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Kirisawa T, Okuno T, Hagimoto H, Matsuda A, Maejima A, Shinoda Y, Nakamura E, Komiyama M, Fujimoto H, Matsui Y. Clinical characteristics and survival outcomes of elderly patients with de novo metastatic germ cell tumors. Int J Urol 2024; 31:804-812. [PMID: 38693651 DOI: 10.1111/iju.15470] [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: 01/23/2024] [Accepted: 04/03/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES To determine the outcomes for elderly patients with de novo metastatic germ cell tumors and the influence of patient age on adherence to standard chemotherapy. METHODS A total of 150 patients who were initially diagnosed with metastatic germ cell tumors and treated at our institution between 2007 and 2021 were included. Patients were classified according to three age groups: aged <40, 40-49, and ≥50 years. Clinicopathological features, adherence to standard first-line chemotherapy, overall survival, and disease-free survival were compared between these groups. We also analyzed the outcomes of patients who received low-intensity induction chemotherapy due to adverse events and/or comorbidities. RESULTS There was no significant difference in any of the survival outcomes and in the rate of adherence to standard first-line chemotherapy between the three age groups, although elderly patients with intermediate/poor prognosis group tended to receive less-intense chemotherapies. The rate of febrile neutropenia as a chemotherapy-related adverse event was significantly higher in patients aged ≥50 years. No statistical significance in survival outcomes was detected between the group of patients who received relatively low-intensity induction chemotherapy and those who received adequately intensive planned chemotherapy. CONCLUSIONS The adherence rate of standard fist-line chemotherapy of elderly patients is almost comparable to that of younger patients, although some adverse events should be carefully managed. Even elderly patients with metastatic germ cell tumors can aim for equivalently good survival outcome like younger populations, with effort to adhere to standard chemotherapy.
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Affiliation(s)
- Takahiro Kirisawa
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoya Okuno
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Hagimoto
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumu Matsuda
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aiko Maejima
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuo Shinoda
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Eijiro Nakamura
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Motokiyo Komiyama
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Fujimoto
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiyuki Matsui
- Department of Urology and Retroperitoneal Surgery, National Cancer Center Hospital, Tokyo, Japan
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Fontanet S, Huguet J, Gaya JM, Territo A, Gallioli A, Aumatell J, Algaba F, Palou J, Breda A. Indications and histology of 489 orchiectomies analyzed by patient age. Actas Urol Esp 2023; 47:416-421. [PMID: 36427799 DOI: 10.1016/j.acuroe.2022.11.004] [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: 08/22/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the indications and histology of our series of orchiectomies, analysing the results by patient's age. METHODS We included the orchiectomies realized in our hospital between 2005 and 2020 in patients older than 18 years. We estimated demographic data, indications, histology and effectiveness of testicular ultrasound by three groups of age. RESULTS We included 489 orchiectomies, which 364 (74%) belonged to Group A (patients between 18-50 years), 59 (12%) to Group B (50-70 years) and 66 (14%) to Group C (older than 70 years). In Group A, 284 (78%) orchiectomies were indicated due to malignancy suspect. In 91.9% cases (261) malign neoplasm was confirmed at final histology and 253 (89%) were germinal cells. Testicular ultrasound had a positive predictive value (PPV) of 90% in this group. In Group B, 34 (57%) orchiectomies were indicated because of malignancy suspect. At final histologic analysis, 25/34 (73.5%) confirmed malign neoplasm. Ultrasound had a PPV of 68%. In Group C, orchiepididymitis was the main cause of testicular removal with 30 cases (45,5%). From the 20 cases (30.3%) with suspicion of malignancy, only 6 had confirmed malign histology. Testicular ultrasound PPV for malignancy was 31%. CONCLUSION In patients younger than 70 years the main orchiectomy's indication was suspect of malignancy and in older than 70, testicular inflammation. The germinal neoplasm was the predominant histology in younger than 70 years. In older than that, malignancy was infrequent. The positive predictive value of testicular ultrasound for malignancy decreased with patient's age. In patients older than 50 years proper image diagnosis to assess malignancy should be considered before orchiectomy is done.
