1
|
Mason JB, Srivastava A, Lanzotti NJ, Ellis JL, Carlo HND, Gearhart JP, Bowen DK, Gupta M, Picken MM, Gupta GN, Patel HD. Variations in germ cell tumor histology by age and implications for cancer-specific survival among pediatric and adult males: A population-based study. Urol Oncol 2024; 42:292.e17-292.e26. [PMID: 38839493 PMCID: PMC11250700 DOI: 10.1016/j.urolonc.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/22/2024] [Accepted: 04/26/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Few studies have quantified differences in histology and implications for survival between male children and adults with germ cell tumors (GCT). We evaluated these differences and associations with cancer-specific survival (CSS) using Surveillance, Epidemiology, and End Results (SEER) cancer registries. METHODS SEER (1988-2016) was used to identify male patients 0 to 40 years of age diagnosed with seminoma and nonseminomatous GCT (NSGCT). Demographic and tumor characteristics were tabulated with histology distributions compared by age group (0-4, 12-18, 19-40 years old). CSS was evaluated in multivariable Cox proportional hazards regression models. RESULTS Among 27,204 patients identified, 1,538 (5.7%) were pediatric (0-18 years). Seminoma (54.3%) predominated in adult patients (ages 19-40). Among 0 to 4 years-old, yolk sac tumor (71.2%) and teratoma (21.5%) were most common. Mixed GCT (52.7%) was most prevalent among 12 to 18 years-old with seminoma, embryonal, and teratoma occurring in 12 to 15% each. Relative to pediatric patients, adult patients had similar CSS for seminoma but worse CSS for NSGCT on Kaplan-Meier curves with 9 years mean follow-up. Choriocarcinoma and yolk sac tumors carried the worst prognosis relative to seminoma for both children (HR 5.7 and HR 11.1, respectively, both P < 0.01) and adults (HR 4.6 and HR 4.6, respectively, both P < 0.01) adjusted for stage. CONCLUSION Histology of GCTs vary by age with yolk sac tumors and teratoma predominating for male patients 0 to 4 years, mixed GCT for 12 to 18 years, and seminoma for 19 to 40 years. Pediatric patients with NSGCT had higher CSS than their adult counterparts. Mixed GCT represented an increasing proportion of GCT over the study period. Age, stage, and histology impact CSS in both pediatric and adult populations.
Collapse
Affiliation(s)
- J Bradley Mason
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC.
| | - Arnav Srivastava
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Jeffrey L Ellis
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Heather N Di Carlo
- Department of Urology ,The James Buchanan Brady Urologic Institute, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - John P Gearhart
- Department of Urology ,The James Buchanan Brady Urologic Institute, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Diana K Bowen
- Department of Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mohit Gupta
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC
| | - Maria M Picken
- Department of Pathology, Loyola University Medical Center, Maywood, IL
| | - Gopal N Gupta
- Department of Urology, Loyola University Medical Center, Maywood, IL
| | - Hiten D Patel
- Department of Urology, Loyola University Medical Center, Maywood, IL; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| |
Collapse
|
2
|
Surucu A, de Biase D, Ricci C, di Sciascio L, Collins K, Idrees MT, Ebare K, Fiorentino M, Bridge JA, Ulbright TM, Acosta AM. Beta-Catenin Alterations in Postchemotherapy Yolk Sac Tumor, Postpubertal-Type With Enteroblastic Features. Mod Pathol 2024; 37:100513. [PMID: 38763421 DOI: 10.1016/j.modpat.2024.100513] [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: 01/30/2024] [Revised: 04/05/2024] [Accepted: 05/11/2024] [Indexed: 05/21/2024]
Abstract
Postchemotherapy postpubertal-type yolk sac tumors (YST) with glandular and solid phenotypes are aggressive and commonly resistant to systemic chemotherapy. These neoplasms show morphologic features that significantly overlap with those of somatic carcinomas with "enteroblastic" or "fetal" phenotype (the preferred terminology depends on the site of origin). They often present as late or very late recurrences, and their diagnosis is challenging because they frequently affect patients in an age group at risk for carcinomas of somatic origin. Recently, we incidentally identified examples of postchemotherapy glandular and solid YST with "enteroblastic" phenotypes and nuclear expression of beta-catenin, prompting us to further evaluate the prevalence of this phenomenon. We found nuclear expression of beta-catenin in 10 (29%) of 34 such tumors. A subset of cases with nuclear beta-catenin expression was further analyzed with a DNA sequencing panel (n = 6) and fluorescence in situ hybridization for isochromosome 12p [i(12p); n = 5]. Sequencing identified exon 3 CTNNB1 variants in 3 (50%) of 6 analyzed cases, and fluorescence in situ hybridization was positive for i(12p) in 5 of 5 cases. In conclusion, a significant subset of postchemotherapy YST with glandular or solid architecture and "enteroblastic" phenotype demonstrates beta-catenin alterations, suggesting that activation of Wnt signaling may play a role in the progression of these neoplasms. Moreover, nuclear beta-catenin expression in these tumors represents a potential diagnostic pitfall given that carcinomas of true somatic origin with overlapping morphology may also be positive for this marker.
Collapse
Affiliation(s)
- Ahmet Surucu
- Department of Pathology, Indiana University, Indianapolis, Indiana
| | - Dario de Biase
- Department of Pathology, Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Pharmacy and Biotechnology (FaBit), University of Bologna, Bologna, Italy
| | - Costantino Ricci
- DIAP-Dipartimento InterAziendale di Anatomia Patologica di Bologna, Maggiore Hospital-AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Luisa di Sciascio
- DIAP-Dipartimento InterAziendale di Anatomia Patologica di Bologna, Maggiore Hospital-AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Katrina Collins
- Department of Pathology, Indiana University, Indianapolis, Indiana
| | | | - Kingsley Ebare
- Department of Pathology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Michelangelo Fiorentino
- DIAP-Dipartimento InterAziendale di Anatomia Patologica di Bologna, Maggiore Hospital-AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Julia A Bridge
- Department of Pathology, University of Nebraska Medical Center, Omaha, Nebraska; Cytogenetics and Fluorescence In Situ Hybridization, ProPath Laboratories, Dallas, Texas
| | | | - Andres M Acosta
- Department of Pathology, Indiana University, Indianapolis, Indiana.
| |
Collapse
|
3
|
Holmboe SA, Beck AL, Andersson AM, Main KM, Jørgensen N, Skakkebæk NE, Priskorn L. The epidemiology of cryptorchidism and potential risk factors, including endocrine disrupting chemicals. Front Endocrinol (Lausanne) 2024; 15:1343887. [PMID: 38633762 PMCID: PMC11021654 DOI: 10.3389/fendo.2024.1343887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Congenital cryptorchidism, also known as undescended testis, is the condition where one or both testes are not in place in the scrotum at birth and is one of the most common birth defects in boys. Temporal trends and geographic variation in the prevalence of cryptorchidism from 1% to 9% have been reported in prospective cohort studies. The testes develop in the abdominal cavity and descend to the scrotum in two phases, which should be completed by gestational week 35. Thus, the risk of cryptorchidism is higher in preterm boys. In many cases a spontaneous descent occurs during the first months of life during the surge of gonadotropins and testosterone. If not, the testis is usually brought down to the scrotum, typically by surgery, to increase future fertility chances and facilitate cancer surveillance. The increasing frequency of impaired semen quality and testicular cancer, with which cryptorchidism is associated, represents a concern for male reproductive health in general and a need to understand its risk factors. The risk of cryptorchidism is closely related to gestational factors (preterm birth, low birth weight and intrauterine growth restriction), and especially maternal smoking seems to be a risk factor. Evidence is accumulating that the increasing prevalence of cryptorchidism is also related to prenatal exposure to environmental chemicals, including endocrine disrupting compounds. This association has been corroborated in rodents and supported by ecological studies. Conducting human studies to assess the effect of endocrine disrupting chemicals and their interactions is, however, challenged by the widespread concomitant exposure of all humans to a wide range of chemicals, the combined effect of which and their interactions are highly complex.
Collapse
Affiliation(s)
- Stine A. Holmboe
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Astrid L. Beck
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Katharina M. Main
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Niels E. Skakkebæk
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lærke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
4
|
Rosen DB, Tan AJN, Pursley J, Kamran SC. Advances in radiation therapy for testicular seminoma. World J Urol 2023; 41:3895-3903. [PMID: 37979002 DOI: 10.1007/s00345-023-04674-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/26/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE Novel techniques and advances in radiation therapy (RT) have been explored to treat testicular seminoma, a highly radiosensitive and curable histology. We evaluated the historical and current indications for radiation therapy (RT) in testicular seminoma. METHODS A narrative literature review was performed. Studies of RT for testicular seminoma were included. Additionally, recent trials testing the use of combination or surgical therapies for clinical stage (CS) II were included. Search parameters included radiation therapy, testicular seminoma, surgery, and chemoradiation. Parameters and outcomes assessed were progression-free survival (PFS), overall survival (OS), acute toxicities, long-term sequelae, and rates of secondary malignancies. RESULTS Practice defining and changing studies in the use or omission of radiation therapy for testicular seminoma were identified along with resultant changes in National Comprehensive Cancer Network (NCCN) and European guidelines. Recent trials in combined chemoradiation and upfront surgical approaches to CS II disease were reviewed. CONCLUSION RT has historically been used as adjuvant treatment for CS I disease and is highly effective at treating CS II (A/B) testicular seminoma. The drive to maintain therapeutic efficacy and reduce acute and long-term side effects, namely secondary malignancies, is being tested using new radiation technologies, combined modality therapy in the form of chemoradiation and with upfront surgical approaches. Also, as guidelines now "strongly prefer" surveillance instead of adjuvant RT for CS I disease, the current CS II population comprises patients presenting with CS II disease ("de novo") and those who present with CSII after relapsing post orchiectomy for CS I ("relapsed"). Emerging evidence suggests that these two groups have different outcomes with respect to RT and chemoradiation. Consequently, future trials may need to sub-stratify according to these groups.
Collapse
Affiliation(s)
| | - Arvin Jeremy N Tan
- Internal Medicine Residency Program, University of Hawaii, Honolulu, HI, USA
| | - Jennifer Pursley
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sophia C Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| |
Collapse
|
5
|
Park MJ, Han KD, Cho JH, Choi JH. Testicular Cancer Incidence among Obstructive Sleep Apnea (OSA) Patients: South Korean National Health Insurance Data. Cancers (Basel) 2023; 15:3273. [PMID: 37444382 DOI: 10.3390/cancers15133273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Obstructive sleep apnea (OSA) has been linked to an increased risk of acquiring many types of cancer. No data on the prevalence of testicular cancer in OSA patients have been reported in the literature. The goal of the present investigation is to find out the impact of OSA on the incidence of testicular cancer based on the Korea National Health Insurance Service (KNHIS) dataset. A cohort of adult male patients newly registered with OSA in the KNHIS data from 2007 to 2014 who had no history of any previous cancer diagnosis was included. The main outcome measure was newly diagnosed testicular cancer in the National Medical Expenses Support Program. The control group was set at five times larger than the OSA group, and it was matched with age and sex. The cumulative incidence and hazard ratio (HR) for the development of testicular cancer were compared between the OSA and control groups. Further subgroup analysis was conducted in the three different age groups. In the study period, a total of 152,801 male adult patients newly diagnosed with OSA were included, whereas 764,005 individuals were recruited as the control group. The HR of OSA for developing testicular cancer was 1.58 (95% confidence interval [CI]: 0.92-2.60), showing no significant HR regardless of confounding adjustment. However, the subgroup analysis revealed a significantly increased HR to develop testicular cancer of 3.39 (95% CI: 1.08-10.06) in groups aged more than 65, whereas the age ranges of 20-40 and 40-64 showed no significance (1.19 (0.44-2.75) and 1.27 (0.50-2.80), respectively). OSA may not influence the incidence of testicular cancer in the general adult population. However, compared to younger males, males over 65 may be more susceptible to OSA when it comes to developing testicular cancer.
