401
|
Dusaud M, Malavaud B, Bayoud Y, Sebe P, Hoepffner JL, Salomon L, Houlgatte A, Pignot G, Rigaud J, Fléchon A, Pfister C, Rouprêt M, Soulié M, Méjean A, Durand X. Post-chemotherapy retroperitoneal teratoma in nonseminomatous germ cell tumors: Do predictive factors exist? Results from a national multicenter study. J Surg Oncol 2016; 114:992-996. [DOI: 10.1002/jso.24464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/13/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Marie Dusaud
- Department of Urology; Hopital d'Instruction des Armees Begin; Saint Mandé France
| | | | - Younes Bayoud
- Department of Urology; Hopital d'Instruction des Armees Begin; Saint Mandé France
| | | | | | | | - Alain Houlgatte
- Hopital d'Instruction des Armees du Val-de-Grace; Paris France
| | | | | | | | | | | | | | | | - Xavier Durand
- Department of Urology; Hopital d'Instruction des Armees Begin; Saint Mandé France
| |
Collapse
|
402
|
Yamada Y, Nakagawa T, Sugihara T, Horiuchi T, Yoshizaki U, Fujimura T, Fukuhara H, Urano T, Takayama K, Inoue S, Kume H, Homma Y. Prognostic value of CD66b positive tumor-infiltrating neutrophils in testicular germ cell tumor. BMC Cancer 2016; 16:898. [PMID: 27863478 PMCID: PMC5116192 DOI: 10.1186/s12885-016-2926-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 11/06/2016] [Indexed: 11/10/2022] Open
Abstract
Background Prognostic value of immune cells is not clear in testicular germ cell tumors (TGCTs). We aimed to investigate the prognostic value of tumor-infiltrating neutrophils in TGCTs. Methods A total of 102 patients who underwent orchiectomy for TGCT were investigated for CD66b positive tumor-infiltrating neutrophils (CD66b + TINs). Immmunostaining for CD66b was performed in 102 sections as described. Clinicopathological parameters as well as cancer specific survival and overall survival were assessed for correlation with CD66b + TIN density. Results High density group was significantly correlated with tumor diameter ≥ 10 cm, presence of nodal/distant metastasis, S stage, diagnosis of nonseminomatous germ cell tumor (NGCT), and presence of venous invasion (p = 0.0198, p < 0.0001, p = 0.0275, p = 0.0004, and p = 0.0287, respectively). It was also significantly associated with cancer-specific and overall survival (logrank p = 0.0036, and p = 0.0002, respectively). Multivariate analysis showed that increased CD66b + TIN was an independent prognostic factor for overall survival (p = 0.0095). Conclusions Increased CD66b + TIN was significantly associated with presence of metastasis, S stage, and nonseminomatous germ cell tumor diagnosis. It was also an independent prognostic factor of overall survival in patients with TGCT. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2926-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yuta Yamada
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Toru Sugihara
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takamasa Horiuchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Uran Yoshizaki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine and Anti-Aging Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kenichi Takayama
- Department of Functional Biogerontology, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Satoshi Inoue
- Department of Functional Biogerontology, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
403
|
Demirer Z, Güragac A, Uguz S, Uslu AU, Zor M. RE: White blood cell counts and neutrophil to lymphocyte ratio in the diagnosis of testicular cancer: a simple secondary serum tumor marker. Int Braz J Urol 2016; 42:1251-1252. [PMID: 27813388 PMCID: PMC5117987 DOI: 10.1590/s1677-5538.ibju.2016.0319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/06/2016] [Indexed: 02/07/2023] Open
Affiliation(s)
- Zafer Demirer
- Department of Urology, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Ali Güragac
- Department of Urology, Tatvan Military Hospital, Bitlis Turkey
| | - Sami Uguz
- Department of Urology, Gülhane Military Medical Faculty School of Medicine, Ankara, Turkey
| | - Ali Ugur Uslu
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Murat Zor
- Department of Urology, Gülhane Military Medical Faculty School of Medicine, Ankara, Turkey
| |
Collapse
|
404
|
Gizzi M, Oberic L, Massard C, Poterie A, Le Teuff G, Loriot Y, Albiges L, Baciarello G, Michels J, Bossi A, Blanchard P, Escudier B, Fizazi K. Predicting and preventing thromboembolic events in patients receiving cisplatin-based chemotherapy for germ cell tumours. Eur J Cancer 2016; 69:151-157. [PMID: 27821318 DOI: 10.1016/j.ejca.2016.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/05/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with germ cell tumours (GCT) receiving cisplatin-based chemotherapy are at high risk of thromboembolic events (TEE). Previously, we identified serum lactate dehydrogenase (LDH) and body surface area (BSA) as independent predictive factors for TEE. The aim of this study was to validate these predictive factors and to assess the impact of thromboembolism prophylaxis in patients at risk of deep venous thrombosis (DVT). METHODS Between 2001 and 2014, 295 patients received first-line cisplatin-based chemotherapy for GCT. Preventive anticoagulation with low-molecular-weight heparin (LMWH) was progressively implemented in patients with predictive factors. Sixteen patients with evidence of TEE before starting chemotherapy were excluded from the analysis. RESULTS Among 279 eligible patients, a TEE occurred in 38 (14%) consisting of DVT (n = 26), arterial thrombosis (n = 2), and superficial thrombophlebitis (n = 10). DVT occurred in 26 (12.7%) of 204 patients with risk factors versus two (2.6%) of 75 patients with no risk factors (p = 0.01). After a prevention protocol was progressively implemented from 2005, primary thromboprophylaxis was administered to 104 patients (68%) with risk factors. Among patients at risk (n = 151), the incidence of DVT decreased by roughly half when they received a LMWH: 9/97 (9.2%) and 9/54 (16.6%), respectively (p = 0.23). CONCLUSION Patients with GCT who receive cisplatin-based chemotherapy are at risk of developing a TEE which can be predicted by elevated serum LDH. To our knowledge this is the first study exploring LMWH as thromboprophylaxis in GCT patients. A prospective trial testing prophylactic anticoagulation is warranted.
Collapse
Affiliation(s)
- Marco Gizzi
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Lucie Oberic
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Christophe Massard
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Audrey Poterie
- Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Gwenael Le Teuff
- Department of Biostatistics and Epidemiology, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Yohann Loriot
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Giulia Baciarello
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Judith Michels
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Alberto Bossi
- Department of Radiation Oncology, Institut Gustave Roussy, University of Paris Sud, 94800 Villejuif, France
| | - Pierre Blanchard
- Department of Radiation Oncology, Institut Gustave Roussy, University of Paris Sud, 94800 Villejuif, France
| | - Bernard Escudier
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France
| | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris-Sud, 94800 Villejuif, France.
| |
Collapse
|
405
|
Gumus M, Bilici A, Odabas H, Ustaalioglu BBO, Kandemir N, Demirci U, Cihan S, Bayoglu IV, Ozturk T, Turkmen E, Urakci Z, Seker MM, Gunaydin Y, Selcukbiricik F, Turan N, Sevinc A. Outcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumors. World J Urol 2016; 35:1103-1110. [PMID: 27812752 DOI: 10.1007/s00345-016-1964-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Currently, it is accepted that risk assessment of clinical stage I (CS I) nonseminomatous germ cell tumors (NSGCT) patient is mainly dependent on the presence of lymphovascular invasion (LVI). Initial active surveillance, adjuvant chemotherapy and retroperitoneal lymph node dissection (RPLND) are acceptable treatment options for these patients, but there is no uniform consensus. The purpose of this study was to compare outcomes of active surveillance with adjuvant chemotherapy. METHODS A total of 201 patients with CS I NSGCT after orchiectomy were included. Outcomes of active surveillance and adjuvant chemotherapy were retrospectively analyzed. The prognostic significance of risk factors for survival and relapse was evaluated. RESULTS Of the 201 patients, 110 (54.7%) received adjuvant chemotherapy, while the remaining 91 patients (45.3%) underwent surveillance. Relapses were significantly higher for patients underwent surveillance compared to adjuvant chemotherapy group (18.3 vs. 1.2%, p < 0.001). The 5-year relapse-free survival (RFS) rate for patients who were treated with adjuvant chemotherapy was significantly better than those of patients underwent surveillance (97.6 vs. 80.8%, respectively; p < 0.001). Univariate analysis showed that the presence of LVI (p = 0.01) and treatment option (p < 0.001) were prognostic factors for RFS and pT stage (p = 0.004) and invasion of rete testis (p = 0.004) and the presence of relapse (p < 0.001) were significant prognostic factors for OS. Multivariate analysis revealed that the treatment strategy was an independent prognostic factor for RFS (p < 0.001, HR 0.54). A logistic regression analysis demonstrated that treatment options (p = 0.031), embryonal carcinoma (EC) >50% (p = 0.013) and tumor diameter (p = 0.016) were found to be independent factors for predicting relapse. CONCLUSIONS Our results indicate that adjuvant chemotherapy is associated with improved RFS compared with surveillance for CS I NSGCT patients. Moreover, the treatment strategy is an important prognostic indicator for RFS and a predictive factor for relapse. Although adjuvant chemotherapy seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still preferred management option.