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Affiliation(s)
- S Fontanet
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain.
| | - J Huguet
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J M Gaya
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Territo
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Gallioli
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J Aumatell
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - F Algaba
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Pathological Anatomy, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J Palou
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Breda
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
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Pliszka A, Rajda S, Wawrzyniak A, Walocha J, Polguj M, Wysiadecki G, Clarke E, Golberg M, Zarzecki M, Balawender K. Testicular Metastasis from Renal Cell Carcinoma: A Systematic Review. J Clin Med 2023; 12:5636. [PMID: 37685703 PMCID: PMC10488956 DOI: 10.3390/jcm12175636] [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: 07/22/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
Approximately one-third of renal cell carcinoma (RCC) is recognized in its metastatic stage. This systematic review aimed to summarize knowledge on the occurrence and treatment of testicular RCC metastasis. The literature search was performed by two authors independently, with the use of main electronic medical databases (Science Direct, Web of Science, and PubMed) until March 2023 to identify relevant articles that could potentially contribute to this review. Neither language nor publication dates were set as limits. Although we found a total of 51 case reports, only 31 of them contained all the required information. Testicular metastasis in patients with RCC suggests a late stage of the disease. Moreover, it usually does not present typical systemic or specific symptoms except for swelling and enlargement of the affected testis. Knowledge of the possibility of such variants of RCC metastases will allow a clinician to make an appropriate diagnosis and implement adequate treatment without delay, which is crucial in the management of neoplastic disease.
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Affiliation(s)
- Anna Pliszka
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College of Rzeszow University, 35-315 Rzeszow, Poland; (A.P.); (S.R.)
| | - Sebastian Rajda
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College of Rzeszow University, 35-315 Rzeszow, Poland; (A.P.); (S.R.)
| | - Agata Wawrzyniak
- Department of Histology and Embryology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-315 Rzeszow, Poland;
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland;
- Youthoria, Youth Research Organization, 33-332 Kraków, Poland
| | - Michał Polguj
- Department of Normal and Clinical Anatomy, Medical University of Lodz, 90-752 Łódź, Poland; (M.P.); (E.C.)
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Medical University of Lodz, 90-752 Łódź, Poland; (M.P.); (E.C.)
| | - Edward Clarke
- Department of Normal and Clinical Anatomy, Medical University of Lodz, 90-752 Łódź, Poland; (M.P.); (E.C.)
| | - Michał Golberg
- Department of Histology and Embryology, Medical University of Lodz, 90-752 Łódź, Poland;
| | - Michał Zarzecki
- Department of Neonatology and Neonatal Intensive Care, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Krzysztof Balawender
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College of Rzeszow University, 35-315 Rzeszow, Poland; (A.P.); (S.R.)
- Clinical Department of Urology and Urological Oncology, Municipal Hospital in Rzeszow, 35-241 Rzeszow, Poland
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Secondino S, Viglio A, Neri G, Galli G, Faverio C, Mascaro F, Naspro R, Rosti G, Pedrazzoli P. Spermatocytic Tumor: A Review. Int J Mol Sci 2023; 24:ijms24119529. [PMID: 37298487 DOI: 10.3390/ijms24119529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Spermatocytic tumor (ST) is a very rare disease, accounting for approximately 1% of testicular cancers. Previously classified as spermatocytic seminoma, it is currently classified within the non-germ neoplasia in-situ-derived tumors and has different clinical-pathologic features when compared with other forms of germ cell tumors (GCTs). A web-based search of MEDLINE/PubMed library data was performed in order to identify pertinent articles. In the vast majority of cases, STs are diagnosed at stage I and carry a very good prognosis. The treatment of choice is orchiectomy alone. Nevertheless, there are two rare variants of STs having very aggressive behavior, namely anaplastic ST and ST with sarcomatous transformation, that are resistant to systemic treatments and their prognosis is very poor. We have summarized all the epidemiological, pathological and clinical features available in the literature regarding STs that have to be considered as a specific entity compared to other germ GCTs, including seminoma. With the aim of improving the knowledge of this rare disease, an international registry is required.