Collapse
Affiliation(s)
- Marn Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University Hospital, School of Medicine, Inha University, 27 Inhang-ro, Jung-gu, Incheon 22332, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea
| | - Jae Hoon Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Konkuk University, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Ji Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Bucheon Hospital, Soonchunhyang University, 170 Jomaru-ro, Bucheon 14584, Republic of Korea
| |
Collapse
|
6
|
Wang Q, Shi Y, Bian Q, Zhang N, Wang M, Wang J, Li X, Lai L, Zhao Z, Yu H. Molecular mechanisms of syncytin-1 in tumors and placental development related diseases. Discov Oncol 2023; 14:104. [PMID: 37326913 DOI: 10.1007/s12672-023-00702-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Human endogenous retroviruses (HERVs) have evolved from exogenous retroviruses and account for approximately 8% of the human genome. A growing number of findings suggest that the abnormal expression of HERV genes is associated with schizophrenia, multiple sclerosis, endometriosis, breast cancer, bladder cancer and other diseases. HERV-W env (syncytin-1) is a membrane glycoprotein which plays an important role in placental development. It includes embryo implantation, fusion of syncytiotrophoblasts and of fertilized eggs, and immune response. The abnormal expression of syncytin-1 is related to placental development-related diseases such as preeclampsia, infertility, and intrauterine growth restriction, as well as tumors such as neuroblastoma, endometrial cancer, and endometriosis. This review mainly focused on the molecular interactions of syncytin-1 in placental development-related diseases and tumors, to explore whether syncytin-1 can be an emerging biological marker and potential therapeutic target.
Collapse
Affiliation(s)
- Qianqian Wang
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Ying Shi
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Qiang Bian
- Collaborative Innovation Center, Jining Medical University, Jining, 272067, Shandong, People's Republic of China
- Department of Pathophysiology, Weifang Medical University, Weifang, 261053, Shandong, People's Republic of China
| | - Naibin Zhang
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Meng Wang
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Jianing Wang
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Xuan Li
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China
| | - Luhao Lai
- Collaborative Innovation Center, Jining Medical University, Jining, 272067, Shandong, People's Republic of China
| | - Zhankui Zhao
- The Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, 272029, Shandong, People's Republic of China.
| | - Honglian Yu
- Department of Biochemistry, Jining Medical University, 133 Hehua Road, Jining, 272067, Shandong, People's Republic of China.
- Collaborative Innovation Center, Jining Medical University, Jining, 272067, Shandong, People's Republic of China.
| |
Collapse
|
7
|
Schoch J, Haunschild K, Strauch A, Nestler K, Schmelz H, Paffenholz P, Pfister D, Persigehl T, Heidenreich A, Nestler T. German specialists treating testicular cancer follow different guidelines with resulting inconsistency in assessment of retroperitoneal lymph-node metastasis: clinical implications and possible corrective measures. World J Urol 2023; 41:1353-1358. [PMID: 37014392 DOI: 10.1007/s00345-023-04364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/01/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Testicular germ cell tumors (GCTs) are aggressive but highly curable tumors. To avoid over/undertreatment, reliable clinical staging of retroperitoneal lymph-node metastasis is necessary. Current clinical guidelines, in their different versions, lack specific recommendations on how to measure lymph-node metastasis. OBJECTIVE We aimed to assess the practice patterns of German institutions frequently treating testicular cancer for measuring retroperitoneal lymph-node size. METHODS An 8-item survey was distributed among German university hospitals and members of the German Testicular Cancer Study Group. RESULTS In the group of urologists, 54.7% assessed retroperitoneal lymph nodes depending on their short-axis diameter (SAD) (33.3% in any plane, 21.4% in the axial plane), while 45.3% used long-axis diameter (LAD) for the assessment (42.9% in any plane, 2.4% in the axial plane). Moreover, the oncologists mainly assessed lymph-node size based on the SAD (71.4%). Specifically, 42.9% of oncologists assessed the SAD in any plane, while 28.5% measured this dimension in the axial plane. Only 28.6% of oncologists considered the LAD (14.3% in any plane, 14.3% in the axial plane). None of the oncologists and 11.9% of the urologists (n = 5) always performed an MRI for the initial assessment, while for follow-up imaging, the use increased to 36.5% of oncologists and 31% of urologists. Furthermore, only 17% of the urologists, and no oncologists, calculated lymph-node volume in their assessment (p = 0.224). CONCLUSION Clear and consistent measurement instructions are urgently needed to be present in all guidelines across different specialistic fields involved in testicular cancer management.
Collapse
Affiliation(s)
- Justine Schoch
- Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany
| | - Kathrin Haunschild
- Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany
| | - Angelina Strauch
- Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany
| | - Kai Nestler
- Institute of Diagnostic and Interventional Radiology, Federal Armed Forces Hospital Koblenz, Koblenz, Germany
| | - Hans Schmelz
- Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany
| | - Pia Paffenholz
- Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany
| | - David Pfister
- Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany
| | - Axel Heidenreich
- Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany
- Department of Urology, Medical University Vienna, Vienna, Austria
| | - Tim Nestler
- Department of Urology, Federal Armed Forces Hospital Koblenz, Ruebenacherstrasse 170, 56072, Koblenz, Germany.
- Department of Urology, Faculty of Medicine, University Hospital Cologne, University Cologne, Cologne, Germany.
| |
Collapse
|
8
|
Lew CZ, Liu HC, Hou JY, Huang TH, Yeh TC. Pediatric Extracranial Germ Cell Tumors: Review of Clinics and Perspectives in Application of Autologous Stem Cell Transplantation. Cancers (Basel) 2023; 15:cancers15071998. [PMID: 37046659 PMCID: PMC10093083 DOI: 10.3390/cancers15071998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023] Open
Abstract
Pediatric extracranial germ cell tumors (GCTs) are rare, accounting for approximately 3.5% of childhood cancers. Since the introduction of platinum-based chemotherapy, the survival rate of patients has improved to more than 80%. However, poor-risk subtypes of pediatric extracranial GCTs do not respond well to chemotherapy, leading to refractory or relapsed (R/R) diseases. For example, long-term survival rates of mediastinal GCTs or choriocarcinoma are less than 50%. According to reports in recent years for adult patients with R/R GCTs, the use of high-dose chemotherapy (HDCT) combined with autologous stem cell transplantation (ASCT) has clinical advantages; however, HDCT combined with ASCT has rarely been reported in pediatric GCTs. The R/R and poor-risk groups of pediatric GCTs could benefit from HDCT and ASCT.
Collapse
Affiliation(s)
- Chong-Zhi Lew
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children’s Hospital, Mackay Medical College, Taipei 104, Taiwan
| | - Hsi-Che Liu
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children’s Hospital, Mackay Medical College, Taipei 104, Taiwan
| | - Jen-Yin Hou
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children’s Hospital, Mackay Medical College, Taipei 104, Taiwan
| | - Ting-Huan Huang
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | - Ting-Chi Yeh
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Mackay Children’s Hospital, Mackay Medical College, Taipei 104, Taiwan
- Correspondence:
| |
Collapse
|
9
|
Amer M, Vaccalluzzo L, Vena W, Mazziotti G, Morenghi E, Pizzocaro A. Oncological diseases in Klinefelter Syndrome: an overview. Minerva Endocrinol (Torino) 2023; 48:106-114. [PMID: 34014064 DOI: 10.23736/s2724-6507.21.03440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epidemiological studies have highlighted a higher incidence of morbidity and mortality among individuals with Klinefelter's Syndrome (KS), however, the relative impact of oncological diseases on KS subjects is still uncertain. While some malignancies (e.g., hematological and lung cancers) may show an increased prevalence in the KS population, only a few rare tumors (i.e., extragonadal germ cell tumors [GCTs] and male breast cancer [MBC]) seem to follow this trend. Additionally, hormonal and genetic determinants may be involved in the pathogenesis of neoplasia in KS, even if subjects affected by this syndrome generally show lower incidence of prostate cancer along with lower disease-specific mortality despite testosterone replacement therapy (TRT). This review deals with the pathophysiological and clinical aspects of neoplastic diseases occurring in KS.
Collapse
Affiliation(s)
- Myriam Amer
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Liborio Vaccalluzzo
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Walter Vena
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy -
| | - Gherardo Mazziotti
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Alessandro Pizzocaro
- Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| |
Collapse
|
10
|
Berjaoui MB, Herrera-Caceres JO, Li T, Qaoud Y, Tiwari R, Ma D, Khondker A, Naidu S, Ajaj R, Lajkosz K, Kenk M, Ajib K, Chandraseka T, Goldberg H, Fleshner N. Age related differences in primary testicular lymphoma: A population based cohort study. Urol Oncol 2023; 41:151.e1-151.e10. [PMID: 36702705 DOI: 10.1016/j.urolonc.2022.10.032] [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: 02/21/2022] [Revised: 07/16/2022] [Accepted: 10/30/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Primary testicular non-Hodgkin's lymphoma (PTL) is a very rare disease, comprising 1% of all non-Hodgkin's lymphoma and <5% of all cases of testicular tumors. With a median age at diagnosis of 67 years, PTL is the most common testicular malignancy in men aged >60 years. There is limited published data on PTL incidence and outcomes in younger patients. The aim of this study is to compare the clinical parameters and survival outcomes between the patients older and younger than 50. METHODS The SEER database was queried for all patients diagnosed with PTL between 1983 and 2017. Data collected consisted of demographic, and clinical parameters, including staging, pathological assessments, and survival data. Patients were stratified according to their age and compared. RESULTS There was a total of 1,581 patients diagnosed with PTL between the year 2000 and 2017, of whom 215 (13.6%) were younger than 50 years old. The median age at diagnosis was 41 (interquartile range [IQR] 1-50), and 72 (IQR 51-95) years old for patients ≤50 and patients > 50 years of age, respectively. Comparison of younger and older patients detected similarities in disease laterality (92% vs. 94%, P = 0.38) and Ann Arbor stage I to II at diagnosis (76% vs. 75%, P = 0.59). The most common diffuse large B-cell lymphoma (DLBCL) subtype was more common in older patients (61% vs. 87%, P < 0.001). Radical orchiectomy (71% vs. 79%, P = 0.004) and radiation treatment (40% vs. 37%, P = 0.49) rates were comparable between both groups. However, a higher proportion of younger patients underwent chemotherapy (83% vs. 72%, P < 0.001). Patients ≤50 and >50 years old had a hazard ratio (HR) of 0.63 (95% CI: 0.57-0.71) and 0.34 (95% CI: 0.31-0.37), respectively, for 10-year OS with a median survival time for patients >50 of 5.75 years (95% CI: 5.25-6.33), P < 0.001. Patients ≤50 years old had a HR of 0.33 (95% CI: 0.26-0.40) compared to HR of 0.40 (95% CI: 0.37-0.43) in patients >50 years old for cumulative disease-specific mortality (DSM, P = 0.0204). Age >50 years was associated with worse DSM with a HR of 1.39 (95% CI: 1.05- 1.86, P = 0.024). Ann Arbor stage II and higher was also associated with worse DSM, while undergoing surgery, radiotherapy, and chemotherapy were associated with improved DSM. CONCLUSIONS PTL is the most common testicular malignancy in men older than 60 years of age, but more than a quarter of the patients are younger than 60 and more than 13% are ≤50 years. Younger patients are more likely to receive chemotherapy and radiation, and overall do better in terms of DSM. Being younger, having a lower Ann Arbor stage and being treated with chemotherapy and radiotherapy increase the chances of survival.