Collapse
Affiliation(s)
- Mahmut Gumus
- Department of Medical Oncology, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey. .,Tem Avrupa Otoyolu, Goztepe Cikisi, N0:1, 34214, Bagcilar, Istanbul, Turkey.
| | - Hatice Odabas
- Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | | | - Nurten Kandemir
- Department of Medical Oncology, Ankara Onkoloji Education and Research Hospital, Ankara, Turkey
| | - Umut Demirci
- Department of Medical Oncology, Ataturk Education and Research Hospital, Ankara, Turkey
| | - Sener Cihan
- Department of Medical Oncology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim Vedat Bayoglu
- Department of Medical Oncology, Izmir Ataturk Education and Research Hospital, Izmir, Turkey
| | - Turkan Ozturk
- Department of Medical Oncology, Medical Faculty, Karadeniz University, Trabzon, Turkey
| | - Esma Turkmen
- Department of Medical Oncology, Medical Faculty, Trakya University, Edirne, Turkey
| | - Zurat Urakci
- Department of Medical Oncology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Mehmet Metin Seker
- Department of Medical Oncology, Medical Faculty, Cumhuriyet University, Sivas, Turkey
| | - Yusuf Gunaydin
- Department of Medical Oncology, Medical Faculty, Gazi University, Ankara, Turkey
| | - Fatih Selcukbiricik
- Department of Medical Oncology, Medical Faculty, Koc University, Istanbul, Turkey
| | - Nedim Turan
- Department of Medical Oncology, Malatya State Hospital, Malatya, Turkey
| | - Alper Sevinc
- Department of Medical Oncology, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| |
Collapse
|
406
|
|
407
|
Brouwer OR, van der Poel HG, Bevers RF, van Gennep EJ, Horenblas S. Beyond penile cancer, is there a role for sentinel node biopsy in urological malignancies? Clin Transl Imaging 2016; 4:395-410. [PMID: 27738628 PMCID: PMC5037151 DOI: 10.1007/s40336-016-0189-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Abstract
This review aims to discuss the current state-of-the-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B). The feasibility of SN biopsy in prostate cancer has been repeatedly demonstrated and its potential value is increasingly being recognised. However, conclusive prospective clinical data as well as consensus on methodology and patient selection are still lacking. For bladder, renal and testicular cancer, only few studies have been published, and concerns around high false-negative rates remain. Throughout the years, the uro-oncological field has portrayed a pivotal role in the development of the SN concept. Recent advances such as hybrid tracers and novel intraoperative detection tools such as fluorescence and portable gamma imaging will hopefully encourage prospectively designed clinical trials which can further substantiate the potential of the SN approach in becoming an integral part of staging in urological malignancies beyond penile cancer.
Collapse
Affiliation(s)
- O R Brouwer
- Department of Urologyand Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - H G van der Poel
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - R F Bevers
- Department of Urologyand Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - E J van Gennep
- Department of Urologyand Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - S Horenblas
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| |
Collapse
|
408
|
Oldenburg J, Dieckmann KP. Contralateral biopsies in patients with testicular germ cell tumours: What is the rationale? World J Urol 2016; 35:1161-1166. [PMID: 27738807 DOI: 10.1007/s00345-016-1945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/26/2016] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION In 1979, the Copenhagen group around Dr. Skakkebaek introduced contralateral biopsy in patients with testicular germ cell tumour (GCT) as a means of early diagnosing a contralateral testicular tumour (Berthelsen et al. in Br Med J 2(6186):363-364, 1). Although the rationale of contralateral biopsies is based on much of scientific evidence, no issue regarding the management of GCTs has been more controversial than the issue of contralateral biopsies (Heidenreich in BJU Int 104(9 Pt B):1346-1350, 2; Grigor and Rorth in Eur Urol 23(1):129-135, 3). A poll conducted during the GCT Consensus Meeting in Berlin 2011 revealed that 43 % of 60 leading experts would not recommend a contralateral biopsy and only 13.7 % would do the biopsy in all cases with GCT (Beyer et al. in Ann Oncol 24(4):878-888, 4). Likewise, the European Association of Urology and the European Society of Medical Oncology offer only weak recommendations with respect to contralateral biopsies in their guidelines of testicular cancer (Albers et al. in Eur Urol 68(6):1054-1068, 5; Oldenburg et al. in Ann Oncol 24(Suppl 6):vi125-vi132, 6). CONCLUSION This review summarizes contemporary knowledge regarding contralateral biopsies to provide professionals caring for GCT patients with sufficient information to decide for or against the procedure in clinical practice.
Collapse
Affiliation(s)
- Jan Oldenburg
- Department of Oncology, Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Klaus-Peter Dieckmann
- Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Suentelstrasse 11a, 22457, Hamburg, Germany
| |
Collapse
|
409
|
Mearini L, Nunzi E, Di Biase M, Silvi E, Sabatini I, Porena M. Robotic Retroperitoneal Lymph Node Dissection in Advanced Stage Disease. Urol Int 2016; 97:380-385. [PMID: 27723654 DOI: 10.1159/000450924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/19/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The current report describes the feasibility of robotic retroperitoneal lymph node dissection (RRPLND), including some technical tricks for port placement for both right- and left-sided surgery. METHODS Patients with advanced stage retroperitoneal disease underwent RRPLND using the 4-arm da Vinci Si Surgical System (Intuitive Surgical, Inc.). In both cases, the field of dissection was an ipsilateral template for lymph node dissection. RESULTS RRPLND in such configuration was safe and effective in both cases. The illustrated port placement with perpendicular docking of the robot allowed for a wide range of motion with limited external clashing, providing sufficient space for the assistant surgeon. The operative time was 300 min (including docking and console time), with no perioperative complications and short hospital stay. CONCLUSION The port configuration for right- or left-sided unilateral template RRPLND was feasible, permitting a wide range of motion for the robotic arms and thus facilitating an efficient and safe dissection.
Collapse
Affiliation(s)
- Luigi Mearini
- Department of Urology, Perugia Hospital, University of Perugia, Perugia, Italy
| | | | | | | | | | | |
Collapse
|
410
|
Nicolai N, Cattaneo F, Biasoni D, Catanzaro M, Torelli T, Zazzara M, Necchi A, Giannatempo P, Raggi D, Piva L, Colecchia M, Salvioni R, Stagni S. Laparoscopic Postchemotherapy Retroperitoneal Lymph-Node Dissection Can Be a Standard Option in Defined Nonseminomatous Germ Cell Tumor Patients. J Endourol 2016; 30:1112-1119. [DOI: 10.1089/end.2016.0458] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nicola Nicolai
- Testis Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Davide Biasoni
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Mario Catanzaro
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Tullio Torelli
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Michele Zazzara
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Necchi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Patrizia Giannatempo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Daniele Raggi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Luigi Piva
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Maurizio Colecchia
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Roberto Salvioni
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Silvia Stagni
- Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| |
Collapse
|
411
|
Lorch A, Beyer J. High-dose chemotherapy as salvage treatment in germ-cell cancer: when, in whom and how. World J Urol 2016; 35:1177-1184. [DOI: 10.1007/s00345-016-1941-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 09/19/2016] [Indexed: 03/08/2023] Open
|
412
|
Weiner AB, Pearce SM, Eggener SE. Management trends for men with early-stage nonseminomatous germ cell tumors of the testicle: An analysis of the National Cancer Database. Cancer 2016; 123:245-252. [DOI: 10.1002/cncr.30332] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/16/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Adam B. Weiner
- Pritzker School of Medicine; University of Chicago; Chicago Illinois
- Department of Urology; Northwestern University Feinberg School of Medicine; Chicago Illinois
| | - Shane M. Pearce
- Section of Urology, Department of Surgery; University of Chicago; Chicago Illinois
| | - Scott E. Eggener
- Section of Urology, Department of Surgery; University of Chicago; Chicago Illinois
| |
Collapse
|
413
|
Soares DG, Millot F, Lacroix I, Lotz JP. Heterophile Antibody Interference led to Unneeded Chemotherapy in a Testicular Cancer Patient. Urol Case Rep 2016; 9:1-3. [PMID: 27617210 PMCID: PMC5007586 DOI: 10.1016/j.eucr.2016.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022] Open
Abstract
Human heterophile antibodies may develop after infection or contact with animal tissues or animal serum products. These antibodies have the capacity to bind to the animal immunoglobulins used in immunoassays leading to erroneous results. We here report a case of a testicular germ cell tumor patient who developed heterophile antibodies during the surveillance period of his disease. Following false-positive results of human chorionic gonadotropin (hCG) he received unneeded chemotherapy. This article also stresses the problem of using serum tumor markers without no major imaging abnormalities to diagnose a patients' relapse.