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Affiliation(s)
- Simona Secondino
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Alessandra Viglio
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Giuseppe Neri
- Anatomic Pathology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Giulia Galli
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Carlotta Faverio
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Federica Mascaro
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Richard Naspro
- Urology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Giovanni Rosti
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Paolo Pedrazzoli
- Oncology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
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Yazici S, Del Biondo D, Napodano G, Grillo M, Calace FP, Prezioso D, Crocetto F, Barone B. Risk Factors for Testicular Cancer: Environment, Genes and Infections-Is It All? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040724. [PMID: 37109682 PMCID: PMC10145700 DOI: 10.3390/medicina59040724] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/11/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023]
Abstract
The incidence of testicular cancer is steadily increasing over the past several decades in different developed countries. If on one side better diagnosis and treatment have shone a light on this disease, on the other side, differently from other malignant diseases, few risk factors have been identified. The reasons for the increase in testicular cancer are however unknown while risk factors are still poorly understood. Several studies have suggested that exposure to various factors in adolescence as well as in adulthood could be linked to the development of testicular cancer. Nevertheless, the role of environment, infections, and occupational exposure are undoubtedly associated with an increase or a decrease in this risk. The aim of this narrative review is to summarize the most recent evidence regarding the risk factors associated with testicular cancer, starting from the most commonly evaluated (cryptorchidism, family history, infections) to the newer identified and hypothesized risk factors.
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Affiliation(s)
- Sertac Yazici
- Department of Urology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
| | - Dario Del Biondo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Giorgio Napodano
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Marco Grillo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
- University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Paolo Calace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Domenico Prezioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
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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.
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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
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7
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Almutairi F, Geisler D, Rammal R, Korentzelos D, Bastacky S, Dhir R, Bhattu A, Quiroga-Garza GM. Malignant germ cell tumors in men aged 50 years and over are associated with adverse pathologic features and higher stage at presentation. Ann Diagn Pathol 2023; 62:152070. [PMID: 36495736 DOI: 10.1016/j.anndiagpath.2022.152070] [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: 09/14/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Germ cell tumors (GCT) are the most common malignancy in men in the third and fourth decades of life. The occurrence of malignant GCT in men aged 50 years or over is rare, and their histopathologic characteristics and outcome is insufficiently characterized in the medical literature. Hence, we report the histopathologic features and clinical outcome of malignant GCTs in men aged ≥50 years at our institution. DESIGN We performed a retrospective search of our database from 2005 to 2021 to identify men aged 50 years or older with malignant GCT. Cases of spermatocytic tumor were excluded. Clinical and histopathologic features of the tumors were reviewed. RESULTS Forty-seven cases were identified, showing a sharp decline in incidence over the age of 65. Thirty-nine (83 %) tumors were testicular while eight (17 %) were non-testicular in presentation. Cases included 26 (55 %) seminomas, 15 (32 %) non-seminoma/mixed malignant GCT, and 5 (11 %) regressed testicular germ cell tumors. The most common component in mixed malignant GCTs was embryonal carcinoma (77 %), followed by seminoma and yolk sac tumor (62 % each). Germ cell neoplasia in situ (GCNIS) accompanied 57 % of the cases. Aggressive pathologic features, including lymphovascular invasion, retroperitoneal/lymph node involvement and higher stage at presentation, were identified in a significant proportion of cases (36/47, 77 %). Clinical follow up showed six patients (14 %) died of disease-related causes. CONCLUSION Our findings expand and corroborate the previously reported data on malignant GCT in older men. Unique characteristics include tendency for higher stage at presentation with adverse pathologic features and more aggressive clinical course.