Collapse
Affiliation(s)
- Mohamad B Berjaoui
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
| | - Jaime O Herrera-Caceres
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Tiange Li
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Yazan Qaoud
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Raj Tiwari
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Danny Ma
- University of Toronto, Toronto, ON, Canada
| | | | | | - Ran Ajaj
- University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Miran Kenk
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Khaled Ajib
- Division of Urology, Medical College of Georgia at Augusta University, Albany, GA
| | | | - Hanan Goldberg
- Urology Department, SUNY Upstate Medical University, Syracuse, NY
| | - Neil Fleshner
- Division of Urology, Department of Surgery, Princess Maraget Cancer Centre, University Health Network, Toronto, ON, Canada
| |
Collapse
|
11
|
An alternative technique for cyclization synthesis, in vitro anti-esophageal cancer evaluation, and molecular docking of novel thiazolidin-4-one derivatives. J Mol Struct 2023. [DOI: 10.1016/j.molstruc.2023.135079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
12
|
Panner Selvam MK, Sikka SC. Role of endocrine disruptors in male infertility and impact of COVID-19 on male reproduction. REPRODUCTIVE AND DEVELOPMENTAL TOXICOLOGY 2022. [PMCID: PMC8864147 DOI: 10.1016/b978-0-323-89773-0.00059-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several epidemiological studies suggest strong association of endocrine disruptors (EDs) with impaired male reproduction. High levels of polychlorinated biphenyls in serum are associated with low sperm count and poor fertility. A high dichloro diphenyl trichloroethane (DDT) concentration results in low serum testosterone (T) and poor semen quality. DDT stimulates estrogen production by acting as estrogen receptor agonist and potent androgen receptor antagonist. Phthalates, another group of EDs, induce seminiferous tubule degeneration with impaired spermatogenesis via disruption of gene expression that regulates cholesterol and lipid homeostasis resulting in low T. Bisphenol A, a strong exogenous estrogen with antiandrogen effect, lowers serum follicle-stimulating hormone, luteinizing hormone, and T, resulting in impaired development of seminiferous tubules and spermatogenesis. Di(2-ethylhexyl) phthalates can exert their antiandrogenic action by directly inhibiting testosterone biosynthesis via cytochrome P-450 dysfunction. Since these EDs are commonly found in plastic bottles, cosmetics, pesticides, some metal food cans, etc., and accumulate in the environment, it is very important to observe caution and avoid their exposure. This updated chapter also reviews the impact of COVID-19-related infection on male reproduction.
Collapse
|
13
|
Giovanni SM, Letizia AAM, Chiara M, Vincenzo S, Erika P, Marta S. The Male Reproductive System and Endocrine Disruptors. Endocr Metab Immune Disord Drug Targets 2021; 22:686-703. [PMID: 34607552 DOI: 10.2174/1871530321666211004100633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022]
Abstract
The male reproductive system is exposed to a great number of chemical substances which can interfere with the normal hormonal milieu and reproductive function; these are called endocrine disruptors (EDs). Despite a growing number of studies evaluating the negative effects of EDs, their production is continuously growing although some of which have been prohibited. The prevalence of poor semen quality, hypospadias, cryptorchidism, and testicular cancer have increased in the last decades, and recently, it has been postulated that these could all be part of a unique syndrome called testicular dysgenesis syndrome. This syndrome could be related to exposure to a number of EDs which cause imbalances in the hormonal milieu and oestrogenic over-exposure during the foetal stage. The same EDs can also impair spermatogenesis in offspring and have epigenetic effects. Although studies on animal and in vitro models have raised concerns, data are conflicting. However, these studies must be considered as the basis for future research to promote male reproductive health.
Collapse
Affiliation(s)
| | | | - Maneschi Chiara
- Department of Internal Medicine, Villa Salus Hospital, Mestre (VE). Italy
| | - Sciabica Vincenzo
- Department of Internal Medicine, Villa Salus Hospital, Mestre (VE). Italy
| | - Pigatto Erika
- Department of Internal Medicine, Villa Salus Hospital, Mestre (VE). Italy
| | - Sanna Marta
- Department of Internal Medicine, Villa Salus Hospital, Mestre (VE). Italy
| |
Collapse
|
14
|
Muhanna A, Nimri F, Almomani ZA, Al Momani L, Likhitsup A, Hamid F. Small Bowel Metastasis as a Presentation of Testicular Seminoma. Cureus 2021; 13:e17962. [PMID: 34548993 PMCID: PMC8439170 DOI: 10.7759/cureus.17962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/05/2022] Open
Abstract
Testicular germ cell tumors account for 95% of testicular cancers in men with approximately 71,000 patients being diagnosed with testicular cancer every year. The overall survival of testicular germ cell tumors is approximately 95%. However, the prognosis becomes less favorable when distant metastasis is present. Gastrointestinal (GI) tract metastasis occurs in less than 5% of patients with non-seminomatous tumors, and in less than 1% in patients with pure seminomas. GI metastasis usually involves the colon, esophagus, and stomach with the most common symptoms of GI metastasis being diarrhea, nausea, vomiting, and obstruction. We discuss the case of a 42-year-old male patient with GI manifestations as the first presentation of testicular seminoma with metastasis to the small bowel. Computed tomography of the abdomen and pelvis revealed a small bowel mass, and the diagnosis was confirmed with histopathologic examination of endoscopic biopsy samples. The patient subsequently underwent chemotherapy treatment with close surveillance. Clinicians should maintain a high index of suspicion in the differential diagnosis of abdominal pain in young male patients, especially when associated with symptoms like unexplained weight loss, constitutional symptoms, and testicular pain or swelling. Metastasis to the GI tract from the testis should be promptly diagnosed and managed, as the overall survival rates can significantly decrease with the delay of diagnosis.
Collapse
Affiliation(s)
- Adel Muhanna
- Internal Medicine, University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, USA
| | - Faisal Nimri
- Internal Medicine, Henry Ford Health System, Detroit, USA
| | - Zaid A Almomani
- Internal Medicine, Jordan University of Science and Technology, Irbid, JOR
| | - Laith Al Momani
- Gastroenterology, University of Missouri-Kansas City (UMKC), Kansas City, USA
| | - Alisa Likhitsup
- Hepatology, University of Missouri-Kansas City (UMKC), Kansas City, USA
| | - Fadi Hamid
- Gastroenterology, University of Missouri-Kansas City (UMKC), Kansas City, USA
| |
Collapse
|
15
|
Parada H, Vu AH, Pinheiro PS, Thompson CA. Comparing Age at Cancer Diagnosis between Hispanics and Non-Hispanic Whites in the United States. Cancer Epidemiol Biomarkers Prev 2021; 30:1904-1912. [PMID: 34321282 DOI: 10.1158/1055-9965.epi-21-0389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/24/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Population age structure may confound the comparison of age at cancer diagnosis across racial/ethnic groups. We compared age at cancer diagnosis for U.S. Hispanics, a population that is younger on average, and non-Hispanic whites (NHW), before and after adjustment for the age structure of the source population. METHODS We used Surveillance, Epidemiology, and End Results data from 18 U.S. regions in 2015 for 34 cancer sites to calculate crude and adjusted (using age- and sex-specific weights) mean ages at diagnosis. Differences in age at diagnosis comparing Hispanics to NHWs (δ) were assessed using independent sample t tests. RESULTS Crude mean ages at diagnosis were lower among Hispanic males and females for all sites combined and for most cancer sites. After age-adjustment, Hispanic (vs. NHW) males remained younger on average at diagnosis of chronic myeloid leukemia [δ = -6.1; 95% confidence interval (CI), -8.1 to -4.1 years], testicular cancer (δ =-4.7; 95% CI, -5.4 to -4.0), Kaposi sarcoma (δ =-3.6; 95% CI,-6.3 to -0.8), mesothelioma (δ =-3.0; 95% CI,-4.3 to -1.7), and anal cancer (δ =-2.4; 95% CI, -3.9 to -0.8), and older at diagnosis of gallbladder cancer (δ = +3.8; 95% CI, 1.8 to 5.7) and Hodgkin's lymphoma (δ = +7.5; 95% CI, 5.7 to 9.4), and Hispanic (vs. NHW) females remained younger at diagnosis of mesothelioma (δ = -3.7; 95% CI, -6.7 to -0.7) and gallbladder cancer (δ = -3.0; 95% CI, -4.3 to -1.7) and older at diagnosis of skin cancer (δ = +3.8; 95% CI, 3.1 to 4.5), cervical cancer (δ = +4.1; 95% CI, 3.3 to 4.8), and Hodgkin's lymphoma (δ = +7.0; 95% CI, 5.0 to 9.1). CONCLUSIONS On average, Hispanics are diagnosed with cancer at younger ages than NHWs; however, for many cancers these differences reflect the younger age structure in Hispanics. IMPACT Population age structure should be considered when comparing age at cancer diagnosis across racial/ethnic groups.
Collapse
Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California. .,University of California, San Diego Moores Cancer Center, La Jolla, California.,Department of Radiation Medicine and Applied Science, University of California, San Diego, La Jolla, California
| | - Andrew H Vu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Caroline A Thompson
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California.,University of California, San Diego Moores Cancer Center, La Jolla, California.,The Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, California
| |
Collapse
|
16
|
Huang MM, Cheaib JG, Su ZT, Biles MJ, Sharma R, Zhang A, Singla N, Bass EB, Pierorazio PM. Assessing quality of care in the diagnosis and treatment of early-stage testicular cancer: A critical review and summary. Urol Oncol 2021; 39:400-408. [PMID: 33642227 DOI: 10.1016/j.urolonc.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review the current literature on quality of care in the diagnosis and management of early-stage testicular cancer. METHODS PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies on quality of care in testicular cancer diagnosis and management from January 1980 to August 2018. Major overlapping themes related to quality of care in the diagnosis and management of TGCT were identified and evidence related to these themes were abstracted. EVIDENCE 62 studies were included in the review. A number of themes were identified including (1) trends in survival and outcomes, (2) management patterns, (3) adherence to evidence-based clinical guidelines, (4) delays in care, (5) treatment complications and toxicities, (6) sociodemographic factors, (7) volume of patients treated, (8) gaps in provider knowledge and medical errors, and (9) multidisciplinary approaches to care. EVIDENCE SUMMARY As survival for patients with testicular cancer improves, there has been a greater emphasis on other components of quality of care, such as reducing treatment toxicity and minimizing delays in diagnosis. Efforts to meet these goals include encouragement of adherence to evidence-based guidelines, greater utilization of surveillance, and promotion of multidisciplinary team-based care. Although outcomes have improved, social determinants of health, such as insurance status, race, and geographical residence all may influence survival and cancer-related outcomes. Additionally, qualitative review indicates patients who receive care at high-volume institutions appear to experience better outcomes than those treated at smaller centers. CONCLUSIONS As outcomes and survival improve for patients with testicular cancer, quality of care has become an important consideration. Future avenues of research on this topic include identifying an appropriate balance between centralization of care and expanding access to underserved areas, minimizing delays in care, ensuring greater adherence to clinical guidelines, and addressing sociodemographic and racial disparities in outcomes.