Collapse
Affiliation(s)
- Daniele G Soares
- Department of Medical Oncology, APREC (Alliance Pour la Recherche En Cancérologie), Hospital Tenon (Public Assistance - Paris Hospitals, AP-HP), 4, rue de la Chine, 75970 Paris Cedex 20, France
| | - Françoise Millot
- Department of Biochemistry, Hospital Tenon (Public Assistance - Paris Hospitals, AP-HP), 4, rue de la Chine, 75970 Paris Cedex 20, France
| | | | - Jean-Pierre Lotz
- Department of Medical Oncology, APREC (Alliance Pour la Recherche En Cancérologie), Hospital Tenon (Public Assistance - Paris Hospitals, AP-HP), 4, rue de la Chine, 75970 Paris Cedex 20, France; Sorbonne Universities, University Pierre et Marie Curie (IUC-UPMC Univ. Paris 06), France
| |
Collapse
|
414
|
Abstract
Clinical stage I testicular germ cell tumours (TGCT) are highly curable neoplasms. The treatment of stage I testicular cancer is complex and requires a multidisciplinary approach. Standard options after radical orchiectomy for seminoma include active surveillance, radiation therapy or 1-2 cycles of carboplatin, and options for nonseminoma include active surveillance, retroperitoneal lymph node dissection (RPLND) or 1-2 cycles of bleomycin plus etoposide plus cisplatin (BEP). All the options should be discussed with each patient and treatment choices should be made by shared decision making as virtually all patients with clinical stage I TGCT can be cured of their disease. Long-term survival of men with stage I disease is ∼99% and care must be taken to limit the long-term risks of treatment. Orchiectomy is curative in the majority of patients. The management of clinical stage I TGCT remains controversial among experts at high-volume centres throughout the world. The main controversy is whether to overtreat a substantial number of patients with stage I disease to prevent relapse, or to observe and treat only patients who experience disease relapse as adjuvant treatment and surveillance strategy both bring curative outcome. Thus, a summary of the available evidence in stage I disease and recommendations for disease management from a high-volume centre such as Indiana University might be of interest to treating clinicians.
Collapse
|
415
|
Nicolai N, Trama A. Personalise Medicine, Do Not Medicalise Persons: The Case of Patients with Stage I Testis Tumour Undergoing Surveillance. Eur Urol 2016; 71:128-129. [PMID: 27614694 DOI: 10.1016/j.eururo.2016.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 08/31/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Nicola Nicolai
- Testis Surgery Unit, Urology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| |
Collapse
|
416
|
Necchi A, Miceli R, Oualla K, Sonpavde G, Giannatempo P, Raggi D, Nicolai N, Boffi R, Busia A, Mariani L, Salvioni R. Effect of Bleomycin Administration on the Development of Pulmonary Toxicity in Patients With Metastatic Germ Cell Tumors Receiving First-Line Chemotherapy: A Meta-Analysis of Randomized Studies. Clin Genitourin Cancer 2016; 15:213-220.e5. [PMID: 27692810 DOI: 10.1016/j.clgc.2016.08.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/11/2016] [Accepted: 08/26/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Limited information is available about the effect of bleomycin administration on the development of pulmonary toxicity in metastatic germ cell tumors (GCT). PATIENTS AND METHODS A literature search was conducted to identify randomized trials of first-line chemotherapy for GCT. We conducted univariate and multivariate analyses using random effects models to evaluate the predictive role of bleomycin administration in the development of all Grade and Grade 3 to 4 (G3-4) pulmonary toxicity. The results were adjusted for length of follow-up, prognostic risk group, year of treatment, presence of lung metastases, and primary mediastinal GCT. RESULTS Fifty-three study arms of 25 phase II and III trials encompassing 6498 patients were selected: 40 that used bleomycin (n = 5093) and 13 that did not (n = 1405). The pooled probability of all-Grade pulmonary toxicity in the bleomycin and nonbleomycin arms was 11.7% (95% confidence interval [CI], 8.4%-16.0%) and 1.7% (95% CI, 0.7%-4.2%), respectively. Univariate analysis indicated that bleomycin administration was associated with the incidence of all-Grade (odds ratio [OR], 7.57; 95% CI, 2.84-20.18; Wald test P < .001) and G3-4 pulmonary toxicity (OR, 5.19; 95% CI, 1.57-17.16; P = .007). Multivariate analysis showed a significant association of bleomycin administration with the incidence of all-Grade pulmonary toxicity (OR, 4.14; 95% CI, 1.36-12.59; P = .012) and a trend toward significance for G3-4 toxicity (OR, 2.24; 95% CI, 0.91-5.51; P = .080). CONCLUSION We quantified the bleomycin-associated effect on the development of pulmonary toxicity in patients with GCT who received first-line chemotherapy. This information might be useful for planning clinical trials aimed at reducing chemotherapy as well as to inform patients in the clinic.
Collapse
Affiliation(s)
- Andrea Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
| | - Rosalba Miceli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | | | | | - Daniele Raggi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Nicola Nicolai
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Luigi Mariani
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | |
Collapse
|
417
|
A Statistical Approach to Determine the Optimal Duration of Post-Treatment Follow-Up: Application to Metastatic Nonseminomatous Germ Cell Tumors. Clin Genitourin Cancer 2016; 15:230-236. [PMID: 27594552 DOI: 10.1016/j.clgc.2016.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 07/18/2016] [Accepted: 07/30/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The objective of this study was to present a statistical method to define an optimal duration of follow-up for patients in remission after treatment for cancer, for detection of recurrences. PATIENTS AND METHODS Surveillance duration was estimated using the 2-step approach proposed by Mould et al. Relapse-free interval was modeled using the parametric cure model proposed by Boag. The optimal length of follow-up was then estimated as the minimal elapsed time after which the probability of a patient to relapse and to be cured with success is below a given threshold value. The method is applied to 2 real data sets of patients treated for metastatic non seminomatous germ-cell tumors: T93BP and T93MP. RESULTS For the T93BP, cure rate was estimated at 91.3% and proportions of patients who relapsed after 3 and 5 years were estimated at 0.5% and 0.2%. With a probability of success of salvage treatment equal to 80% and 50%, numbers of delayed cases after 5 years were 2 and 1. For T93MP, the proportion of patients who presented relapse after 5 and 10 years were estimated at 5.2% and 2.6%. Considering a probability of salvage treatment equal to 20%, the number of delayed cases after 5 and 10 years were 10 and 5. CONCLUSION Using this methodology, duration of post-therapeutic follow-up might be tailored according to an objective criteria: the number of patients who present relapse after the end of follow-up and who could have been treated with success in case of early detection.