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Affiliation(s)
- Fawaz Almutairi
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America; Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Daniel Geisler
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Rayan Rammal
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Dimitrios Korentzelos
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Sheldon Bastacky
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Rajiv Dhir
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Amit Bhattu
- Department of Urology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
| | - Gabriela M Quiroga-Garza
- Department of Pathology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, United States of America
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Yohannan B, Omo-Ogboi A, Kachira JJ, Jafri SH. Metastatic seminoma presenting as neck and axillary lymphadenopathy in an elderly man. Proc AMIA Symp 2023; 36:395-397. [PMID: 37091773 PMCID: PMC10120549 DOI: 10.1080/08998280.2023.2167184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A man in his 60s presented with a gradual progressive right-sided neck mass. Initial core biopsy was inconclusive and he was treated with a short course of oral prednisone for presumed sarcoidosis. Two months later, the patient developed worsening dysphagia, hoarseness of voice, dyspnea, and weight loss. Physical examination revealed bilateral cervical and right axillary lymphadenopathy. A right axillary lymph node excisional biopsy was performed and immunohistochemistry was diffusely positive for OCT4, SALL4, CD117, PLAP, confirming the diagnosis of metastatic seminoma. He received three cycles of bleomycin, etoposide, and cisplatin; bleomycin was omitted for the fourth cycle due to concern for toxicity. Restaging scans after four cycles of chemotherapy showed a favorable response to therapy. Unfortunately, the patient died from bleomycin pulmonary toxicity. This case illustrates a rare and atypical presentation of metastatic seminoma in an elderly patient.
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Affiliation(s)
- Binoy Yohannan
- Division of Hematology and Oncology, University of Texas Health Science Center, McGovern Medical School, Houston, Texas
| | - Allen Omo-Ogboi
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, McGovern Medical School, Houston, Texas
| | - Johncy John Kachira
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Syed H. Jafri
- Division of Hematology and Oncology, University of Texas Health Science Center, McGovern Medical School, Houston, Texas
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Sharma A, Morrison L, Milic M, Ghose A, Gogbashian A, Vasdev N, Agarwal S, Pullar B, Rustin G. A North-West London Experience of the Impact of Treatment Related Toxicity on Clinical Outcomes of Elderly Patients with Germ Cell Tumors. Cancers (Basel) 2022; 14:cancers14204977. [PMID: 36291757 PMCID: PMC9599778 DOI: 10.3390/cancers14204977] [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: 06/27/2022] [Revised: 09/19/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background/Aim: The occurrence of germ cell tumour (GCT) in the elderly is rare, with scarce data available. The aim of this study was to understand the clinical outcomes of patients with GCT in patients aged > 45 years. Materials and Methods: A retrospective study was conducted in a large tertiary cancer centre in north-west London. Between 1 January 2003 and 31 March 2022, 108 cases of GCT in men aged > 45 years were identified and treated at the Mount Vernon Cancer Centre. The median age at diagnosis was 54 years (range = 45−70 years). Results: The 5-year survival rate of all patients was 96%, and the toxicity profile was similar to the younger age group. Conclusion: Older patients with GCT are able to tolerate chemotherapy; however, care must be taken to prevent life-threatening complications using appropriate dose modification.
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Affiliation(s)
- Anand Sharma
- Department of Medical Oncology, Mount Vernon Cancer Centre, London HA6 2RN, UK
- Correspondence:
| | - Laura Morrison
- Department of Medical Oncology, Mount Vernon Cancer Centre, London HA6 2RN, UK
| | - Marina Milic
- Department of Medical Oncology, Mount Vernon Cancer Centre, London HA6 2RN, UK
| | - Aruni Ghose
- Department of Medical Oncology, Mount Vernon Cancer Centre, London HA6 2RN, UK
| | - Andrew Gogbashian
- Department of Radiology, Mount Vernon Cancer Centre, Paul Strickland Scanner Centre, London HA6 2RN, UK
| | - Nikhil Vasdev
- Hertfordshire and Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, East and North Herts NHS Trust, Stevenage SG1 4AB, UK
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK
| | - Samita Agarwal