Collapse
Affiliation(s)
- Mitchell M Huang
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Joseph G Cheaib
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zhuo T Su
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael J Biles
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ritu Sharma
- The Johns Hopkins Evidence-Based Practice Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Allen Zhang
- The Johns Hopkins Evidence-Based Practice Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Nirmish Singla
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eric B Bass
- The Johns Hopkins Evidence-Based Practice Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Phillip M Pierorazio
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.
| |
Collapse
|
17
|
Adeyemi TE, Channa ML, Nadar A. Evaluation of maternal high-fat diet and Quercetin-3-O-rutinoside treatment on the reproductive profile of diet naïve male offspring. Life Sci 2021; 271:119179. [PMID: 33577849 DOI: 10.1016/j.lfs.2021.119179] [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: 11/04/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Male infertility and reproductive dysfunctions have become major global health problems. Although several causative factors have been attributed to this challenge, of importance are alterations in maternal-foetal environment, diet-induced transcriptional changes and dysregulation in chemical signaling via hypothalamic-gonadal axis. AIM The present study investigated the impact of maternal high-fat diet (HFD) consumption and the putative role of Quercetin-3-O-rutinoside on reproductive functions of male offspring rats at critical developmental stages with a quest to unravel the underpinned molecular changes. MATERIALS AND METHODS Fifty-six pregnant rats (previously fed normal diet ND) or 45% HFD) were maintained on supplemented chow (150 mg/kg QR) - ND/QR, HFD/QR throughout gestation. Subsequently, dams (n = 7) and offspring (n = 6) were sacrificed at post-natal day (PND) 21, 28 and 35, respectively, and the blood, placenta, hypothalamus (HT), and testicular samples were processed for molecular analysis of Gonadotropin-releasing hormone (GnRH), Luteinizing hormone (LH), testosterone, chemerin, chemokine-like receptor 1 (CMKLR1), tumour necrosis factor α (TNF-α), interleukin 1β (IL-1β) and nuclear factor kappa B (NF-κB). KEY FINDINGS We observed a significant decrease in GnRH level in the HFD group at PND21 and PND28 in male offspring and treatment with QR significantly reduced GnRH. There was a significant reduction in LH levels in the HFD group at PND 21 in the male offspring accompanied by a significant decrease in testosterone level at PND 28 and PND35 which appears to be age dependent. In the HT, Chemerin and CMKLR1 was significantly upregulated in the HFD group at PND 21 and PND 35 respectively while CMKLR1 was significantly downregulated in the HFD group of the placenta and testis at PND 21. TNF-α, IL-1β and NF-κB were also expressed in the placenta, HT and testis at PND 21. SIGNIFICANCE Male fertility is affected by maternal HFD consumption while chemerin, CMKLR1 and TNF-α, may play a significant role in male steroidogenesis. Treatment with QR had little or no ameliorative effect on HFD induced alterations in male reproductive functions.
Collapse
Affiliation(s)
- Toluwalope E Adeyemi
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
| | - Mahendra L Channa
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
| | - Anand Nadar
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
| |
Collapse
|
18
|
von Vaupel-Klein AM, Walsh RJ. Considerations in genetic counseling of transgender patients: Cultural competencies and altered disease risk profiles. J Genet Couns 2020; 30:98-109. [PMID: 33368789 PMCID: PMC7898523 DOI: 10.1002/jgc4.1372] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/29/2022]
Abstract
Transgender people are a growing population with specific healthcare needs, barriers to care, and disease risk factors. Cultural competencies for working with transgender people in healthcare settings are essential to reduce barriers to care and combat the associated health disparities. Genetic counselors support their patients to understand and manage medically and personally complex life events and decisions. A genetic counselor caring for a transgender patient or a patient with a transgender relative will therefore require specific cultural competencies and medical knowledge that may not have been covered in their training. Transgender health is also a relatively young field in which new insights may quickly become fundamental. The present paper therefore provides an overview of current best practices for culturally sensitive working with transgender patients, and an introduction to the additional considerations for assessment of disease risk in transgender people. Guidance on how to ensure communication with patients and other stakeholders is inclusive and affirming of transgender identities, is offered. Medical interventions used for gender transitions are described, and their (potential) effects on cancer and cardiovascular disease risk are discussed. Furthermore, the effects of sociocultural risk factors such as minority stress are outlined. In sum, we invite the reader to consider the specific biological, psychological, and social context of the consultation. Finally, we explore culturally competent approaches to pedigree charting and physical examinations with transgender people and provide recommendations for practice.
Collapse
Affiliation(s)
| | - Reubs J Walsh
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Gender Identity Research and Education Society (GIRES), Ashtead, UK
| |
Collapse
|
19
|
Kollerud RDR, Haugnes HS, Claussen B, Thoresen M, Nafstad P, Farnham JM, Blaasaas KG, Naess Ø, Cannon-Albright LA. A population-based study of testicular cancer risk among children and young adults from Norway and Utah, USA. Int J Cancer 2020; 147:1604-1611. [PMID: 32142164 DOI: 10.1002/ijc.32949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/01/2020] [Accepted: 02/24/2020] [Indexed: 02/02/2023]
Abstract
Similar family-based cancer and genealogy data from Norway and Utah allowed comparisons of the incidence of testicular cancer (TC), and exploration of the role of Scandinavian ancestry and family history of TC in TC risk. Our study utilizes data from the Utah Population Database and Norwegian Population Registers. All males born during 1951-2015 were followed for TC until the age of 29 years. A total of 1,974,287 and 832,836 males were born in Norway and Utah, respectively, of whom 2,686 individuals were diagnosed with TC in Norway and 531 in Utah. The incidence per year of TC in Norway (10.6) was twice that observed in Utah (5.1) for males born in the last period (1980-1984). The incidence rates of TC in Utah did not differ according to the presence or absence of Scandinavian ancestry (p = 0.669). Having a brother diagnosed with TC was a strong risk factor for TC among children born in Norway and Utah, with HR = 9.87 (95% CI 5.68-17.16) and 6.02 (95% CI 4.80-7.55), respectively; with even higher HR observed among the subset of children in Utah with Scandinavian ancestry (HR = 12.30, 95% CI 6.78-22.31). A clear difference in TC incidence among individuals born in Norway and descendants of Scandinavian people born in Utah was observed. These differences in TC rates point to the possibility of environmental influence. Family history of TC is a strong risk factor for developing TC in both populations.
Collapse
Affiliation(s)
- Ruby Del Risco Kollerud
- Institute of Health and Society, University of Oslo, Oslo, Norway.,The National Centre for Occupational Rehabilitation in Norway, Rauland, Norway
| | - Hege S Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway.,Institute of Clinical Medicine, UIT-The Arctic University, Tromsø, Norway
| | | | - Magne Thoresen
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Per Nafstad
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - James M Farnham
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Øyvind Naess
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lisa A Cannon-Albright
- Genetic Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
20
|
Brandt MP, Gust KM, Bon D, Tsaur I, Thomas C, Neisius A, Haferkamp A, Herrmann E, Bartsch G. Trend analysis and regional tumor incidence in Germany for testicular cancer between 2003 and 2014. Andrology 2020; 7:408-414. [PMID: 31310057 DOI: 10.1111/andr.12666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/12/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Testicular germ cell tumor (TGCT) is one the most common solid tumors in men between the age of 15 and 35 with an overall incidence rate of 1-1.5 %. Epidemiologic studies have demonstrated different incidence patterns in western civilized countries with overall rising incidence trends. OBJECTIVE To analyze differences in regional tumor incidence rates for TGCT and perform a trend analysis for TGCT between 2003 and 2014 in Germany. MATERIAL AND METHODS TGCT cases in Germany which were diagnosed between 2003 and 2014 were provided by the Robert-Koch-Institute, Berlin. For statistical analysis, cluster and spatial scan tests according to Kulldorff were used for cases with seminoma and non-seminoma. Results are presented in administrative districts and graphically illustrated. We performed a trend-analysis in order to evaluate age-adjusted incidence trends in Germany. Tests were two-sided with a level of significance of α=0.05. RESULTS In total we included 35,066 patients. Overall, 22,634 cases had newly diagnosed seminoma and 12,432 were diagnosed as non-seminoma. Maximum incidence of seminoma and non-seminoma was observed for age-group 38-40 years and 26-28 years, respectively. No second peak for the incidences of seminoma and non-seminoma with respect to age were observed. Cluster analysis revealed areas with high and low incidence rates as well as slightly different spatial distribution in Germany between seminoma and nonseminoma. Furthermore, there was no significant increase in age-adjusted incidence rates over the reviewed time period in both cohorts. DISCUSSION In this study differences in reginal tumor incidence rates for seminoma and non-seminoma are reported with both tumor entities revealing distinct clusters. Furthermore, tumor incidence trends for seminoma and nonseminoma between 2003 and 2014 were stable which might indicate the beginning of a plateau phase for TGCT incidence rates in Germany. CONCLUSION In this analysis we were able to identify regions with significantly higher tumor incidence rates for both seminoma and non-seminoma which were specific for these two subtypes. Furthermore, trend analysis revealed a steady incidence rate for testicular cancer in Germany.
Collapse
Affiliation(s)
- M P Brandt
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - K M Gust
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - D Bon
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - I Tsaur
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - C Thomas
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - A Neisius
- Department of Urology and Pediatric Urology, Hospital Barmherzige Brüder, Trier, Germany
| | - A Haferkamp
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - E Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - G Bartsch
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| |
Collapse
|
21
|
Cost-effectiveness Analysis of Non–risk-adapted Active Surveillance for Postorchiectomy Management of Clinical Stage I Seminoma. Eur Urol Focus 2020; 7:1409-1417. [DOI: 10.1016/j.euf.2020.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/08/2020] [Accepted: 06/19/2020] [Indexed: 11/20/2022]
|
22
|
DeRouen MC, McKinley M, Shah SA, Borno HT, Aoki R, Lichtensztajn DY, Leppert JT, Brooks JD, Chung BI, Gomez SL, Cheng I. Testicular cancer in Hispanics: incidence of subtypes over time according to neighborhood sociodemographic factors in California. Cancer Causes Control 2020; 31:713-721. [PMID: 32440828 DOI: 10.1007/s10552-020-01311-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/04/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Hispanic men in the USA experience the second-highest incidence rate of testicular germ cell tumors (TGCTs), behind non-Hispanic (NH) White men, and have experienced steep increases in TGCT in recent decades. It is unknown whether increases in incidence differ according to neighborhood sociodemographic factors. METHODS We conducted a population-based study of n = 3759 Hispanic and n = 8469 NH White men (n = 12,228 total) diagnosed with TGCT in California during the three most recent pericensal periods. We calculated incidence rates according to neighborhood socioeconomic status (nSES) and among Hispanics, according to ethnic enclave. We calculated incidence rate ratios to compare rates across nSES and ethnic enclave and to examine changes in rates over pericensal time periods according to these neighborhood factors for major histologic types (i.e., seminoma and nonseminoma). RESULTS Hispanic men residing in high SES, compared to low SES, neighborhoods had greater incidence of seminoma and nonseminoma testicular cancer across pericensal periods, as did Hispanic men in low enclave (less ethnic), compared to high enclave, neighborhoods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced a 39% increased incidence of seminoma, while those residing in low and middle SES neighborhoods experienced 87% and 48% increased incidence of nonseminoma, respectively. CONCLUSION While TGCT incidence has increased among all Hispanic men, incidence increases appear to be driven disproportionately by those residing in lower SES and lower enclave neighborhoods, particularly for nonseminoma.