Collapse
|
418
|
Fizazi K. Biennial report on genitourinary cancers. Eur J Cancer 2016; 66:125-30. [PMID: 27569040 DOI: 10.1016/j.ejca.2016.06.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 12/26/2022]
Abstract
The last 2 years (2014 and 2015) have witnessed major advances in the treatment of genitourinary malignancies. Of note and in marked contrast to previous years, all four major cancers (prostate cancer, testicular cancer, kidney cancer, and bladder cancer) have benefited from this progress. In prostate cancer, it was clearly demonstrated that a local treatment should be administered for high-risk localised disease. The standard of care was changed for patients with upfront metastatic disease with combined androgen deprivation therapy plus docetaxel becoming the new standard for fit patients with multiple bony metastases. In castrate-resistant disease, AR-V7 variants were shown to be predictive factors for resistance to next-generation AR axis-targeting agents and DNA repair targeting emerged as a promising new strategy. In poor-prognosis advanced non-seminoma, a better outcome was randomly demonstrated for the first time when a switch-intensified treatment was used in patients with a slow tumour marker decline. In metastatic kidney cancer, both cabozantinib and checkpoint inhibitors (nivolumab) are now associated with improved outcomes in pretreated patients and should soon change the standard of care for these patients. Last but not least, in urothelial bladder cancer, molecular classification is evolving and suggesting that immunotherapy with checkpoint inhibitors is active, as demonstrated in early trials.
Collapse
Affiliation(s)
- Karim Fizazi
- Department of Cancer Medicine, Gustave Roussy, University Paris Sud, 94800 Villejuif, France.
| |
Collapse
|
419
|
The Evolving Management of Patients With Clinical Stage I Seminoma. Urology 2016; 98:113-119. [PMID: 27527410 DOI: 10.1016/j.urology.2016.07.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/01/2016] [Accepted: 07/01/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine trends in management and factors associated with men receiving either chemotherapy or radiation therapy post orchiectomy for clinical stage I (CSI) seminoma in a contemporary setting. PATIENTS AND METHODS The National Cancer Data Base was queried for all patients with CSI seminoma from 1998 to 2012. Adjuvant treatment after orchiectomy was classified into 3 groups: surveillance, radiotherapy, and chemotherapy. Yearly trends in management are described. Subgroup analysis for the years 2010-2012 was completed using logistic regression to determine predictors of receiving treatment. RESULTS Of 80,385 patients with testicular cancer, 16,931 had CSI seminoma. There was a progressive decline in the use of post-orchiectomy treatment from 1998 to 2012. In the years 2010-2012 (n = 5816), 59.9% of patients chose surveillance compared with 25.1% receiving radiotherapy and 15.0% receiving chemotherapy. Regression modeling demonstrated that men aged 18-30 were less likely (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.69-1.00, P = .048) to receive treatment than those aged 31-37. Increasing pathologic stage was associated with a greater likelihood of treatment (OR 1.77, 95% CI 1.52-2.06), whereas patients treated at academic hospitals were less likely to receive adjuvant therapy (OR 0.77, 95% CI 0.62-0.94). CONCLUSION Despite a trend toward increased use of post-orchiectomy surveillance for patients with CSI seminoma, a significant portion of patients are still receiving treatment. Pathologic stage and treating hospital type have the strongest association with management decisions. Improved guideline adherence may reduce the potential for adverse effects after chemotherapy or radiation therapy for CSI seminoma.
Collapse
|
420
|
Frisina RD, Wheeler HE, Fossa SD, Kerns SL, Fung C, Sesso HD, Monahan PO, Feldman DR, Hamilton R, Vaughn DJ, Beard CJ, Budnick A, Johnson EM, Ardeshir-Rouhani-Fard S, Einhorn LH, Lipshultz SE, Dolan ME, Travis LB. Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer. J Clin Oncol 2016; 34:2712-20. [PMID: 27354478 PMCID: PMC5019759 DOI: 10.1200/jco.2016.66.8822] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. PATIENTS AND METHODS Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. RESULTS Increasing cumulative cisplatin dose (median, 400 mg/m(2); range, 200 to 800 mg/m(2)) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends, .021 to < .001): every 100 mg/m(2) increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P < .001). Cumulative cisplatin doses > 300 mg/m(2) were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P = .0066) and worse normative-matched quartiles (odds ratio, 1.33; P = .093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P < .001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P = .59). Hypertension was significantly related (P = .0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. CONCLUSION Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.
Collapse
Affiliation(s)
- Robert D Frisina
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Heather E Wheeler
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Sophie D Fossa
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Sarah L Kerns
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Chunkit Fung
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Howard D Sesso
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Patrick O Monahan
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Darren R Feldman
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Robert Hamilton
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - David J Vaughn
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Clair J Beard
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Amy Budnick
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Eileen M Johnson
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Shirin Ardeshir-Rouhani-Fard
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Lawrence H Einhorn
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI.
| | - Steven E Lipshultz
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - M Eileen Dolan
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Lois B Travis
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| |
Collapse
|
421
|
Dieckmann KP, Radtke A, Spiekermann M, Balks T, Matthies C, Becker P, Ruf C, Oing C, Oechsle K, Bokemeyer C, Hammel J, Melchior S, Wosniok W, Belge G. Serum Levels of MicroRNA miR-371a-3p: A Sensitive and Specific New Biomarker for Germ Cell Tumours. Eur Urol 2016; 71:213-220. [PMID: 27495845 DOI: 10.1016/j.eururo.2016.07.029] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Clinical management of germ cell tumours (GCTs) relies on monitoring of serum tumour markers. However, the markers α-fetoprotein (AFP), the β-subunit of human chorionic gonadotropin (bHCG), and lactate dehydrogenase (LDH) are expressed in <60% of GCT cases. OBJECTIVE To test the utility of the microRNAs (miRNAs) miR-371a-3p, miR-372-3p, miR-373-3p, and miR-367-3p as sensitive and specific GCT serum biomarkers. DESIGN, SETTING, AND PARTICIPANTS Serum levels of miRNAs were measured in 166 consecutive patients with GCT before and after treatment and in 106 male controls. In the first 50 consecutive patients, all four miRNAs were measured. In the main study, only the most sensitive miRNA was further analysed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The specificity and sensitivity of the four miRNAs were studied using receiver operating characteristic curves. miRNA sensitivities were compared to those of classical markers. Statistical cross-comparisons of miRNA levels for GCT subgroups and controls were performed at various time points during treatment. RESULTS AND LIMITATIONS Overall, miR-371a-3p performed best, with 88.7% sensitivity (95% confidence interval [CI] 82.5-93.3%) and 93.4% specificity (95% CI 86.9-97.3%) and an area under the curve of 0.94, outperforming AFP, bHCG, and LDH (combined sensitivity 50%). According to Kernel density estimation, the sensitivity and specificity were 86.3% and 92.5%, respectively. miR-371a-3p levels dropped to normal after completion of treatment. The miRNA levels correlated with treatment failure and relapse. Teratoma did not express miR-371a-3p. CONCLUSIONS The miRNA miR-371a-3p is a specific and sensitive novel serum GCT biomarker that accurately correlates with disease activity. Validation of this test in a large-scale prospective study is needed. PATIENT SUMMARY: miR-371a-3p is a novel serum marker for germ cell tumours that is expressed by 88.7% of patients and thus is far more sensitive and specific than classical serum markers. It correlates with tumour burden and treatment results. Validation in a large patient cohort is needed.