- Department of Histopathology, Lister Hospital, East and North Herts NHS Trust, Stevenage SG1 4AB, UK
| | - Ben Pullar
- Hertfordshire and Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, East and North Herts NHS Trust, Stevenage SG1 4AB, UK
| | - Gordon Rustin
- Department of Medical Oncology, Mount Vernon Cancer Centre, London HA6 2RN, UK
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Different Expression Patterns of Metabolic Reprogramming Proteins in Testicular Germ Cell Cancer. ENDOCRINES 2022. [DOI: 10.3390/endocrines3040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Metabolic reprogramming is an emerging hallmark of cancer, involving the overexpression of metabolism-related proteins, such as glucose and monocarboxylate transporters and intracellular glycolytic enzymes. The biology of testicular germ cell tumors (TGCTs) is very complex, and although their metabolic profile has been scantily explored, some authors have recently reported that the metabolic rewiring of cancer cells resulted in an association with aggressive clinicopathological characteristics. In this study we have investigated, by immunohistochemical analysis, the expression of key proteins sustaining the hyperglycolytic phenotype in pure seminoma (SE, nr. 35), pure embryonal carcinoma (EC, nr. 17) tissues samples, and normal testes (nr. 5). GLUT1, CD44, PFK-1, MCT1, MCT4, LDH-A, and PDH resulted in more expression in EC cells compared to SE cells. TOM20 was more expressed in SE than in EC. GLUT1, MCT1, and MCT4 expression showed a statistically significant association with SE histology, while for EC, the association resulted in being significant only for GLUT1 and MCT4. Finally, we observed that EC resulted as negative for p53, suggesting that the GLUT1 and MTC overexpression observed in EC could be also attributed to p53 downregulation. In conclusion, our findings evidenced that EC exhibits a higher expression of markers of active aerobic glycolysis compared to SE, suggesting that the aggressive phenotype is associated with a higher glycolytic rate. These data corroborate the emerging evidence on the involvement of metabolic reprogramming in testicular malignancies as well, highlighting that the metabolic players should be explored in the future as promising therapeutic targets.
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11
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Secondino S, Rosti G, Tralongo AC, Nolè F, Alaimo D, Carminati O, Naspro RLJ, Pedrazzoli P. Testicular tumors in the “elderly” population. Front Oncol 2022; 12:972151. [PMID: 36185182 PMCID: PMC9523537 DOI: 10.3389/fonc.2022.972151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Germ cell tumors arise in childhood but peak at around 30 years of age. They are the most common cancers in males under the age of 35. Over 95% arise in the testes while a minority originate in extragonadal sites such as the anterior mediastinum, or mainly in childhood the pineal gland or the sacrococcygeal area. These tumors show an extraordinary sensitivity to chemotherapy (and for seminoma, also to radiation) and cure rates are relatively high even in second or subsequent relapses. Very few data are present in the literature regarding patients diagnosed after 50 years and no specific trials have been conducted in this setting. Nearly all patients reported in the literature had testicular cancers, with occasional reports of extragonadal tumors. Despite the fact that > 50 years may be considered an “elderly” population, these patients are treated with the same cisplatin containing combinations as their younger counterparts with consequent higher toxicity. In this review we will present epidemiological and clinical data from this rare population of patients with testicular cancer.
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Affiliation(s)
- Simona Secondino
- Department of Oncology and Hematology, Medical Oncology Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Giovanni Rosti
- Department of Oncology and Hematology, Medical Oncology Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
- *Correspondence: Giovanni Rosti,
| | - Antonino C. Tralongo
- Medical Oncology Unit Umberto I Hospital, Rete Assistenza Oncologica (RAO) Department of Oncology, Azienda Sanitaria Provinciale (ASP), Siracusa, Italy
| | - Franco Nolè
- Medical Oncology Division of Urogenital and Head & Neck Tumours, European Institute of Oncology Istituto di Ricerca e Cura a Carattere Scientifico, Milan, Italy
| | - Domiziana Alaimo
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Ornella Carminati
- Medical Oncology, Ospedale per gli Infermi, AUSL Romagna, Rimini, Italy
| | | | - Paolo Pedrazzoli
- Department of Oncology and Hematology, Medical Oncology Unit, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