Collapse
Affiliation(s)
- Mindy C DeRouen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA. .,UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA. .,, 2nd Floor, 550 16th St, Stanford, CA, 94158, USA.
| | - Meg McKinley
- Greater Bay Area Cancer Registry, San Francisco, CA, USA
| | - Sumit Anil Shah
- Division of Oncology, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford, CA, USA
| | - Hala T Borno
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rhonda Aoki
- Department of Health Research and Policy, Stanford School of Medicine, Stanford, CA, USA
| | - Daphne Y Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.,Greater Bay Area Cancer Registry, San Francisco, CA, USA
| | - John T Leppert
- Stanford Cancer Institute, Stanford, CA, USA.,Division of Urology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Urology, Stanford School of Medicine, Stanford, CA, USA
| | - James D Brooks
- Stanford Cancer Institute, Stanford, CA, USA.,Department of Urology, Stanford School of Medicine, Stanford, CA, USA
| | - Benjamin I Chung
- Stanford Cancer Institute, Stanford, CA, USA.,Department of Urology, Stanford School of Medicine, Stanford, CA, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.,UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,Greater Bay Area Cancer Registry, San Francisco, CA, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.,UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,Greater Bay Area Cancer Registry, San Francisco, CA, USA
| |
Collapse
|
23
|
Li Y, Lu Q, Wang Y, Ma S. Racial differences in testicular cancer in the United States: descriptive epidemiology. BMC Cancer 2020; 20:284. [PMID: 32252689 PMCID: PMC7137202 DOI: 10.1186/s12885-020-06789-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Testicular cancer (TC) is the most common malignancy in young adult men, and in many countries the incidence rates of testicular cancer have been increasing since the middle of the twentieth century. Since disease presentation and tumor progression patterns are often heterogeneous across racial groups, there may be important racial differences in recent TC trends. METHODS In this study, Surveillance, Epidemiology, and End Results (SEER) data on TC patients diagnosed between 1973 and 2015 were analyzed, including the following racial/ethnic groups: non-Hispanic whites (NHW), Hispanic whites (HW), blacks, and Asians and Pacific Islanders (API). Patient characteristics, age-adjusted incidence rates, and survival were compared across racial groups. A multivariate Cox model was used to analyze the survival data of TC patients, in order to evaluate racial differences across several relevant factors, including marital status, age group, histologic type, treatment, stage, and tumor location. RESULTS NHWs had the highest incidence rates, followed by blacks, HWs, and APIs. There were significant survival differences among the racial groups, with NHWs having the highest survival rates and blacks having the lowest. CONCLUSION An analysis of SEER data showed that racial differences existed among TC patients in the United States with respect to patient characteristics, incidence, and survival. The results can be useful to stakeholders interested in reducing the burden of TC morbidity and mortality.
Collapse
Affiliation(s)
- Yang Li
- Center for Applied Statistics, Renmin University of China, Beijing, China
- School of Statistics, Renmin University of China, Beijing, China
| | - Qi Lu
- School of Statistics, Renmin University of China, Beijing, China
| | - Yu Wang
- Center for Applied Statistics, Renmin University of China, Beijing, China.
- School of Statistics, Renmin University of China, Beijing, China.
| | - Shuangge Ma
- School of Statistics, Renmin University of China, Beijing, China
- School of Public Health, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
24
|
Berney DM, Stoneham S, Arora R, Shamash J, Lockley M. Ovarian germ cell tumour classification: views from the testis. Histopathology 2020; 76:25-36. [PMID: 31846529 DOI: 10.1111/his.14016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/06/2019] [Indexed: 12/14/2022]
Abstract
The classification of ovarian germ cell tumours has remained unchanged for many years, while there have been considerable changes in the testicular classification. In recent years there has been concern about the overtreatment of clinical stage 1 testicular germ cell tumours with increasing use of surveillance for low-risk disease. We outline here the current classification of germ cell tumours of the ovary with particular regard to treatment and outcome and highlight some areas which may cause confusion, particularly pertaining to immature teratomas and mixed germ cell tumours. We suggest that some minor changes to the classification, evidenced by a recent retrospective series by some of the authors, may lead to less adjuvant chemotherapy for immature teratomas and may obviate the need for the grading of immature teratomas, by aligning with testicular experience in pure post-pubertal teratomas. Adoption of this will require retrospective and prospective re-evaluation, but may avoid long-term patient morbidity.
Collapse
Affiliation(s)
- Daniel M Berney
- Centre for Molecular Oncology, Barts Cancer Institute, Charterhouse Square, Queen Mary University of London, London, UK
| | - Sara Stoneham
- Department of Paediatric and Adolescent Haematology and Oncology, University College Hospitals London, London, UK
| | - Rupali Arora
- Department of Histopathology, University College Hospitals London, London, UK
| | - Jonathan Shamash
- Department of Medical Oncology, Bartshealth NHS Trust, St Bartholomew's Hospital, London, UK
| | - Michelle Lockley
- Centre for Molecular Oncology, Barts Cancer Institute, Charterhouse Square, Queen Mary University of London, London, UK
| |
Collapse
|
25
|
Gürsoy P, Çakar B, Gökmen E, Sarsık Kumbaracı B, Semerci B, Caner A, Sert F, Özkök S, Haydaroğlu A. Ege Üniversitesi Hastanesinde testis kanserlerinin epidemiyolojisi ve genel sağ kalım özellikleri. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.669478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
26
|
Gürsoy P, Çakar B, Gökmen E, Sarsık Kumbaracı B, Semerci B, Caner A, Sert F, Özkök S, Haydaroğlu A. Ege Üniversitesi Hastanesinde testis kanserlerinin epidemiyolojisi ve genel sağ kalım özellikleri. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.669472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
27
|
Abdulkadir A, Sanusi HM, Alhaji SA. Histopathological Pattern of Testicular Lesions in Kano, Northwestern Nigeria. Niger J Surg 2019; 25:158-162. [PMID: 31579369 PMCID: PMC6771181 DOI: 10.4103/njs.njs_44_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The global distribution of testicular disorders differs conforming with differences in demographic denominators. The diagnostic dictum for these disorders customarily adheres to findings at clinical assessment, relevant imaging, and laboratory evaluation. Histopathological confirmation remains the ultimate for the diagnosis of testicular malignancies and many testicular dysfunctions. The epidemiological review of the histological outcomes among Kano populace, however, is deficient. Objective: The aim of the study was to analyse histological pattern of testicular lesions in Kano, Nigeria. Methodology: The study is a 14-year retrospective review of testicular specimens subjected to histology in Kano from January 2003 to December 2016. The variables obtained were the age of patients, laterality, and histological diagnoses. These were collated and analyzed; the findings were presented as mean, patients’ age range, and laterality ratio with frequency tables. Results: Three hundred and forty-three testicular tissues were assessed. The nonneoplastic lesions were 79.2% with patients’ age range of 3–90 years. Atrophies and maturation arrests formed 29.4% and 18.0%, respectively. Specimens from the right were more with a ratio of 1.6:1. Neoplastic lesions were 3.5% and patients’ age range from 3 to 65 years. Seminomas were the predominant neoplastic lesion and constituted 66.7%. The right testes were more commonly affected and have a ratio of 1.4:1. Conclusion: This appraisal affirms that testicular lesions could be found across a wide age range and majorities are nonneoplastic. The findings in this study concur with the published African and Asian conclusions.
Collapse
Affiliation(s)
- Abubakar Abdulkadir
- Urology Unit, Department of Surgery, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - Haruna Muhammad Sanusi
- Department of Morbid Anatomy and Forensic Medicine, Usmanu Danfodiyo University, Sokoto, Kano State, Nigeria
| | - Sule Alfa Alhaji
- Department of Pathology, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| |
Collapse
|
28
|
Sun H, Ding H, Wang J, Zhang E, Fang Y, Li Z, Yu X, Wang C, Zhao Y, Chen K, Wen S, Li L, Shan S, Hong L, Chen F, Su P. The differences between gonadal and extra-gonadal malignant teratomas in both genders and the effects of chemotherapy. BMC Cancer 2019; 19:408. [PMID: 31039746 PMCID: PMC6492338 DOI: 10.1186/s12885-019-5598-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 04/11/2019] [Indexed: 11/21/2022] Open
Abstract
Background A tumor comprising of different types of tissues (such as hair, muscle, bone, etc.) is known as a teratoma. It is a type of germ cell (cells that make sperm or eggs) tumor. When these germ cells have rapid cancerous growth, then such a teratoma is called a malignant teratoma. We have studied the differences between gonadal and extra-gonadal malignant teratomas and the effects of chemotherapy in both genders. Methods The samples of 3799 male and 1832 female patients with malignant teratoma samples, between the ages of 1 and 85+ years, were selected from the years 1973 to 2014. Trends in incidence, estimated prevalence, incidence rates, and frequency were calculated in gonadal and extra-gonadal tumors with age adjustment. The five-year observed, expected, and relative survival rates were analyzed to study the prognosis. Results The gonadal took over a majority percentage of malignant teratomas compared with the extra-gonadal (90% vs. 10% in male; 83% vs. 17% in female). For the male, the total of the gonadal and the extra-gonadal were all significantly decreased from 1973 to 2014 (p < 0.05). For the female, there were no significant trends. As for prevalence, incidence, and frequency, there were two separate peaks of malignant teratomas. One peak was at under 1 year old, which was composed of the extra-gonadal tumor; the other peak was at 20–24 for male and 10–34 for female, which was composed of the gonadal tumor. This separation of the gonadal and extra-gonadal showed a significant difference (p < 0.05). As for the prognosis, the extra-gonadal tumor showed significantly lower survival rates than the gonadal (p < 0.05). In the short term, the survival rate of the chemotherapy group was higher than the supportive care group. However, in the long term, the survival rate of the chemotherapy group was lower than the supportive care group. Conclusion The gonadal and extra-gonadal malignant teratomas show lots of differences. Chemotherapy might not help improve survival rates. Electronic supplementary material The online version of this article (10.1186/s12885-019-5598-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hang Sun
- Department of Endocrinology, Shanghai Tenth Peoples' Hospital, Tongji University, No.301 Middle Yanchang Road, Shanghai, 200072, China.
| | - Hongxin Ding
- Hospital of Yantai University, Yantai University, Yantai, China
| | - Jianjun Wang
- Tongji Hospital, Tongji University, Shanghai, China
| | - Emma Zhang
- Mannjo Informatics Studio, Shanghai, China
| | - Yihua Fang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhenhua Li
- Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China
| | - Xiao Yu
- Huangshan First Peoples' Hospital, Huangshan, China
| | - Chongren Wang
- Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yifan Zhao
- Department of Endocrinology, Shanghai Tenth Peoples' Hospital, Tongji University, No.301 Middle Yanchang Road, Shanghai, 200072, China
| | - Kan Chen
- Department of Endocrinology, Shanghai Tenth Peoples' Hospital, Tongji University, No.301 Middle Yanchang Road, Shanghai, 200072, China
| | - Siwan Wen
- Tongji Hospital, Tongji University, Shanghai, China
| | - Liang Li
- Tongji Hospital, Tongji University, Shanghai, China
| | - Shan Shan
- Shanghai Sixth Peoples' Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liu Hong
- Sam M. Walton College of Business, University of Arkansas, Fayetteville, AR, USA
| | - Face Chen
- Department of Informatics, Discovery & Analytical Solutions, PerkinElmer, Shanghai, No.1670, Zhang Heng Road, Zhangjiang Hi-Tech Park, Shanghai, 201203, China
| | - Pu Su
- Department of Informatics, Discovery & Analytical Solutions, PerkinElmer, Shanghai, No.1670, Zhang Heng Road, Zhangjiang Hi-Tech Park, Shanghai, 201203, China.