Collapse
Affiliation(s)
| | - Arlo Radtke
- Centre for Human Genetics, University of Bremen, Bremen, Germany
| | | | - Thomas Balks
- Department of Urology, Albertinen Krankenhaus, Hamburg, Germany
| | - Cord Matthies
- Department of Urology, Bundeswehr Krankenhaus, Hamburg, Germany
| | - Pascal Becker
- Department of Urology, Bundeswehr Krankenhaus, Hamburg, Germany
| | - Christian Ruf
- Department of Urology, Bundeswehr Krankenhaus, Hamburg, Germany
| | - Christoph Oing
- Department of Medical Oncology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Karin Oechsle
- Department of Medical Oncology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- Department of Medical Oncology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Hammel
- Department of Urology, Zentralklinikum Bremen, Bremen, Germany
| | | | - Werner Wosniok
- Institute of Statistics, University of Bremen, Bremen, Germany
| | - Gazanfer Belge
- Centre for Human Genetics, University of Bremen, Bremen, Germany
| |
Collapse
|
422
|
Late Relapses in Stage I Testicular Cancer Patients on Surveillance. Eur Urol 2016; 70:365-71. [DOI: 10.1016/j.eururo.2016.03.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/06/2016] [Indexed: 11/21/2022]
|
423
|
Schröder C, Lock G, Schmidt C, Löning T, Dieckmann KP. Real-Time Elastography and Contrast-Enhanced Ultrasonography in the Evaluation of Testicular Masses: A Comparative Prospective Study. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1807-1815. [PMID: 27181687 DOI: 10.1016/j.ultrasmedbio.2016.03.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 03/19/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
This study investigates the usefulness of contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for the characterization of testicular masses by comparing pre-operative ultrasound findings with post-operative histology. Sixty-seven patients with 68 sonographically detected testicular masses underwent B-mode, color-coded Doppler sonography (CCDS), CEUS and RTE according to defined criteria. For RTE, elasticity score (ES), difference of elasticity score (D-ES), strain ratio (SR) and size quotient (Qsize) were evaluated. Histopathologically, 54/68 testicular lesions were neoplastic (47 malignant, 7 benign). Descriptive statistics revealed the following results (neoplastic vs. non-neoplastic) for sensitivity, specificity, positive predictive value, negative predictive value and accuracy, respectively: B-mode, 100%, 43%, 87%, 100%, 88%; CCDS 81%, 86%, 96%, 55%, 82%; CEUS 93%, 85%, 96%, 73%, 91%; ES 98%, 25%, 85%, 75%, 85%; D-ES 98%, 50%, 90%, 83%, 89%; SR 90%, 45%, 86%, 56%, 81%; and Qsize 57%, 83%, 94%, 28%, 61%. B-mode with CCDS remains the standard for assessing testicular masses. In characterization of testicular lesions, CEUS clearly outperformed all other modalities. Our study does not support the routine use of RTE in testicular ultrasonography because of its low specificity.
Collapse
Affiliation(s)
- Claudia Schröder
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany
| | - Guntram Lock
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany.
| | - Christa Schmidt
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany
| | - Thomas Löning
- Institute of Pathology, Albertinen-Krankenhaus, Hamburg, Germany
| | | |
Collapse
|
424
|
Wells H, Hayes MC, O'Brien T, Fowler S. Contemporary retroperitoneal lymph node dissection (RPLND) for testis cancer in the UK - a national study. BJU Int 2016; 119:91-99. [DOI: 10.1111/bju.13569] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Hannah Wells
- Department of Urology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Matthew C. Hayes
- Department of Urology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Tim O'Brien
- Department of Urology; Guy's and St Thomas’ NHS Foundation Trust; London UK
| | - Sarah Fowler
- British Association of Urological Surgeons (BAUS) Cancer Registry; The Royal College of Surgeons of England; London UK
| |
Collapse
|
425
|
Preorchiectomy Leydig Cell Dysfunction in Patients With Testicular Cancer. Clin Genitourin Cancer 2016; 15:e37-e43. [PMID: 27524512 DOI: 10.1016/j.clgc.2016.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/28/2016] [Accepted: 07/13/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known about preorchiectomy Leydig cell function in patients with testicular germ cell cancer (TGCC). The aim was to estimate the prevalence of preorchiectomy Leydig cell dysfunction and evaluate factors associated with this condition in a cohort of patients with TGCC. PATIENTS AND METHODS We evaluated luteinizing hormone (LH), total testosterone (TT), calculated free T (cFT), estradiol, and sex hormone-binding globulin (SHBG) preorchiectomy in 561 patients with TGCC and compared with 561 healthy controls. We calculated TT/LH and cFT/LH ratios and constructed bivariate charts of TT/LH and cFT/LH from the controls. Logistic regression analysis with an abnormal cFT/LH ratio as outcome and clinical stage, tumor size, age, histology, presence of contralateral germ cell neoplasia in situ (GCNIS), and bilateral tumors as covariates was performed. RESULTS In patients who were negative for human chorionic gonadotropin (hCG) (n = 374), TT (P = .004), cFT (P < .001), TT/LH ratio (P = .003), and cFT/LH ratio (P = .002) were lower than in controls. A total of 95 (25%) and 91 (24%) of hCG-negative patients had abnormal values when using combined evaluation of TT/LH and cFT/LH, respectively. Increasing tumor size, contralateral GCNIS, and increasing age were associated with Leydig cell dysfunction. In patients positive for hCG (n = 187), all reproductive hormones except SHBG were different from controls (P < .001). CONCLUSION Patients with TGCC are at increased risk of Leydig cell dysfunction before orchiectomy. Contralateral GCNIS, increasing age, and increasing tumor size are associated with Leydig cell dysfunction. We hypothesize that patients with preexisting Leydig cell dysfunction are at increased risk of testosterone deficiency following treatment.
Collapse
|
426
|
Yap SA, Yuh LM, Evans CP, Dall’Era MA, Wagenaar RM, Cress R, Lara PN. Evolving patterns of care in the management of stage I non-seminomatous germ cell tumors: data from the California Cancer Registry. World J Urol 2016; 35:277-283. [DOI: 10.1007/s00345-016-1870-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/31/2016] [Indexed: 11/29/2022] Open
|
427
|
Kamarulzaman MN, Mohamed SKC. RE: The value of testicular ultrasound in the prediction of the type and size of testicular tumors. Int Braz J Urol 2016; 42:397-8. [PMID: 27256199 PMCID: PMC4871406 DOI: 10.1590/s1677-5538.ibju.2015.0728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/08/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Mohd Nazli Kamarulzaman
- Urology Unit, Department of Surgery International islamic University Malaysia Jalan Hospital Campus Jalan Penjara, Kuantan, Malaysia
| | - Siti Kamariah Che Mohamed
- Department of Radiology, International Islamic University, Malaysia Kulliyyah of Medicine, Kuantan, Pahang, Malaysia
| |
Collapse
|
428
|
Klang E, Rozendorn N, Raskin S, Portnoy O, Sklair M, Marom EM, Konen E, Amitai MM. CT measurement of breast glandular tissue and its association with testicular cancer. Eur Radiol 2016; 27:536-542. [PMID: 27229339 DOI: 10.1007/s00330-016-4414-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 04/20/2016] [Accepted: 05/13/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To evaluate the associations between breast glandular tissues diameters as determined by CT and b-hCG levels, histological types, tumour spread and prognosis in patients with testicular germ cell tumour. METHODS Ninety-four patients with pre-treatment CT scan and markers (b-hCG, AFP, LDH) were retrospectively collected. A radiologist measured diameters in all CT examinations and correlation between diameters and log (b-hCG) was assessed (Pearson's coefficient). The ability of measured diameters to predict lymphatic and distant haematogenous metastatic spread was evaluated (ROC curves). The associations between measured diameter cut-off values of 20 and 25 mm and International Germ Cell Cancer Collaborative Group (IGCCCG) classification, lymphatic and distant haematogenous metastatic spread and histological subtypes were evaluated (chi squared test). RESULTS Breast glandular diameters correlated to log(b-hCG) (r = 0.579) and predicted distant haematogenous metastatic spread (AUC = 0.78). Worse prognosis (intermediate or poor IGCCCG) was shown for 20 mm (27.3 vs. 4.2 %, p = 0.005) and 25 mm (33.3 vs. 6.1 %, p = 0.014). A diameter of 25 mm was associated with non-seminoma (91.7 vs. 48.8 %, p = 0.005). CONCLUSION Breast glandular tissue diameters correlated with log(b-hCG) and predicted distant haematogenous metastases. Twenty and 25 mm were associated with worse prognosis and 25 mm was able to distinguish between seminoma and non-seminoma. KEY POINTS • CT breast glandular tissue diameter correlates with log(b-HCG) • Gynaecomastia in CT is associated with worse prognosis • Gynaecomastia in CT is associated with non-seminoma histological subtype.