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12
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Huang J, Chan SC, Tin MS, Liu X, Lok VTT, Ngai CH, Zhang L, Lucero-Prisno DE, Xu W, Zheng ZJ, Chiu PKF, Ng ACF, Enikeev D, Nicol D, Spiess PE, Laguna P, Teoh JYC, Wong MCS. Worldwide Distribution, Risk Factors, and Temporal Trends of Testicular Cancer Incidence and Mortality: A Global Analysis. Eur Urol Oncol 2022; 5:566-576. [PMID: 35863988 DOI: 10.1016/j.euo.2022.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/31/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Testicular cancer is a common malignancy among young males in western countries. OBJECTIVE To examine the global disease burden and trends of testicular cancer incidence and mortality by age and country, and their associations with human development index (HDI), gross domestic product (GDP), lifestyle habits, and metabolic risk factors. DESIGN, SETTING, AND PARTICIPANTS We retrieved the Global Cancer Observatory database for the testicular cancer incidence and mortality in 2020; the World Bank for GDP per capita; the United Nations for HDI; the WHO Global Health Observatory for prevalence of smoking and alcohol drinking; and the Cancer Incidence in Five Continents, WHO mortality database, Surveillance, Epidemiology, and End Results programme and Nordic Cancer Registries (NORDCAN) for trend analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We presented the testicular cancer incidence and mortality using age-standardised rates. We examined their associations with HDI, GDP, smoking, alcohol drinking, physical inactivity, overweight, obesity, and medical conditions including diabetes, hypertension, and hypercholesterolaemia by linear regression. We estimated the 10-yr trend of incidence and mortality by joinpoint regression with average annual percentage change with 95% confidence intervals in different age groups. RESULTS AND LIMITATIONS There was a wide variation in the testicular cancer burden with the highest mortality found in low-income countries, and the regions of Central America and South America, while the highest incidence was observed in high-income countries, especially in Western and Northern Europe. We found a positive association for HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia with testicular cancer incidence, while a negative correlation was observed between GDP and mortality of testicular cancer. Globally, there was an overall increasing incidence trend of testicular cancer for the past decade, particularly in younger males; the mortality trends of testicular cancer were relatively stable. However, we did not analyse the trend of different stages and subtypes of testicular cancer due to data unavailability. CONCLUSIONS There was a global variation in the testicular cancer burden associated with HDI, GDP, alcohol drinking, inactivity, overweight, obesity, and hypercholesterolaemia. Testicular cancer had an increasing incidence but decreasing mortality. The increasing testicular cancer incidence in the younger population is of concern and calls for early detection and preventive interventions. PATIENT SUMMARY Globally, testicular cancer incidence had been increasing particularly in the younger population, although its deaths rates had been decreasing. Socioeconomic indices, alcohol drinking, inactivity, overweight, obesity, and high plasma lipid levels are associated with testicular cancer incidence and mortality.
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Affiliation(s)
- Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Sze Chai Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Man Sing Tin
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Xianjing Liu
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Veeleah Ting-Ting Lok
- Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Chun Ho Ngai
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Lin Zhang
- School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Centre of Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK; Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Wanghong Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Peter Ka-Fung Chiu
- S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; European Association of Urology-Young Academic Urologists (EAU-YAU), The Netherlands
| | - Anthony Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - David Nicol
- Department of Urology, the Royal Marsden NHS Foundation Trust, London, UK
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Pilar Laguna
- Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; European Association of Urology-Young Academic Urologists (EAU-YAU), The Netherlands.
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Global Health, School of Public Health, Peking University, Beijing, China.