| |
Collapse
|
29
|
Berghen C, Albersen M, Blanchard P, Bossi A, Briganti A, Cozzarini C, Decaestecker K, Fonteyne V, Haustermans K, Joniau S, Lim Joon D, Khoo V, Nguyen PL, Ost P, Villeirs G, Vulsteke C, Zietman A, De Meerleer G. Readressing the rationale of irradiation in stage I seminoma guidelines: a critical essay. BJU Int 2019; 124:35-39. [PMID: 30680874 DOI: 10.1111/bju.14686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Charlien Berghen
- Department of Radiation Oncology, Leuven University Hospital, Leuven, Belgium
| | - Maarten Albersen
- Department of Urology, Leuven University Hospital, Leuven, Belgium
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alberto Bossi
- Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Cesare Cozzarini
- Department of Radiation Oncology, San Raffaele Hospital, Milan, Italy
| | | | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Karin Haustermans
- Department of Radiation Oncology, Leuven University Hospital, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, Leuven University Hospital, Leuven, Belgium
| | - Daryl Lim Joon
- Olivia Newton John Cancer Centre, Melbourne, Vic., Australia
| | | | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Bringham and Women's Hospital, Boston, MA, USA
| | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Geert Villeirs
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Christof Vulsteke
- Department of Oncology, Ghent Maria Middelares Hospital, Ghent, Belgium.,Department of Molecular Imaging, Pathology, Radiotherapy and Oncology, (MIPRO) Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - Anthony Zietman
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Gert De Meerleer
- Department of Radiation Oncology, Leuven University Hospital, Leuven, Belgium
| |
Collapse
|
30
|
Abstract
BACKGROUND Testicular germ cell tumor such as seminoma is strongly associated with male reproductive problems commonly associated with the alteration of sperm parameters as described in testicular dysgenesis syndrome. Interestingly, numerous studies have reported that the precursor of germ cell cancer, germ cell neoplasia in situ (GCNIS), present similarities to fetal gonocytes, specifically characterized by global DNA hypomethylation particularly on imprinting sequences. These disorders may have a common origin derived from perturbations of embryonal programming during fetal development. Presently, there is no available information concerning the sperm DNA methylation patterns of testicular cancer patients. For the first time, we evaluated the sperm imprinting of seminoma patients. A total of 92 cryopreserved sperm samples were included, 31 before seminoma treatment (S): 23 normozoospermic (SN) and 8 oligozoospermic (SO) and 61 sperm controls samples: 31 normozoospermic (N) and 30 oligozoospermic (O). DNA methylation levels of seven differentially methylated regions (DMRs) of imprinted genes [H19/IGF2: IG-DMR (CTCF3 and CTCF6 of H19 gene); IGF2-DMRs (DMR0 and DMR2); MEG3/DLK1:IG-DMR; SNURF:TSS-DMR; KCNQ1OT1:TSS-DMR] were assessed by pyrosequencing. All comparative analyses were adjusted for age. RESULTS Comparisons of sperm DNA methylation levels between seminoma (S) and normozoospermic (N) samples showed a significant difference for the SNURF sequence (p = 0.017), but after taking into account the sperm parameters, no difference was observed. However, we confirmed a significant association between oligozoospermia (O) and imprinting defects for H19/IGF2-CTCF6 (p = 0.001), MEG3/DLK1 (p = 0.017), IGF2-DMR2 (p = 0.022), and SNURF (p = 0.032) in comparison with control groups (N). CONCLUSIONS This study highlights the high risk of sperm imprinting defects in cases of oligozoospermia and shows for the first time that seminoma patients with normal spermatogenesis present sperm imprinting integrity. These data suggest a low probability of the involvement of a common imprinting defect in fetal cells leading to both TGCT and subfertility.
Collapse
|
31
|
Lymperi S, Giwercman A. Endocrine disruptors and testicular function. Metabolism 2018; 86:79-90. [PMID: 29605435 DOI: 10.1016/j.metabol.2018.03.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 03/19/2018] [Accepted: 03/22/2018] [Indexed: 02/07/2023]
Abstract
Despite concerns of the scientific community regarding the adverse effects of human exposure to exogenous man-made chemical substances or mixtures that interfere with normal hormonal balance, the so called "endocrine disruptors (EDs)", their production has been increased during the last few decades. EDs' extensive use has been implicated in the increasing incidence of male reproductive disorders including poor semen quality, testicular malignancies and congenital developmental defects such as hypospadias and cryptorchidism. Several animal studies have demonstrated that exposure to EDs during fetal, neonatal and adult life has deleterious consequences on male reproductive system; however, the evidence on humans remains ambiguous. The complexity of their mode of action, the differential effect according to the developmental stage that exposure occurs, the latency from exposure and the influence of the genetic background in the manifestation of their toxic effects are all responsible factors for the contradictory outcomes. Furthermore, the heterogeneity in the published human studies has hampered agreement in the field. Interventional studies to establish causality would be desirable, but unfortunately the nature of the field excludes this possibility. Therefore, future studies based on standardized guidelines are necessary, in order to estimate human health risks and implement policies to limit public exposure.
Collapse
Affiliation(s)
- Stefania Lymperi
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | |
Collapse
|
32
|
Trevino KE, Esmaeili-Shandiz A, Saeed O, Xu H, Ulbright TM, Idrees MT. Pathological risk factors for higher clinical stage in testicular seminomas. Histopathology 2018; 73:741-747. [DOI: 10.1111/his.13667] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/31/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Karen E Trevino
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Alaleh Esmaeili-Shandiz
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Omer Saeed
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Huiping Xu
- Department of Biostatistics; Indiana University School of Medicine; Indianapolis IN USA
| | - Thomas M Ulbright
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| | - Muhammad T Idrees
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
| |
Collapse
|
33
|
Gurney JK, Stanley J, McGlynn K, Richiardi L, Shaw C, Edwards R, Merriman TR, Robson B, Koea J, McLeod M, Kennedy MA, Sarfati D. Testicular Cancer in New Zealand (TCNZ) study: protocol for a national case-control study. BMJ Open 2018; 8:e025212. [PMID: 30082371 PMCID: PMC6078234 DOI: 10.1136/bmjopen-2018-025212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
UNLABELLED Testicular cancer (TC) is by far the most common cancer to affect young men; however, the exposures that cause this disease are still poorly understood. Our own research has shown that Māori men have the highest rates of this disease in New Zealand-a puzzling observation, since internationally TC is most commonly a disease of men of European ancestry. These trends provide us with a unique opportunity: to learn more about the currently unknown exposures that cause TC, and to explain why Māori have the highest rates of this disease in New Zealand. Using epidemiology and genetics, our experienced research team will conduct a nationwide study which aims to answer these internationally important questions. AIM OF STUDY The overall aim of the current national case-control study is to identify the key exposures in the development of TC in New Zealand, and explore which factors might explain the difference in the incidence of TC between Māori and non-Māori. METHODS AND ANALYSIS Outside of our own investigations into cryptorchidism, we still do not know which exposures are driving the significant incidence disparity between ethnic groups in NZ. The aim of the proposed research is to use a population-based case-control study to identify the key exposures in the development of TC in New Zealand. We will recruit 410 TC cases and 410 controls, and collect (1) environmental exposure data, via interview and (2) genetic information, via genome-wide genotyping. ETHICS AND DISSEMINATION Ethical approval for this study was sought and received from the New Zealand Ministry of Health's Health and Disability Ethics Committee (reference # 17/NTA/248). Following a careful data interpretation process, we will disseminate the findings of this study to a wide and varied audience ranging from general academia, community groups and clinical settings, as well as to the participants themselves.
Collapse
Affiliation(s)
- Jason K Gurney
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Katherine McGlynn
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Maryland, USA
| | | | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Bridget Robson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jonathan Koea
- Department of Surgery, Waitemata District Health Board, Auckland, New Zealand
| | - Melissa McLeod
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Martin A Kennedy
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Diana Sarfati
- Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand
| |
Collapse
|
34
|
Knuutinen O, Kuitunen H, Alahuhta S, Isokangas JM, Sonkajärvi E, Turpeenniemi-Hujanen T, Kuittinen O. Case Report: Chemotherapy in Conjunction With Blood-Brain Barrier Disruption for a Patient With Germ Cell Tumor With Multiple Brain Metastases. Clin Genitourin Cancer 2018; 16:e993-e996. [PMID: 29844007 DOI: 10.1016/j.clgc.2018.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 05/07/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Oula Knuutinen
- Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland.
| | - Hanne Kuitunen
- Department of Oncology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Seppo Alahuhta
- Department of Anaesthesiology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha-Matti Isokangas
- Department of Diagnostic Radiology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Eila Sonkajärvi
- Department of Anaesthesiology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Taina Turpeenniemi-Hujanen
- Department of Oncology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Outi Kuittinen
- Department of Oncology, Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
35
|
Abstract
PURPOSE Seminomas are solid tumors in young men, but which rarely metastasize to the orbit. The authors review the known literature on seminoma metastatic to the orbit, and describe an additional case in a 33-year-old man. METHODS A literature search was performed on the MEDLINE database using keywords "seminoma," "testicular germ-cell tumors," "testicular cancer," "testicular neoplasm," "orbital metastasis," and "germ-cell neoplasms." RESULTS Malignant neoplasms of the testis account for only 1% of cancers in men. None-the-less, testicular germ cell seminoma is the most common solid tumor found in young men between the ages of 15 and 39. Only seven previous cases have been mentioned in the literature. The pathogenesis remains unclear although genetic, environmental, and maternal factors may play a role. The number of cases is too few to determine the best treatment options, but surgical excision and adjunctive orbital radiotherapy appear to be most appropriate. CONCLUSIONS Although metastases to the orbit are rare, seminoma should be considered in the differential diagnosis of all young men with proptosis.
Collapse
|
36
|
An X-linked agammaglobulinemia contiguous gene syndrome with metachronous coprimary testicular cancers. Ann Allergy Asthma Immunol 2018; 120:215-217. [PMID: 29307603 DOI: 10.1016/j.anai.2017.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/31/2017] [Accepted: 11/20/2017] [Indexed: 11/23/2022]
|
37
|
Hanson BM, Eisenberg ML, Hotaling JM. Male infertility: a biomarker of individual and familial cancer risk. Fertil Steril 2018; 109:6-19. [DOI: 10.1016/j.fertnstert.2017.11.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/15/2017] [Accepted: 11/07/2017] [Indexed: 12/13/2022]
|
38
|
Physical long-term side-effects in young adult cancer survivors: germ cell tumors model. Curr Opin Oncol 2017; 29:229-234. [PMID: 28463858 DOI: 10.1097/cco.0000000000000375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW After the important advances in the treatment of germ cell tumors (GCTs) leading to high cure rates, physical long-term side-effects represent an important cause of death in these young adult survivors. Highlighting these physical long-term side-effects, their monitoring and their prevention modalities is necessary for a better management of these cancer survivors. RECENT FINDINGS Impaired fertility, increased risk of developing a second cancer, cardiac, pulmonary, renal and neural toxicity, hearing and vision impairment are the major physical side-effects in young adult cancer survivors. Long-term cardiac toxicity, next to second malignancies, represents life-threatening conditions in testicular cancer survivors. The long-term nephrotoxity in testicular GCTs survivors is most frequently associated to the treatment either in those treated with cisplatin-based chemotherapy, mainly Bleomycine, Etoposide, Cisplatin, or those receiving infradiaphragmatic radiation therapy, whereas pulmonary toxicity is mainly attributed to bleomycin related toxicities. SUMMARY There are no clear and comprehensive data concerning the monitoring and prevention of long-term side-effects in testicular cancer survivors. Physical activity and interventions in modifiable cardiovascular risk factors and lifestyles may reduce the incidence of long-term side-effects in these cancer survivors.