Collapse
Affiliation(s)
- Eyal Klang
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel. .,The Chaim Sheba Medical Center, Tel Hashomer, 5265601, Israel.
| | - Noa Rozendorn
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Steve Raskin
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Orith Portnoy
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Miri Sklair
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Edith M Marom
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Eli Konen
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Michal M Amitai
- Department of Radiology, Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
429
|
Pearce SM, Golan S, Gorin MA, Luckenbaugh AN, Williams SB, Ward JF, Montgomery JS, Hafez KS, Weizer AZ, Pierorazio PM, Allaf ME, Eggener SE. Safety and Early Oncologic Effectiveness of Primary Robotic Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Testicular Cancer. Eur Urol 2016; 71:476-482. [PMID: 27234998 DOI: 10.1016/j.eururo.2016.05.017] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Primary robot-assisted retroperitoneal lymph node dissection (R-RPLND) has been studied as an alternative to open RPLND in single-institution series for patients with low-stage nonseminomatous germ cell tumors (NSGCT). OBJECTIVE To evaluate a multicenter series of primary R-RPLND for low-stage NSGCT. DESIGN, SETTING, AND PARTICIPANTS Between 2011 and 2015, 47 patients underwent primary R-RPLND at four centers for Clinical Stage (CS) I-IIA NSGCT. SURGICAL PROCEDURE R-RPLND was performed using the da Vinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Data were collected regarding patient demographics, primary tumor characteristics, pathologic findings, and clinical outcomes. RESULTS AND LIMITATIONS Forty-two patients (89%) were CS I and five (11%) were CS IIA. The median operative time was 235min (interquartile range [IQR]: 214-258min), estimated blood loss was 50ml (IQR: 50-100ml), node count was 26 (IQR: 18-32), and length of stay was 1 d. There were two intraoperative complications (4%), four early postoperative complications (9%), no late complications, and the rate of antegrade ejaculation was 100%. Of the eight patients (17%) with positive nodes (seven pN1and one pN2), five (62%) received adjuvant chemotherapy. The one recurrence was out of template in the pelvis after adjuvant chemotherapy (resected teratoma). The median follow-up was 16 mo and the 2-yr recurrence-free survival rate was 97% (95% confidence interval: 82-100%). Limitations include retrospective design and limited follow-up. CONCLUSIONS Our multicenter experience supports R-RPLND as a potential option at experienced centers in select patients with low-stage NSGCT. Informal comparison to open and laparoscopic series suggests R-RPLND has an acceptably low morbidity profile, but oncologic efficacy evaluation requires further evaluation. PATIENT SUMMARY We examined outcomes after robot-assisted retroperitoneal lymph node dissection for patients with low-stage nonseminomatous testicular cancer with our data suggesting the robotic approach has acceptable morbidity and early oncologic outcomes.
Collapse
Affiliation(s)
- Shane M Pearce
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
| | - Shay Golan
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA
| | - Michael A Gorin
- Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amy N Luckenbaugh
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Stephen B Williams
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John F Ward
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Khaled S Hafez
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Alon Z Weizer
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Mohamad E Allaf
- Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Scott E Eggener
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA
| |
Collapse
|
430
|
Iyigun E, Tastan S, Ayhan H, Kose G, Acikel C. Validity and reliability analysis of the planned behavior theory scale related to the testicular self-examination in a Turkish context. Postgrad Med 2016; 128:496-501. [PMID: 27130481 DOI: 10.1080/00325481.2016.1182872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to determine the validity and reliability levels of the Planned Behavior Theory Scale as related to a testicular self-examination. METHODS The study was carried out in a health-profession higher-education school in Ankara, Turkey, from April to June 2012. The study participants comprised 215 male students. Study data were collected by using a questionnaire, a planned behavior theory scale related to testicular self-examination, and Champion's Health Belief Model Scale (CHBMS). RESULTS The sub-dimensions of the planned behavior theory scale, namely those of intention, attitude, subjective norms and self-efficacy, were found to have Cronbach's alpha values of between 0.81 and 0.89. Exploratory factor analysis showed that items of the scale had five factors that accounted for 75% of the variance. Of these, the sub-dimension of intention was found to have the highest level of contribution. A significant correlation was found between the sub-dimensions of the testicular self-examination planned behavior theory scale and those of CHBMS (p < 0.05). CONCLUSION The findings suggest that the Turkish version of the testicular self-examination Planned Behavior Theory Scale is a valid and reliable measurement for Turkish society.
Collapse
Affiliation(s)
- Emine Iyigun
- a School of Nursing , Gulhane Military Medical Academy , Ankara , Turkey
| | - Sevinc Tastan
- a School of Nursing , Gulhane Military Medical Academy , Ankara , Turkey
| | - Hatice Ayhan
- a School of Nursing , Gulhane Military Medical Academy , Ankara , Turkey
| | - Gulsah Kose
- a School of Nursing , Gulhane Military Medical Academy , Ankara , Turkey
| | - Cengizhan Acikel
- b Department of Biostatistics , Gulhane Military Medical Academy , Ankara , Turkey
| |
Collapse
|
431
|
Ondrusova M, Balogova S, Lehotska V, Kajo K, Mrinakova B, Ondrus D. Controversies in the management of clinical stage I testicular seminoma. Cent European J Urol 2016; 69:35-9. [PMID: 27123323 PMCID: PMC4846723 DOI: 10.5173/ceju.2016.699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/21/2015] [Accepted: 12/11/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction Following orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as adjuvant therapy for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches – AS versus adjuvant chemotherapy (ACT) on survival in patients with CSI testicular seminoma. Material and methods The cross-sectional study analyzed a total of 106 patients collected at a single centre between 4/2008–8/2015, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches. Results In group A (low-risk), consisting of 84 patients, who underwent AS, relapse occurred in 10 (11.9%) patients after a mean follow-up of 13.8 months. In group B (high-risk), consisting of 22 patients, who were treated with ACT, relapse occurred in two (9.1%) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100% with a mean follow-up of 25.3 months. The statistically significant difference in progression-free survival (PFS) between these two groups was not found. Conclusions ACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines.
Collapse
Affiliation(s)
- Martina Ondrusova
- St. Elisabeth University of Health and Social Sciences, Bratislava, Slovak Republic; Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic; Pharm-In, Ltd., Bratislava, Slovak Republic
| | - Sona Balogova
- Department of Nuclear Medicine, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Viera Lehotska
- 2 Department of Radiology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Karol Kajo
- Department of Pathology, Slovak Medical University & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Bela Mrinakova
- Department of Medical Oncology & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1 Department of Oncology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| |
Collapse
|
432
|
Testicular seminoma clinical stage 1: treatment outcome on a routine care level. J Cancer Res Clin Oncol 2016; 142:1599-607. [PMID: 27116691 PMCID: PMC4899489 DOI: 10.1007/s00432-016-2162-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/11/2016] [Indexed: 11/29/2022]
Abstract
Purpose Clinical stage 1 (CS1) testicular seminoma involves an almost 100 % disease-specific survival in controlled clinical trials. We aimed to find out whether these results can be matched in patients managed on the routine care level. Patients, methods In total, 725 patients with seminoma CS1 were prospectively enrolled from 130 institutions. Adjuvant management as decided by local physicians involved surveillance (n = 256), radiotherapy (41), 1× Carboplatin (362), and 2× Carboplatin (66). We registered type of management, age, duration of follow-up (F/U), relapse, rete testis invasion (RTI), and tumor size. Actuarial relapse-free survival curves were calculated for treatment modalities and stratified for tumor sizes and RTI. A Cox regression model was calculated to explore for factors influencing relapses. Results Disease-specific survival was 100 %. Crude relapse rates were 8.2, 2.4, 5.0, and 1.5 % for surveillance, radiotherapy, 1× Carboplatin, and 2× Carboplatin after a median F/U of 30 months. RTI and tumor size were not associated with progression in surveillance patients. One course Carboplatin caused relapses in 6.8 % in tumor sizes >4 cm and 9.3 % (actuarial 13 %) in sizes >5 cm. The Cox model revealed the association of tumor size with recurrence in the entire seminoma population (Hazard ratio 1.17; 95 % confidence intervals 1.03–1.33). Conclusions The overall outcome of CS1 seminoma managed on the routine care level mirrors that of controlled trials. Unexpectedly, the risk factors in surveillance patients were not confirmed, but tumor size proved to be a risk indicator in the entire group of seminoma. Importantly, one course Carboplatin involved low efficacy to control the disease in large tumors. Electronic supplementary material The online version of this article (doi:10.1007/s00432-016-2162-z) contains supplementary material, which is available to authorized users.
