The changing presentation of germ cell tumours of the testis between 1983 and 2002

Abstract

Authors from London looked at patients diagnosed with germ cell tumours of the testis who presented between 1983 and 2002. They found that there was an overall increase in the percentage of patients presenting with stage I seminoma, with a significant reduction in the size of the primary tumour. The authors do not feel that they can clarify the reason for these changes. There is a 20‐year follow‐up of patients who had tumours of the ureter and renal pelvis treated with resection and renal autotransplantation. In this fascinating series from Gothenberg, it was found that in patients with a normal contralateral kidney, resection and autotransplantation was not indicated. It was possibly beneficial in patients with solitary kidneys, but only after other treatments have been considered. OBJECTIVE To prospectively investigate the presentation of germ cell tumours (GCTs) of the testis in terms of stage or histology, as the incidence of this disease in increasing. PATIENTS AND METHODS Patients diagnosed with GCT of the testis between 1983 and 2002 were categorised into three periods depending on the date of diagnosis of the GCT, and the presentational characteristics assessed. RESULTS There was a significant increase in the proportion of patients presenting with stage I disease (59% to 78%) and seminoma (43% to 58%) over this period. There was also a significant reduction in the size of the primary tumour (5 to 4 cm). CONCLUSION A greater proportion of patients with GCT are presenting with stage I seminoma, the reasons for which are unclear, although earlier diagnosis through improved awareness of GCT may be important.

Risk of Germ Cell Tumors among Men with HIV/Acquired Immunodeficiency Syndrome

“…bP trend = 0.056 for SIR across the three calendar year periods. contrast to seminoma, nonseminoma may be less affected by screening bias because nonseminoma may be less indolent and thus less likely to be diagnosed incidentally (26). However, an accelerated diagnosis of indolent seminoma at AIDS onset would not account for the continuing excess that we observed during the 2 years after AIDS onset.…”

Testosterone Level in Testicular Cancer Patients after Chemotherapy

“…Almost one-third (31.71%) of patients were diagnosed at stage I, which is contradictory to the study of Powles et al who described that the patients with stage I disease were more compared to other diagnosed stages and this was due to improved education and awareness of germ cell tumours, resulting in earlier diagnosis. The incidence of testicular cancer at stage I in seminoma was 17% and in nonseminoma it was 11% in the present study, similar to the study of Powles et al in the UK who observed that nonseminomas developed from seminomas (20). The mean age at stage I was highest as compared to other stages (II and III) in the present study.…”

Testicular cancer: Management challenges in an African developing country

“…[7][8][9][10] However, the distribution of the stages in our series differed markedly from that in the developed world. In developed countries, stage 1 disease is the most common and also shows a consistent rise, 7,11,12 whereas in our study stages 3 and 4 were the most common. The mean interval between onset of symptoms and presentation to a health care facility was unduly long (5.2 months, range 1 -12 months).…”