Early-stage testis cancer

Abstract

The treatment of low-stage testis cancer (defined as clinical stage I or low-volume clinical stage II disease) varies, depending on whether or not the orchiectomy specimen reveals seminoma or nonseminoma. Treatments for clinical stage I seminoma include radiotherapy to the retroperitoneum, surveillance, or two courses of carboplatin chemotherapy. Until the results of an ongoing randomized study comparing radiotherapy with two courses of carboplatin are known, standard accepted treatments currently include radiotherapy or surveillance. In nonbulky clinical stage II seminoma, therapeutic options include radiotherapy or cisplatin-based chemotherapy. For clinical stage I nonseminoma, equivalent short-term survival rates are obtained with either nerve-sparing retroperitoneal lymph node dissection (RPLND), surveillance, or two courses of BEP (bleomycin, etoposide, and platinum) chemotherapy. However, minimization of toxicity of treatment would argue that the two preferred treatments in clinical stage I nonseminoma are nerve-sparing RPLND or surveillance. For low- volume clinical stage II nonseminoma, options include three courses of BEP or primary RPLND. The overall chance for cure is essentially the same for either of these options. Therefore, in each clinical stage of early-stage testis cancer, therapeutic options exist that, based upon current data, are therapeutically equivalent in the short term. Therefore, the ultimate choice of therapy is also dependent upon the short- and long-term toxicity of therapy and the likelihood of late recurrence of disease.

PCPH expression is an early event in the development of testicular germ cell tumors

“…Prognostic factors, such as presence of metastasis and serum levels of specific tumor markers (10,12,14), are also considered for treatment protocol planning. The best results are typically reported in the treatment of testicular cancers at stages I and II (15,16). Recently, new chemotherapy protocols for TGCTs are yielding good results, especially with the use of cisplatin to treat non-seminomatous tumors (17).…”

No Long-Term Increase in Sperm Aneuploidy Rates after Anticancer Therapy

“…Important improvements have recently been achieved in the management of these diseases. After radical orchidectomy, the adjuvant treatment for testicular cancer differs according to the tumor's histology (3)(4)(5)(6). Approximately 95% of malignant tumors arising in the testis are germ-cell tumors and are classified as seminomatous or nonseminomatous (7,8).…”

“…Approximately 95% of malignant tumors arising in the testis are germ-cell tumors and are classified as seminomatous or nonseminomatous (7,8). Patients with lowstage seminoma are usually treated with radiation of the retroperitoneal and ipsilateral pelvic lymph nodes (4,7,9), whereas patients with nonseminomatous tumors or advanced seminomas receive a cisplatin-based chemotherapy, with standard protocols, including cisplatin, etoposide, and bleomycin (3,6,10). For Hodgkin's disease and non-Hodgkin's lymphomas, the treatment is usually based on chemotherapy with or without radiotherapy (11)(12)(13)(14)(15)(16)(17)(18).…”

Expression of CD34 antigen in testicular mixed germ cell tumor

“…Distinction of YST from other types of germ cell tumor is therapeutically and prognostically important 13,14 . In most instances, YST are readily recognized by their characteristic histological patterns 6–8 .…”