Collapse
|
433
|
Białek W, Rudzki S, Wronecki L. Capillary hemangioma of the testis. A case report of a rare benign tumor. J Ultrason 2016; 16:87-93. [PMID: 27104006 PMCID: PMC4834374 DOI: 10.15557/jou.2016.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/27/2015] [Accepted: 10/04/2015] [Indexed: 11/22/2022] Open
Abstract
This paper presents the case of a very rare capillary hemangioma of the testis in a 23-year-old patient. Physical examination revealed a tumor located in the upper pole of the left testis, which was suspected of being malignant due to its significantly increased density and irregular contours. Blood levels of the following tumor markers were determined: alpha-fetoprotein, human chorionic gonadotropin and lactate dehydrogenase. No abnormalities were found in any of these tests. A gray-scale ultrasound scan of the scrotum revealed a lesion located in the upper pole of the left testis, 24 mm in diameter with slightly decreased echogenicity and irregular contours, which suggested infiltration of the tunica albuginea of the testis. Color and power Doppler scans demonstrated a dense network of blood vessels and increased blood flow in the lesion described. In addition, 3D ultrasound scan images were obtained, which allowed for a thorough determination of the topography of the lesion. No abnormalities were found in the patient's medical history, physical examination or ultrasound scan of the right testis. Taking into account the suspected malignancy with signs of infiltration of the tunica albuginea of the upper pole of the testis a decision was made to remove the left testis together with the spermatic cord using the inguinal approach. A histopathological examination of the whole specimen revealed a multifocal capillary hemangioma of the testis, signs of testicular fibrosis and significant atrophy of the spermatogenic epithelium of the seminiferous tubules. Immunohistochemistry: CD31 (+), CD34 (+), FVIII (−), vimentin (+), CK MNF116 (−), mesothelial cells (−), calretinin (−), MIB-1 = 8.4%. The tumor described is one of the few benign lesions originating from the tissues of the testis for which partial resection of the organ may be considered. Intraoperative histopathological examination and resection of the lesion with the preservation of a healthy tissue margin may be considered in patients with a single testis in whom the tumor is found to have a very rich vascular network and the levels of tumor markers are normal.
Collapse
Affiliation(s)
- Waldemar Białek
- Department of Urology, 1st Military Hospital, Lublin, Poland; Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Poland
| | - Sławomir Rudzki
- Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Poland
| | - Lech Wronecki
- Department of Clinical Pathomorphology, Medical University of Lublin, Poland
| |
Collapse
|
434
|
Abstract
Testicular germ cell tumours are at the crossroads of developmental and neoplastic processes. Their cause has not been fully elucidated but differences in incidences suggest that a combination of genetic and environment factors are involved, with environmental factors predominating early in life. Substantial progress has been made in understanding genetic susceptibility in the past 5 years on the basis of the results of large genome-wide association studies. Testicular germ cell tumours are highly sensitive to radiotherapy and chemotherapy and hence have among the best outcomes of all tumours. Because the tumours occur mainly in young men, preservation of reproductive function, quality of life after treatment, and late effects are crucial concerns. In this Seminar, we provide an overview of advances in the understanding of the epidemiology, genetics, and biology of testicular germ cell tumours. We also summarise the consensus on how to treat testicular germ cell tumours and focus on a few controversies and improvements in the understanding of late effects of treatment and quality of life for survivors.
Collapse
Affiliation(s)
- Ewa Rajpert-De Meyts
- Department of Growth and Reproduction, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disrupting Effects on Male Reproduction and Child Health, Copenhagen, Denmark
| | - Katherine A McGlynn
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Keisei Okamoto
- Department of Urology, Shiga University of Medical Science, Tsukinowa, Seta, Shiga, Japan.
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Carsten Bokemeyer
- Department of Oncology, Haematology, Bone Marrow Transplantation with section Pneumology, Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
435
|
Trottmann M, Marcon J, D’Anastasi M, Bruce M, Stief C, Reiser M, Buchner A, Clevert D. Shear-wave elastography of the testis in the healthy man – determination of standard values. Clin Hemorheol Microcirc 2016; 62:273-81. [DOI: 10.3233/ch-162046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. Trottmann
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - J. Marcon
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M. D’Anastasi
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M.F. Bruce
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - C.G. Stief
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M.F. Reiser
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - A. Buchner
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - D.A. Clevert
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| |
Collapse
|
436
|
Bandak M, Jørgensen N, Juul A, Vogelius IR, Lauritsen J, Kier MG, Mortensen MS, Glovinski P, Daugaard G. Testosterone deficiency in testicular cancer survivors - a systematic review and meta-analysis. Andrology 2016; 4:382-8. [DOI: 10.1111/andr.12177] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/21/2015] [Accepted: 02/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- M. Bandak
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - N. Jørgensen
- Department of Growth and Reproduction; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - A. Juul
- Department of Growth and Reproduction; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - I. R. Vogelius
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - J. Lauritsen
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - M. G. Kier
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
- Department of Survivorship; Danish Cancer Society; Copenhagen Denmark
| | - M. S. Mortensen
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - P. Glovinski
- Department of Breast Surgery and Reconstructive Surgery; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - G. Daugaard
- Department of Oncology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| |
Collapse
|
437
|
Dieckmann KP, Spiekermann M, Balks T, Ikogho R, Anheuser P, Wosniok W, Loening T, Bullerdiek J, Belge G. MicroRNA miR-371a-3p - A Novel Serum Biomarker of Testicular Germ Cell Tumors: Evidence for Specificity from Measurements in Testicular Vein Blood and in Neoplastic Hydrocele Fluid. Urol Int 2016; 97:76-83. [DOI: 10.1159/000444303] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/27/2016] [Indexed: 12/21/2022]
|
438
|
Guragac A, Demirer Z. Standard surgical approach of testis-sparing surgery for testicular tumour with benign or malignant tendency. Can Urol Assoc J 2016; 10:66-7. [PMID: 26977210 DOI: 10.5489/cuaj.3565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
No abstract
Collapse
Affiliation(s)
- Ali Guragac
- Tatvan Military Hospital, Department of Urology, Bitlis, Turkey
| | - Zafer Demirer
- Eskisehir Military Hospital, Department of Urology, Eskisehir, Turkey
| |
Collapse
|
439
|
Liu B, Song N. Discussion of standard surgical approach of testis-sparing surgery for testicular tumour with benign tendency. Can Urol Assoc J 2016; 10:67. [PMID: 26977211 DOI: 10.5489/cuaj.3625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Bianjiang Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
440
|
Robotic Primary RPLND for Stage I Testicular Cancer: a Review of Indications and Outcomes. Curr Urol Rep 2016; 17:41. [DOI: 10.1007/s11934-016-0597-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
441
|
Mensah EE, Nicol D, Mayer E. Primary testicular tumours and management of clinical stage 1 testicular cancer. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415816630697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Erik Mayer
- Imperial College London, London, UK
- The Royal Marsden Hospital, London, UK
| |
Collapse
|
442
|
Urologische Malignome und rheumatoide Arthritis. Z Rheumatol 2016; 75:54-62. [DOI: 10.1007/s00393-015-0031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Urologische Malignome sind relativ häufig und nehmen mit zunehmendem Lebensalter zu. Der demografische Wandel führt dazu, dass bei immer mehr Patienten mit entzündlich-rheumatischen Erkrankungen urogenitale Tumoren koinzident sind oder unter antirheumatischer Therapie auftreten. Die Basistherapie rheumatischer Erkrankungen muss in dieses Fällen individuell sorgfältig abgewogen werden, obwohl die begrenzte Evidenz für die meisten Situationen gegen eine massive Risikoerhöhung durch konventionelle und/oder biologische Basistherapeutika spricht. Paraneoplastische Phänomene auch im Bewegungsapparat können durch urogenitale Malignome ausgelöst werden. Mit den sich abzeichnenden Umwälzungen der medikamentösen Tumortherapie durch die Immunonkologie ergeben sich darüber hinaus neue Herausforderungen für die interdisziplinäre Kooperation von Uroonkologen und Rheumatologen. In dieser Übersichtsarbeit werden unter Berücksichtigung der aktuellen deutschen und europäischen Leitlinien die Diagnostik, Standardbehandlung und Nachsorge urologischer Malignome skizziert. Wir beschreiben Kernaspekte, die von Urologen und Rheumatologen beachtet werden sollten. Durch persönliche Absprache, regelmäßigen Erfahrungsaustausch und Einbeziehung von Rheumatologen in interdisziplinäre Tumorboards sollte zukünftig eine bessere Behandlung unserer gemeinsamen Patienten möglich werden.
