Cryptorchism, Orchiopexy, and the Risk of Testicular Cancer

Strader, Clifton H.; Weiss, Noel S.; Daling, Janet R.; Karagas, Margaret R.; McKnight, Barbara

doi:10.1093/oxfordjournals.aje.a114877

Cited by 79 publications

(36 citation statements)

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“…Among the authors who have examined risks separately, Morrison (1976), Stone et al (1991) and Prener et al (1996) found a significantly stronger association with seminoma, Morrison (1976) for example reported OR of 15.6 for pure seminoma compared with 5.3 for non-seminoma, and Prener et al (1996) reported OR of 7.3 and 3.6 respectively. Henderson et al (1979), Moss et al (1986), Swerdlow et al (1987), Strader et al (1988), Haughey et al (1989), Gallagher et al (1995) and reported similar risks associated with undescended testis in the two histological groups, although where separate OR were presented, they were consistently higher for seminomas than other tumours (Moss et al, 1986;Swerdlow et al, 1987;Strader et al, 1988;. In a case-control study only of pure seminoma tumours (Coldman et al, 1982) the OR associated with undescended testis was 17.1.…”

Section: Discussionmentioning

confidence: 87%

Risk factors for testicular germ cell tumours by histological tumour type

Coupland

Chilvers

Davey³

et al. 1999

Br J Cancer

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Summary There are two main histological groups of testicular germ cell tumours, which may have different risk factors. Some authors have analysed potential risk factors by histological group but few consistent differences have been identified. In this paper we examine risk factors for pure seminoma and other tumours using data from the United Kingdom case control study of testicular cancer. Seven hundred and ninetyfour cases were included in the study, each with a matched control; 400 cases had pure seminoma tumours, and 394 had other testicular tumours. The risk of seminoma associated with undescended testis was slightly higher than that for other tumours (odds ratio of 5.3 compared with 3.0). When split at the median age at diagnosis, this difference was greater in men aged 32 and over (odds ratio of 11.9 compared with 5.1) than in the younger men (3.0 compared with 2.5). Risks associated with testicular or groin injuries were higher in the non-seminoma group, as was the risk for a history of sexually transmitted disease. The protective effect of a late puberty was more marked for tumours of other histologies. Some differences were also detected for participation in sports. Whilst some of the differences detected may have arisen by chance, the stronger association between undescended testis and pure seminoma has been identified by a number of other studies and may reflect a genuine difference in aetiology.

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Section: Discussionmentioning

confidence: 87%

Risk factors for testicular germ cell tumours by histological tumour type

Coupland

Chilvers

Davey³

et al. 1999

Br J Cancer

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“…1991). There is a suggestion from some studies that patients who undergo orchipexy before the age of 10 years have a relatively low risk of developing tumours compared with those who undergo correction later (Martin et al, 1979;Strader et al, 1988). It is for these reasons that some authors have recommended orchidectomy for unilateral undescended testis when diagnosed after puberty (Ford et al, 1985).…”

Section: Methods and Resultsmentioning

confidence: 99%

Germ cell tumours in uncorrected cryptorchid testis at Institute Rotary Cancer Hospital, New Delhi

Raina

Shukla²,

Gupta³

et al. 1995

Br J Cancer

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Suiamry Twenty-four out of 164 (14%) adult patients with pnrmary germ cell tumours of testis seen over the last 6 years at the Institute Rotary Cancer Hospital (IRCH) of the All India Institute of Medical Sciences (AIIMS), New Delhi, were found to have cryptorchidism. Only one patient had undergone correction. As a result the testes were intra-abdominal in the vast majority, and patients presented late. Twenty-two patients presented with stage Ilb or more advanced disease. Twelve patients had seminoma and the others had mixed or non-seminomatous germ cell tumour (NSGCT), i.e. 50% each. The earlier patients were managed by initial resection followed by radiation and or chemotherapy. As experience grew the seven patients who presented late were given initial chemotherapy followed by resection in those with residual tumours. The probability of overall survival was 0.65 at 36 months and, was not significantly different from survival in 114 patients with tumours of normally descended testis. Early orchipexy facilitates the detection, but whether it reduces the incidence of tumours is controversial. Uncorrected cryptorchidism is now rarely seen in the West, but in India and many other developing countries tumours of uncorrected cryptorchid testes continue to be seen.

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“…The tumors are in 75–85% of cases seminomas, whereas after orchidopexy the proportion of seminomas is close to normal 50% [60, 61]. Thus, treatment appears to modify tumorigenesis, but it is still equivocal whether cancer risk can be reduced by early treatment of undescended testes [62, 63]. Testicular cancer is preceded in most cases by carcinoma in situ (CIS) [64]that may originate already during fetal development and may be caused by the same factors as cryptorchidism.…”

Section: Pathology In Maldescended Testesmentioning

confidence: 99%

Maldescendus testis

Toppari¹,

Kaleva²

1999

Horm Res Paediatr

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Maldescendus testis is a common congenital abnormality occurring in 2–5% of full-term boys at birth in the Western countries. By 3 months of age, the incidence rate spontaneously reduces to 1–2% in this group. The etiology of the disorder is not known, but normal hypothalamo-pituitary-gonadal axis is usually a prerequisite for normal descent of the testes. Abnormal sexual differentiation is associated with maldescent. However, the majority of boys with maldescended testes show no endocrine abnormalities after birth. Several defects in developmental genes, such as homeobox genes and Insl3, have been described to cause cryptorchidism in mice, and disturbances in the regulation of these genes or their mutations may explain etiology of a large part of human testicular maldescent in the future. Increased degeneration of germ cells can be observed in undescended testes after the first year, and therefore early treatment is recommended. Surgical treatment is the most effective and reliable method to bring testes into the scrotum, but hormone treatment with either hCG or GnRH analogues can be considered, particularly in cases where testes can be palpated in high scrotal position. The efficacy of hormone treatment is less than 20% and depends on the initial location of the testis. Nonpalpable testes rarely descend with hormone treatment. Both surgery and hormone treatment can have untoward effects. Treatment with hCG has been associated with an inflammation-like reaction in the testes and an increased rate of apoptosis of germ cells leading to a reduced adult size of the testes. Vascular complications can occur during surgery, particularly in staged orchidopexies. Men with a history of undescended testis have an increased risk of testicular cancer. Impaired fertility is another long-term risk associated to maldescended testes. Fertility potential may be improved by early treatment. Although our knowledge on cryptorchidism has increased considerably during the last decades, many questions remain to be answered: Is the incidence rate increasing? What is causing maldescent? Do hormones have any role in the treatment?

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Cryptorchism, Orchiopexy, and the Risk of Testicular Cancer

Cited by 79 publications

References 0 publications

Risk factors for testicular germ cell tumours by histological tumour type

Risk factors for testicular germ cell tumours by histological tumour type

Germ cell tumours in uncorrected cryptorchid testis at Institute Rotary Cancer Hospital, New Delhi

Maldescendus testis

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