Guidelines on Testicular Cancer

Albers, Peter; Albrecht, Walter; Algaba, Ferrán; Bokemeyer, Carsten; Cohn‐Cedermark, Gabriella; Horwich, A.; Klepp, O; Laguna, M. Pilar; Pizzocaro, Giorgio

doi:10.1016/j.eururo.2005.06.019

Cited by 229 publications

(211 citation statements)

References 47 publications

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“…Chemotherapy with platinum and its derivatives, surgical treatments and radiotherapy lead to an overall 5-year survival rate of 90%-95% for TN, 92% for Hodgkin lymphoma and 71% for non-Hodgkin lymphoma. 3,4 At the same time, the increase in the overall survival rate of patients with germinal and hematological neoplasias treated with chemo-and radiotherapies is accompanied by an increase in infertility rates. 5,6 Indeed, oncological treatments present severe gonadotoxic effects on both germ and Leydig cells.…”

Section: Introductionmentioning

confidence: 99%

Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders

Bisceglie¹,

Bertagna²,

Composto³

et al. 2013

Asian J Androl

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Pretherapy sperm cryopreservation in young men is currently included in good clinical practice guidelines for cancer patients. The aim of this paper is to outline the effects of different oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders, based on an 8-year experience of the Cryopreservation Centre of a large public hospital. Two hundred and sixty-one patients with testicular neoplasia and 219 patients with lymphoproliferative disorders who underwent chemotherapy and/or radiotherapy and pretherapy semen cryopreservation were evaluated. Sperm and hormonal parameters (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, inhibin B levels) were assessed prior to and 6, 12, 18, 24 and 36 months after the end of cancer treatment. At the time of sperm collection, baseline FSH level and sperm concentration were impaired to a greater extent in patients with malignant testicular neoplasias than in patients with lymphoproliferative disorders. Toxic effects on spermatogenesis were still evident at 6 and 12 months after the end of cancer therapies, while an improvement of seminal parameters was observed after 18 months. In conclusion, an overall increase in sperm concentration was recorded about 18 months after the end of cancer treatments in the majority of patients, even if it was not possible to predict the evolution of each single case 'a priori '. For this reason, pretherapy semen cryopreservation should be considered in all young cancer patients.

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Section: Introductionmentioning

confidence: 99%

Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders

Bisceglie¹,

Bertagna²,

Composto³

et al. 2013

Asian J Androl

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“…Preferred Regimen In the past, patients with a high risk of relapse (VI present) were recommended adjuvant chemotherapy with two cycles of BEP [29,47]. Minimizing toxicity is important in all adjuvant chemotherapy (ACT) studies.…”

Section: Chemotherapymentioning

confidence: 99%

“…According to the EGCCCG and the EAU guidelines, in patients unwilling to undergo a surveillance strategy or adjuvant chemotherapy, nerve-sparing lymphadenectomy (NS-RPLND) may be performed [29,47,62].…”

Section: Retroperitoneal Lymph Node Dissectionmentioning

confidence: 99%

Current Concepts in Management of Stage I NSGCT

Ahluwalia

Gautam

2016

Indian J Surg Oncol

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While about 50% of non-seminomatous germ cell tumors of the testes present as clinical stage I (CSI), further management of these patients continues to be mired in controversy. Active surveillance is a frontline option for low-risk CS I patients and according to some, even the high-risk ones with high embryonal carcinoma (ECA) component and vascular invasion (VI). However, it carries the disadvantage of long-term surveillance, the need for prolonged chemotherapy in case of recurrence and the possibility of secondary malignancies due to radiation exposure from frequent CT scans. One or two cycles of BEP chemotherapy is a popular alternative to active surveillance which carries a very low relapse rate, but valid concerns about overtreatment of a majority of patients, with the attendant chemotherapy-related toxicity exist. Retroperitoneal lymph node dissection has been used as a means of avoiding chemotherapy, especially in high-risk patients, but carries the disadvantage of a high surgical morbidity and complications. As with any major surgical procedure, the best results are dependent on the experience and skill of the individual surgeon.

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“…Metastatic disease does not respond well to radio-chemotherapy, and survival is poor. 6 Sertoli cell tumours may be associated with androgenic deficiency, Peutz-Jeghers syndrome and Carney's syndrome. 6 None of these conditions was present in our case.…”

mentioning

confidence: 99%

“…6 Sertoli cell tumours may be associated with androgenic deficiency, Peutz-Jeghers syndrome and Carney's syndrome. 6 None of these conditions was present in our case. The association between Sertoli cell tumours and azoospermia is not well defined in the literature.…”

mentioning

confidence: 99%