Collapse
|
443
|
Oing C, Seidel C, von Amsberg G, Oechsle K, Bokemeyer C. Pharmacotherapeutic treatment of germ cell tumors: standard of care and recent developments. Expert Opin Pharmacother 2015; 17:545-60. [DOI: 10.1517/14656566.2016.1127357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
444
|
Considine S, Heaney R, Conroy R, Thornhill JA. Post-chemotherapy retroperitoneal lymph node dissection in the management of metastatic testis cancer: the 16-year experience in an Irish setting. Ir J Med Sci 2015; 185:901-907. [PMID: 26692387 DOI: 10.1007/s11845-015-1394-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is an important tool in the management of advanced germ cell testis cancer, particularly non-seminoma. AIM We present the 16-year experience with PC-RPLND in a single Irish tertiary referral centre, and compare our results to the major speciality centres worldwide. METHODOLOGY All 78 patients undergoing PC-RPLND for the treatment of metastatic testis cancer between January 1996 and December 2011 were included. Medical records were reviewed and up to date follow-up obtained from primary referral centres, patient's GPs and individual patient interview. RESULTS The mean age at diagnosis was 28.5 ± 7 years. Initial pathology included non-seminoma 62.8 %, seminoma 6.4 % and combined 19.2 %. All patients underwent pre-operative chemotherapy. The resection template utilised was bilateral infra-hilar in 29.5 %, unilateral infra-hilar in 46.2 % and supra-hilar in 20.5 %. Complete abdominal remission was achieved in all but one patient. Additional procedures were required in 38.5 % of patients (n = 30). Clavien Dindo grade three or four complications were seen in 8.9 %, including five patients who required early reoperation. Histology of RPLND specimen showed mature teratoma (41 %) and active cancer (11.5 %). Follow-up data were available for 66 patients (85 %). Median follow-up was 101 (11-207) months. Nine patients relapsed with median time to relapse 15 (8-60) months. Overall 5-year survival rate was 95.2 % (four deaths). CONCLUSION In this relatively small series due to small population and low disease incidence, we have shown acceptable peri-operative course, morbidity and oncological outcomes with PC-RPLND compared to major international centres.
Collapse
Affiliation(s)
- S Considine
- Department of Urology, Tallaght Hosptial, Dublin 24, Ireland.
| | - R Heaney
- Department of Urology, Tallaght Hosptial, Dublin 24, Ireland
| | - R Conroy
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - J A Thornhill
- Department of Urology, Tallaght Hosptial, Dublin 24, Ireland
| |
Collapse
|
445
|
Kunath F, Spek A, Jensen K, Zengerling F, Schmidt S. Prognostic factors for tumor recurrence in patients with clinical stage I seminoma undergoing surveillance--protocol for a systematic review. Syst Rev 2015; 4:182. [PMID: 26684760 PMCID: PMC4683799 DOI: 10.1186/s13643-015-0167-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/07/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Testicular cancer is primarily treated with the surgical removal of the affected testis. About 50% of testicular cancer patients present with a stage I seminoma. If no chemo- or radiotherapy as adjuvant treatment is initiated after orchiectomy, 15-20% of these patients will develop metastases. Although adjuvant treatment is effective in reducing the relapse risk, there is rising concern about overtreatment of these patients. Prognostic factors at primary diagnosis might have the potential to identify patients at higher risk of tumor relapse, allowing to guide individual therapy and to avoid overtreatment. Therefore, we aim to synthesize the available evidence on tumor or patient characteristics as possible prognostic factors for cancer recurrence in patients with clinical stage I seminoma. METHODS/DESIGN We will conduct a broad systematic review to analyze what prognostic factors predict cancer recurrence in patients with a first time diagnosis of clinical stage I seminoma, who received no adjuvant chemo- or radiotherapy after orchiectomy. The literature search will comprise MEDLINE, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), and the conference proceedings of the American Society of Clinical Oncology (ASCO), American Urologic Association (AUA), and European Urologic Association (EAU) Annual Meetings. Prospective and retrospective longitudinal studies reporting on prognostic factors for cancer recurrence will be considered. We will consider the wealth of any candidate clinical or pathological prognostic factor reported in the literature. Our outcome of interest will be tumor recurrence at a minimum of 2 years follow-up. Study screening, data extraction, and quality assessment will be done by two reviewers independently. Hazard ratios will be used to measure the relationship between the potential prognostic factor and tumor recurrence. Meta-analyses will be conducted with sufficiently homogeneous studies and separately with respect to study design, by using the random-effects generic inverse variance model. DISCUSSION Limitations and strengths will be discussed in our review, and the results will be put into context with other studies in this field. Our results will help to guide evidence-based decision-making on patients with clinical stage I seminoma, allowing a better adjustment of therapies with regard to the individual patient's risk. Our findings will furthermore help to formulate recommendations for future research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014009434.
Collapse
Affiliation(s)
- Frank Kunath
- Department of Urology, University Hospital of Erlangen, Erlangen, Germany.
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
| | - Annabel Spek
- Department of Urology, University Hospital of Munich, Munich, Germany.
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
| | - Friedemann Zengerling
- Department of Urology, University Hospital of Ulm, Ulm, Germany.
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
| | - Stefanie Schmidt
- UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.
| |
Collapse
|
446
|
Liu B, Su H, Cheng G, Li P, Hua L, Song N, Wang Z, Gu M. Experiences and outcomes of organ-sparing surgery for testicular tumour with benign tendency. Can Urol Assoc J 2015; 9:E785-8. [PMID: 26600885 DOI: 10.5489/cuaj.2972] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We retrospectively investigated and summarized our experiences and the outcomes of organ-sparing surgery (OSS) for testicular tumour with benign tendency. METHODS From April 2000 to March 2012, 11 selected patients with testicular tumour underwent OSS. Preoperative and postoperative organ functional and oncologic indexes were analyzed and compared. RESULTS All operations were completed without conversion to radical orchiectomy. Intraoperative frozen section and routine postoperative pathology showed tumours with benign tendency. The normal appearance of the scrotum and functional integrity of the testis were preserved. Preoperative and postoperative serum sex hormone levels, international index of erectile function (IIEF-5) scores, and semen quality were not significantly different. Tumour recurrence or metastasis did not occur during follow-up. CONCLUSIONS Our results showed the feasibility and safety of OSS to treat testicular tumour with benign tendency. With careful selection and rigorous follow-up, some testis tumor can be treated with OSS to maximally maintain normal appearance and function of the testis. The retrospective single-centre study and small sample size are main limitations. More evidence is needed to establish the large-scale application of OSS.
Collapse
Affiliation(s)
- Bianjiang Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huang Su
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Gong Cheng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Pengchao Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lixin Hua
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Gu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
447
|
Wang Z, Yan B, Wei YB, Yin Z, Zhou KQ, Yang JR. Adult metastatic yolk sac tumor descending from an intra-abdominal testis: A case report and review of the literature. Oncol Lett 2015; 10:3647-3650. [PMID: 26788184 DOI: 10.3892/ol.2015.3817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/18/2015] [Indexed: 01/06/2023] Open
Abstract
Pure yolk sac tumors are extremely rare in adults; to the best of our knowledge, <20 cases have been reported. Multiple metastases originating from a pure yolk sac testicular tumor, descending from an intra-abdominal testis, are additionally extremely rare. In the present case, a man exhibiting a 30-year history of cryptorchidism and indirect inguinal hernia, was admitted to the Department of Urology (The Second Xiangya Hospital, Changsha, China) due to a mass that had descended from the abdominal cavity 7 months previously. Elevated levels of specific serum marker (α-fetoprotein, lactate dehydrogenase and human chorionic gonadotropin) did not indicate potential testicular germ cell types prior to surgery and pathological examination. Pathological results and immunohistochemistry revealed a testicular pure yolk sac tumor subsequent to surgery. The present case report and literature review describes the typical characteristics of an adult testicular yolk sac tumor, as well as the diagnosis and management of the disease.
Collapse
Affiliation(s)
- Zhao Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China; Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Bin Yan
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Yong-Bao Wei
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zhuo Yin
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Ke-Qin Zhou
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Jin-Rui Yang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| |
Collapse
|