Collapse
|
39
|
Ghazarian AA, Kelly SP, Altekruse SF, Rosenberg PS, McGlynn KA. Future of testicular germ cell tumor incidence in the United States: Forecast through 2026. Cancer 2017; 123:2320-2328. [PMID: 28241106 PMCID: PMC5629636 DOI: 10.1002/cncr.30597] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND Testicular germ cell tumors (TGCTs) are rare tumors in the general population but are the most commonly occurring malignancy among males between ages 15 and 44 years in the United States (US). Although non-Hispanic whites (NHWs) have the highest incidence in the US, rates among Hispanics have increased the most in recent years. To forecast what these incidence rates may be in the future, an analysis of TGCT incidence in the Surveillance, Epidemiology, and End Results program and the National Program of Cancer Registries was conducted. METHODS TGCT incidence data among males ages 15 to 59 years for the years 1999 to 2012 were obtained from 39 US cancer registries. Incidence rates through 2026 were forecast using age-period-cohort models stratified by race/ethnicity, histology (seminoma, nonseminoma), and age. RESULTS Between 1999 and 2012, TGCT incidence rates, both overall and by histology, were highest among NHWs, followed by Hispanics, Asian/Pacific Islanders, and non-Hispanic blacks. Between 2013 and 2026, rates among Hispanics were forecast to increase annually by 3.96% (95% confidence interval, 3.88%-4.03%), resulting in the highest rate of increase of any racial/ethnic group. By 2026, the highest TGCT rates in the US will be among Hispanics because of increases in both seminomas and nonseminomas. Rates among NHWs will slightly increase, whereas rates among other groups will slightly decrease. CONCLUSIONS By 2026, Hispanics will have the highest rate of TGCT of any racial/ethnic group in the US because of the rising incidence among recent birth cohorts. Reasons for the increase in younger Hispanics merit further exploration. Cancer 2017;123:2320-2328. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Armen A. Ghazarian
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Scott P. Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Sean F. Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Philip S. Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| |
Collapse
|
40
|
Synchronous bilateral testis cancer: clinical and oncological management. Contemp Oncol (Pozn) 2017; 21:70-76. [PMID: 28435402 PMCID: PMC5385482 DOI: 10.5114/wo.2017.66660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 06/22/2016] [Indexed: 01/17/2023] Open
Abstract
Synchronous bilateral testis cancer (SBTC) is a rare event. It represents only 0.5–1% of all new cases of testicular cancer. Patients with this disease require careful management for psychological, oncological, and medical problems. We performed a PubMed search for all series that reported SBTC. We considered only articles in English, reporting on more than three cases. We also performed an analysis of the reported evidence regarding testosterone replacement and surgical treatment. We found 10 studies satisfying inclusion criteria for a total of 73 patients. The majority are bilateral seminoma, which present with a low stage at diagnosis, and mixed histology tumours, both with a good overall survival. On the other hand, cases with bilateral non-seminoma histology are associated with poor prognosis and high stage at presentation. Testis-sparing surgery should be an eligible choice in selected cases, to preserve fertility and avoid testosterone deficiency. Multiple biopsies are recommended in these patients, and in the case of intratubular germ cell neoplasia (ITGCN) presence, scrotal radiotherapy is mandatory. Subcutaneous testosterone pellets guarantee higher patient acceptance and physiological testosterone levels. Lifelong follow-up and psychological support, with special care for infertility and erectile dysfunction, must be considered in this cohort of patients.
Collapse
|
41
|
Giannandrea F, Fargnoli S. Environmental Factors Affecting Growth and Occurrence of Testicular Cancer in Childhood: An Overview of the Current Epidemiological Evidence. CHILDREN-BASEL 2017; 4:children4010001. [PMID: 28067779 PMCID: PMC5296662 DOI: 10.3390/children4010001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 12/09/2016] [Accepted: 12/21/2016] [Indexed: 12/11/2022]
Abstract
Testicular cancer (TC) is the most frequently occurring malignancy among adolescents and young men aged 15–34 years. Although incidence of TC has been growing over the past 40 years in several western countries, the explanations for this increase still remain uncertain. It has been postulated that early life exposure to numerous occupational and environmental estrogenic chemicals, such as endocrine-disrupting chemicals (EDCs), may play a contributing role in the etiology of TC, but the subject is still open to additional investigation. Recently, it has also been suggested that prenatal and postnatal environmental exposures associated with child growth and development might also be involved in TC progression. This review of current epidemiological studies (2000–2015) aims to identify environmental factors associated with TC, with a particular focus on infancy and childhood factors that could constitute a risk for disease development. It may also contribute towards recognizing gaps in knowledge and recent research requirements for TC, and to point out possible interactions between child growth and development in relation to prenatal and postnatal environmental exposures.
Collapse
Affiliation(s)
- Fabrizio Giannandrea
- Occupational Health Unit, Local Health Authority, ASL 2 Abruzzo Lanciano-Vasto-Chieti; S.S. Annunziata University Hospital, 66100 Chieti, Italy.
| | - Stefania Fargnoli
- Department of Public Health and Infectious Diseases, University of Rome Sapienza, 00185 Rome, Italy.
| |
Collapse
|
42
|
Corlan AS, Cîmpean AM, Jitariu AA, Melnic E, Raica M. Endocrine Gland-Derived Vascular Endothelial Growth Factor/Prokineticin-1 in Cancer Development and Tumor Angiogenesis. Int J Endocrinol 2017; 2017:3232905. [PMID: 28386275 PMCID: PMC5366234 DOI: 10.1155/2017/3232905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/15/2017] [Accepted: 01/23/2017] [Indexed: 12/26/2022] Open
Abstract
A lot of data suggests endocrine gland-derived vascular endothelial growth factor (EG-VEGF) to be restricted to endocrine glands and to some endocrine-dependent organs. Many evidences show that EG-VEGF stimulates angiogenesis and cell proliferation, although it is not a member of the VEGF family. At the time, a lot of data regarding the role of this growth factor in normal development are available. However, controversial results have been published in the case of pathological conditions and particularly in malignant tumors. Thus, our present paper has been focused on the role of EG-VEGF in normal tissues and various malignant tumors and their angiogenic processes.
Collapse
Affiliation(s)
- Ana Silvia Corlan
- Department of Endocrinology, “Vasile Goldis” University of Arad, Arad, Romania
| | - Anca Maria Cîmpean
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Timișoara, Romania
- *Anca Maria Cîmpean:
| | - Adriana-Andreea Jitariu
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Timișoara, Romania
| | - Eugen Melnic
- Department of Pathology, “Nicolae Testemitanu” University of Medicine and Pharmacy, Chișinău, Moldova
| | - Marius Raica
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Timișoara, Romania
| |
Collapse
|
43
|
Hanson HA, Mayer EN, Anderson RE, Aston KI, Carrell DT, Berger J, Lowrance WT, Smith KR, Hotaling JM. Risk of childhood mortality in family members of men with poor semen quality. Hum Reprod 2016; 32:239-247. [PMID: 27927843 DOI: 10.1093/humrep/dew289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 10/14/2016] [Accepted: 10/27/2016] [Indexed: 01/18/2023] Open
Abstract
STUDY QUESTION What is the familial childhood mortality in first-degree (FDR) and second-degree relatives (SDR) of patients undergoing semen analysis (SA)? SUMMARY ANSWER The relationship between infertility and congenital malformations (CM) in offspring is complex, with an increased risk of death due to CM in FDR, but not SDR, of men with lower semen parameters. WHAT IS KNOWN ALREADY Semen quality is an established predictor of men's somatic health. We can gain a better understanding of possible genetic or environmental determinants of the infertility phenotype by exploring familial aggregation of childhood mortality in relatives of men with poor semen quality. STUDY DESIGN, SIZE, DURATION Retrospective cohort study from the Subfertility, Health and Assisted Reproduction study (cohort compiled 1996-2011) linked with patient/familial information from the Utah Population Database (UPDB). Index cases included a clinic-referred sample of 12 889 men who underwent SA and had adequate familial and follow-up data in the UPDB. Parameters of semen quality included: semen concentration, sperm count, motility, total motile count, sperm head morphology, sperm tail morphology and vitality. PARTICIPANTS/MATERIALS, SETTING, METHODS SA data were collected from two tertiary medical center andrology laboratories that have captured ~90% of all SA performed in Utah since 2004. Age- and sex-matched fertile controls were selected to create the comparison group for determining risk of childhood death (to age 20 years) in family members. A total of 79 750 siblings and 160 016 aunts/uncles were used to investigate the familial aggregation of childhood mortality. The main outcome was childhood mortality in FDR and SDR of men with SA and their matched controls. All-cause and cause-specific Cox proportional hazard models were used to test the association between semen quality and childhood mortality in family members. Cause-specific models were considered for cancer and CM. MAIN RESULTS AND THE ROLE OF CHANCE In the cohort of men with SA, there were 406 (1.0%) deaths in FDR and 772 (1.1%) deaths in SDR due to any cause. There was no significant difference in the risk of all-cause childhood mortality between the relatives of men with SA and the fertile control group [hazard ratio (HR)Female = 1.08, 95% CI = 0.88, 1.32; HRMale = 0.88, 95% CI = 0.75, 1.04]. We found no association between semen quality and risk for childhood cancer mortality in FDR or SDR (HRFDR = 0.98, 95% CI = 0.62, 1.54; HRSDR = 1.12, 95% CI = 0.83, 1.50). The FDR of men with SA and fertile controls were followed on average for 19.71 and 19.73 years, respectively. During this period of follow-up, FDR of men with SA had an unadjusted 40% relative risk of increased CM-related death. After stratifying by semen parameters and adjusting for birth year, we found FDR of men with worse semen quality, and notably azoospermic men (HR = 2.69, 95% CI = 1.24,5.84), were at higher risk of CM-related death. LIMITATIONS REASONS FOR CAUTION A large proportion of men with SA in the study had normal semen parameters. It is important to note that these men themselves may not be subfertile, but they were subfertile at the couple level (i.e. the female partner may be infertile). In addition, care is needed when interpreting our results, as we do not have semen measures on our sample of fertile men. Second, we were unable to include potential confounders such as medical comorbidities, smoking status, or environmental exposures. Third, men with SA were seen at the University of Utah or Intermountain Health Care clinics for a fertility evaluation thereby suggesting a more select population. Fourth, we chose to categorize morphology into equally distributed quartiles as a response to the fact that the World Health Organization threshold for normal motility changed multiple times during our study period. Lastly, we do not know the proportion of female partners with diagnosed infertility. We chose not to subcategorize each infertile male by infertile diagnosis because our goal was to understand how semen parameters influenced familial childhood mortality. WIDER IMPLICATIONS OF THE FINDINGS We are not the first study to show a relationship between fertility and CMs. Children conceived through ART may be at higher risk of birth defects, however it is not known if the relationship is causal or if there is some underlying factor linking infertility and birth outcomes. This study provides further evidence that the increased risk of congenital birth defects may not be due to the ART, but rather genetic or environmental factors that link the two outcomes. We encourage further research in order to confirm a relationship between semen quality and increased risk for CM. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Institutes of Health - National Institute of Aging [Grant numbers 1R21AG036938-01, 2R01 AG022095 and 1K12HD085852-01]. Authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- Heidi A Hanson
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT , USA .,Population Sciences, Huntsman Cancer Institute, University of Utah, 675 Arapeen Drive, 204, Salt Lake City, UT 84112 , USA
| | - Erik N Mayer
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Ross E Anderson
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kenneth I Aston
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.,Center for Men's Health and Reconstructive Surgery, Salt Lake City, UT , USA.,Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT , USA
| | - Douglas T Carrell
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.,Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT , USA
| | - Justin Berger
- Population Sciences, Huntsman Cancer Institute, University of Utah, 675 Arapeen Drive, 204, Salt Lake City, UT 84112 , USA
| | - William T Lowrance
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Ken R Smith
- Population Sciences, Huntsman Cancer Institute, University of Utah, 675 Arapeen Drive, 204, Salt Lake City, UT 84112 , USA.,Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.,Center for Men's Health and Reconstructive Surgery, Salt Lake City, UT , USA
| |
Collapse
|
44
|
Plant AS, Chi SN, Frazier L. Pediatric malignant germ cell tumors: A comparison of the neuro-oncology and solid tumor experience. Pediatr Blood Cancer 2016; 63:2086-2095. [PMID: 27554756 DOI: 10.1002/pbc.26165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 12/11/2022]
Abstract
Malignant germ cell tumors (GCT) arise from abnormal migration of primordial germ cells and are histologically identical whether they occur inside or outside the central nervous system (CNS). However, the treatment strategy for GCTs varies greatly depending on the location of the tumor. These differences are in part due to the increased morbidity of surgery in the CNS but may also reflect differential sensitivity of the tumors to chemotherapy and radiation therapy (RT) or not-yet-understood biologic differences between these tumors. Historically, specialists caring for extracranial and intracranial GCT in the United States have practiced separately without much cross communication. The focus of this review is a discussion of differences between the management of CNS and extra-CNS GCTs and opportunities for collaboration and future research.
