, although nowadays, they can be a dose-limiting side effect of cisplatin. Patients and Methods: As the literature shows, the ototoxic side effects of cisplatin have been studied mostly by conventional methods. The authors used transiently evoked otoacoustic emissions to determine whether the administration of 20 mg/m² body surface cisplatin daily (in combination with other antitumor drugs) for 5 days alters the amplitude of the transient oto-acoustic emission. Results: The results did not show any significant amplitude change after 20 mg/m² cisplatin daily for 5 days, in contrast with other studies that described a broad frequency reduction of the emission amplitude in 30-86% of cases treated with 100 mg/m² of cisplatin for 1 day. Conclusion: The authors suggest that between similarly effective regimens, those containing lower daily cisplatin doses should be used.

The authors describe the evidence and results obtained in 21 out of 100 patients who underwent salvage retroperitoneal lymphadenectomy for advanced testicular cancer (UICC stage II/B bulky and stage III) in the period 1982-1993, and in whom inductive chemotherapy was not followed by marker conversion. It is stated that if AFP positivity is low (titres below 100 ng/ml) salvage retroperitoneal lymphadenectomy (RLA) is of high therapeutic value, whereas in all cases with HCG positivity or AFP titres higher than 500 ng/ml tumorous death ensued without exception. In our cases viable tumour residues occurred in 81%. Salvage resection was feasible in 76%, but every incomplete resection (19%) was followed by death due to tumour. In all but one of the cases marker positivity, an indicator of therapy-resistant viable tumour residues, persisted after having used more than four PVB combinations or changes in the chemotherapeutic regimen.

Chromosomal aberrations and sister chromatid exchanges were examined in 45 patients with nonseminomatous testicular cancer at different times after the termination of vinblastine, cisplatin and bleomycin (VPB) therapy and in 22 age-matched healthy men and untreated testicular cancer patients. After 36 months, the frequency of unstable aberrations markedly decreased in peripheral blood lymphocytes of VPB-treated patients, however the persistence of aberrant cells even 75 months after the termination of treatment underlines the necessity of longer follow-up of VPB-treated patients in order to evaluate the relationship between their carcinogen sensitivity and the risk of second malignancies.