Collapse
Affiliation(s)
- Ashley S Plant
- Pediatric Hematology/Oncology, Brain Tumors Center, Dana Farber Cancer Institute, Boston, Massachusetts.
| | - Susan N Chi
- Pediatric Hematology/Oncology, Solid Tumor Center, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Lindsay Frazier
- Pediatric Hematology/Oncology, Brain Tumors Center, Dana Farber Cancer Institute, Boston, Massachusetts
| |
Collapse
|
45
|
Biggs ML, Doody DR, Trabert B, Starr JR, Chen C, Schwartz SM. Consumption of alcoholic beverages in adolescence and adulthood and risk of testicular germ cell tumor. Int J Cancer 2016; 139:2405-14. [PMID: 27474852 PMCID: PMC5618434 DOI: 10.1002/ijc.30368] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/27/2016] [Accepted: 07/18/2016] [Indexed: 11/06/2022]
Abstract
The etiology of testicular germ cell tumor (TGCT) remains obscure and accumulating evidence suggests that postnatal environmental or lifestyle factors may play a role. To investigate whether consumption of alcoholic beverages during adolescence or adulthood is associated with TGCT risk, we analyzed data from a USA population-based case-control study of 540 18-44 year-old TGCT cases and 1,280 age-matched controls. Participants were queried separately about consumption of beer, wine and liquor during grades 7-8, grades 9-12 and the 5 years before reference date (date of diagnosis for cases and corresponding date for controls). We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of TGCT risk with alcoholic beverage consumption during the different periods, both total and by specific beverage types and separately for seminomas and nonseminomas. Compared with nondrinkers in the 5 years before reference date, the OR (95% CI) for 1-6, 7-13 and ≥14 drinks per week were 1.20 (0.85, 1.69), 1.23 (0.81, 1.85) and 1.56 (1.03, 2.37), respectively (p-trend = 0.04). The corresponding results for alcohol consumption in grades 9-12 were 1.39 (1.06, 1.82), 1.07 (0.72, 1.60), 1.53 (1.01, 2.31) (p-trend = 0.05). Alcohol consumption in grades 7-8 was uncommon and no statistically significant associations with TGCT were observed. Associations with alcohol consumption in the 5 years before reference date appeared stronger for nonseminomas than for seminomas, but the differences were not statistically significant (p≥0.10). Associations were similar across different alcoholic beverage types. Consumption of alcoholic beverages may be associated with an increased TGCT risk.
Collapse
Affiliation(s)
- Mary L Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Jacqueline R Starr
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA
| | - Chu Chen
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Stephen M Schwartz
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA.
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA.
| |
Collapse
|
46
|
Hauptmann M, Børge Johannesen T, Gilbert ES, Stovall M, van Leeuwen FE, Rajaraman P, Smith SA, Weathers RE, Aleman BMP, Andersson M, Curtis RE, Dores GM, Fraumeni Jr JF, Hall P, Holowaty EJ, Joensuu H, Kaijser M, Kleinerman RA, Langmark F, Lynch CF, Pukkala E, Storm HH, Vaalavirta L, van den Belt-Dusebout AW, Morton LM, Fossa SD, Travis LB. Increased pancreatic cancer risk following radiotherapy for testicular cancer. Br J Cancer 2016; 115:901-8. [PMID: 27599043 PMCID: PMC5046216 DOI: 10.1038/bjc.2016.272] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/18/2016] [Accepted: 08/05/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear. METHODS Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs). RESULTS Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trend<0.001), with an OR of 4.6 (95% CI 1.9-11.0) for ⩾25 Gy vs <25 Gy. Radiation-related risks remained elevated ⩾20 years after TC diagnosis (P=0.020). The risk increased with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum. CONCLUSIONS A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.
Collapse
Affiliation(s)
- Michael Hauptmann
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | | | - Ethel S Gilbert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Marilyn Stovall
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Flora E van Leeuwen
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Preetha Rajaraman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Susan A Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rita E Weathers
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael Andersson
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rochelle E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Graça M Dores
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Joseph F Fraumeni Jr
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eric J Holowaty
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Heikki Joensuu
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Magnus Kaijser
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ruth A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | | | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | | | - Leila Vaalavirta
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Sophie D Fossa
- Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Lois B Travis
- Melvin and Bren Simon Cancer Center, Indianapolis University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
47
|
Chakrabarti PR, Dosi S, Varma A, Kiyawat P, Khare G, Matreja S. Histopathological Trends of Testicular Neoplasm: An Experience over a Decade in a Tertiary Care Centre in the Malwa Belt of Central India. J Clin Diagn Res 2016; 10:EC16-8. [PMID: 27504294 DOI: 10.7860/jcdr/2016/18238.8025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/09/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Testicular and para-testicular neoplasm are rare type of tumours affecting adolescents and young adults, reflected by the paucity of published data in India. AIM This study was undertaken to estimate the epidemiological characteristics and histological types and subtypes of testicular neoplasm according to the WHO classification in our patient group. Identification of histopathological pattern of testicular tumour is immensely important for improved management protocols. MATERIALS AND METHODS This was a retrospective study done over a period of ten years from 2004 to 2014 in a tertiary care centre. All relevant clinical data including patient's age, laterality, history of risk factors and serum tumour markers were collected from records. Histopathological slides were retrieved and reviewed for tumour and its subtype and classified according to WHO classification (2004). RESULTS A total of 37 cases of testicular and paratesticular neoplasm were encountered in our study with a mean age of 38.1 years. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling with heaviness. Germ cell tumour was the most common type accounting for 77.1% followed by lymphomas (17.1%). Germ cell tumours were categorized into seminomatous (48.2%) and non-seminomatous tumours (51.8%). The most common subtype of non-seminomatous tumours was mixed germ cell tumour accounting for 85.8%. CONCLUSION The incidence of testicular neoplasm among general population in Asian countries is low, as reflected in the very few studies that have been performed and published in literature. Epidemiological and histomorphological spectrum of our study was comparable to most of the countries except for some African and Western countries.
Collapse
Affiliation(s)
- Preeti Rihal Chakrabarti
- Assistant Professor, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| | - Shilpi Dosi
- Assistant Professor, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| | - Amit Varma
- Professor and Head, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| | - Priyanka Kiyawat
- Junior Resident, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| | - Gaurav Khare
- Junior Resident, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| | - Sandeep Matreja
- Junior Resident, Department of Pathology, Sri Aurobindo Medical College and PG Institute , Indore, India
| |
Collapse
|
48
|
Di Gregorio M, Nollevaux MC, Lorge F, D'Hondt L. Metachronous testicular seminoma after radiotherapy and chemotherapy: a case report. World J Surg Oncol 2016; 14:147. [PMID: 27184033 PMCID: PMC4867539 DOI: 10.1186/s12957-016-0902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bilateral testicular neoplasia is rare, with an incidence ranging from 1 to 5%. Long-term survival has improved in recent years due to advanced diagnostic approaches and new therapeutic methods that are highly effective against germ cell tumors. CASE PRESENTATION We present the case of a patient with a primary seminomatous testicular tumor, who developed a contralateral metastasis and a subsequent metachronous tumor following chemotherapy and consolidation radiotherapy treatment. CONCLUSIONS Strict follow-up, including physical examination and ultrasound examination of the contralateral testis, enabled early diagnosis of the second tumor, giving the patient a high likelihood of a definitive cure.
Collapse
Affiliation(s)
- Marcelo Di Gregorio
- Urology Department, CHU UCL Namur, 1 Av Gaston Thérasse, B-5530, Yvoir, Belgium.
| | | | - Francis Lorge
- Urology Department, CHU UCL Namur, 1 Av Gaston Thérasse, B-5530, Yvoir, Belgium
| | | |
Collapse
|
49
|
Basiri A, Movahhed S, Parvin M, Salimi M, Rezaeetalab GH. The histologic features of intratubular germ cell neoplasia and its correlation with tumor behavior. Investig Clin Urol 2016; 57:191-5. [PMID: 27195317 PMCID: PMC4869572 DOI: 10.4111/icu.2016.57.3.191] [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: 04/14/2016] [Accepted: 04/25/2016] [Indexed: 11/22/2022] Open
Abstract
Purpose To assess the prevalence of intratubular germ cell neoplasia (ITGCN) in patients with concurrent testis tumor and its correlation with histologic features and serum tumor markers. Materials and Methods From 2003 to 2015, 179 patients underwent radical orchiectomy due to testicular mass. Tissue specimens were evaluated by an expert uro-pathologist using immunohistochemistry (IHC) staining, in addition to light microscopy, to identify presence of ITGCN. Patients' demographic characteristics, histologic subtypes, pathologic stage of tumor and serum tumor markers were gathered and analyzed. Results Eighty-five out of 179 patients (47.5%) had concomitant ITGCN according to IHC staining. There was not statistically significant difference in histologic type, histologic components, cryptorchidism, and lymphovascular invasion between the 2 groups (p=0.151, p=0.11, p=0.233, p=0.413, and p=0.14, respectively). The prevalence of ITGCN was significantly higher in patients with stage T2 and T3 of tumor than those with stage T1. Elevated serum alpha feto protein level is much common in patients with ITGCN (p<0.001). Conclusions The prevalence of concurrent ITGCN in our region is lower than previous data from western countries. ITGCN is more common in higher tumor stages and is accompanied with elevated serum alpha feto protein levels before surgery. Presence of ITGCN in adjacent tissue may suggest a negative cancer behavior.
Collapse
Affiliation(s)
- Abbas Basiri
- Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Movahhed
- Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Parvin
- Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maziar Salimi
- Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholam Hossein Rezaeetalab
- Department of Urology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
50
|
Johnson K, Brunet B. Brain Metastases as Presenting Feature in 'Burned Out' Testicular Germ Cell Tumor. Cureus 2016; 8:e551. [PMID: 27182465 PMCID: PMC4854635 DOI: 10.7759/cureus.551] [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: 10/01/2015] [Accepted: 03/31/2016] [Indexed: 12/24/2022] Open
Abstract
Testicular germ cell tumors (TGCTs) are the most common malignancy in males aged 20 to 39, and the incidence is increasing. TGCTs have a tendency to grow rapidly with a high risk of metastatic spread. TGCTs generally present with a palpable testicular mass, yet may present less commonly with symptoms arising from metastatic disease. A 24-year-old otherwise healthy male presented with progressive headaches. Initial imaging reported a single mass in the right frontal lobe. Complete surgical resection revealed suspicion for metastatic poorly differentiated carcinoma with an inconclusive immunohistochemical profile. Further staging scans revealed pulmonary and pelvic tumor deposits. Tumor markers with alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase were not elevated. Follow-up cranial magnetic resonance imaging revealed intracranial disease progression and he underwent whole brain radiation therapy. Additional outside pathology consultation for chromosomal analysis revealed features consistent with a TGCT. A scrotal ultrasound revealed a minimally atrophic right testicle. With evidence supporting the potential for response to chemotherapeutic treatment in TGCT, the patient was started on cisplatin and etoposide. Bleomycin was planned for the second cycle of chemotherapy if his pulmonary function improved. A salient feature of all invasive TGCTs is a gain in material in the short arm of chromosome 12, and is diagnostic if present. Although the initial pathology revealed a non-diagnostic metastatic tumor, further testing revealed amplification of chromosome 12p. The examination of poorly differentiated carcinomas of an unknown primary site using light microscopy and immunohistochemical profiling alone may be inadequate, and should undergo molecular chromosomal analysis. This case is presented for its unconventional presentation and rarity of occurrence. It brings forward the discussion of both the commonality of TGCT in young male adults, as well as the anomaly of a 'burned out' phenomenon. With unreliable tumor markers, nonspecific symptoms, and pathological findings, 'burned out' TGCTs may account for a challenging diagnosis in a variety of cases, especially with the presenting symptom arising from a less common metastatic site. This case adds to the increasing literature on a rare entity of the 'burned out' TGCT, and upon literature review, presents itself as the first reported case presenting with brain metastasis.
Collapse
Affiliation(s)
- Kate Johnson
- Radiation Oncology, Cancer Care Manitoba, University of Manitoba, Canada
| | | |
Collapse
|