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13
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Oleuropein Counteracts Both the Proliferation and Migration of Intra- and Extragonadal Seminoma Cells. Nutrients 2022; 14:nu14112323. [PMID: 35684123 PMCID: PMC9182631 DOI: 10.3390/nu14112323] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/21/2022] [Accepted: 05/28/2022] [Indexed: 01/07/2023] Open
Abstract
Recent and growing literature has reported that oleuropein (OLE), the main polyphenol in olive leaf extract, inhibits tumor cell proliferation and reduces the invasiveness properties of cancer cells; therefore, OLE may play a significant role in the development of new drugs for cancer treatment. These antineoplastic properties have been reported in many experimental cancer models, but the effect of OLE on seminoma cells is yet to be evaluated. In the present study, we demonstrate, for the first time, that OLE reduces cell viability in both intra- and extragonadal TCAM-2 and SEM-1 seminoma cells, respectively, in a dose-dependent manner. As shown by Western-blot analysis, OLE exposure reduced cyclin-D1 expression and upregulated p21Cip/WAF1, concomitantly affecting the upstream pathway of NF-κB, leading to the reduction of its nuclear content, thereby suggesting that OLE could modulate cell-cycle regulators by inhibiting NF-κB. Moreover, Annexin V staining revealed that OLE induced apoptosis in cancer cells and upregulated the pro-apoptotic factor BAX. Through wound-healing scratch and transmigration assays, we also demonstrated that OLE significantly reduced the migration and motility of TCAM-2 and SEM-1 cells, and downregulated the expression of TGFβ-1, which is known to be the main pro-fibrotic factor involved in the acquisition of the migratory and invasive properties of cancer cells. Collectively, our results indicate that OLE reduces seminoma cell proliferation, promotes apoptosis, and counteracts cell migration and motility. Further studies are needed to explore the molecular mechanisms underlying these observed effects.
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Crocetto F, Arcaniolo D, Napolitano L, Barone B, La Rocca R, Capece M, Caputo VF, Imbimbo C, De Sio M, Calace FP, Manfredi C. Impact of Sexual Activity on the Risk of Male Genital Tumors: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168500. [PMID: 34444249 PMCID: PMC8392571 DOI: 10.3390/ijerph18168500] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/01/2021] [Accepted: 08/09/2021] [Indexed: 12/26/2022]
Abstract
Most cancers are related to lifestyle and environmental risk factors, including smoking, alcohol consumption, dietary habits, and environment (occupational exposures). A growing interest in the association between sexual activity (SA) and the development of different types of tumors in both men and women has been recorded in recent years. The aim of the present systematic review is to describe and critically discuss the current evidence regarding the association between SA and male genital cancers (prostatic, penile, and testicular), and to analyze the different theories and biological mechanisms reported in the literature. A comprehensive bibliographic search in the MEDLINE, Scopus, and Web of Science databases was performed in July 2021. Papers in the English language without chronological restrictions were selected. Retrospective and prospective primary clinical studies, in addition to previous systematic reviews and meta-analyses, were included. A total of 19 studies, including 953,704 patients were selected. Case reports, conference abstracts, and editorial comments were excluded. Men with more than 20 sexual partners in their lifetime, and those reporting more than 21 ejaculations per month, reported a decreased risk of overall and less aggressive prostate cancer (PCa). About 40% of penile cancers (PCs) were HPV-associated, with HPV 16 being the dominant genotype. Data regarding the risk of HPV in circumcised patients are conflicting, although circumcision appears to have a protective role against PC. Viral infections and epididymo-orchitis are among the main sex-related risk factors studied for testicular cancer (TC); however, data in the literature are limited. Testicular trauma can allow the identification of pre-existing TC. SA is closely associated with the development of PC through high-risk HPV transmission; in this context, phimosis appears to be a favoring factor. Sexual behaviors appear to play a significant role in PCa pathogenesis, probably through inflammatory mechanisms; however, protective sexual habits have also been described. A direct correlation between SA and TC has not yet been proven, although infections remain the most studied sex-related factor.
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Affiliation(s)
- Felice Crocetto
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Davide Arcaniolo
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy; (D.A.); (M.D.S.)
| | - Luigi Napolitano
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
- Correspondence:
| | - Biagio Barone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Roberto La Rocca
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Marco Capece
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Vincenzo Francesco Caputo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Ciro Imbimbo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
| | - Marco De Sio
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy; (D.A.); (M.D.S.)
| | - Francesco Paolo Calace
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy; (D.A.); (M.D.S.)
| | - Celeste Manfredi
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80121 Naples, Italy; (F.C.); (B.B.); (R.L.R.); (M.C.); (V.F.C.); (C.I.); (F.P.C.); (C.M.)
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy; (D.A.); (M.D.S.)
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Vasistha A, Kothari R, Mishra A, De Andrés F, LLerena A, Nair S. Current Insights into Interethnic Variability in Testicular Cancers: Population Pharmacogenetics, Clinical Trials, Genetic Basis of Chemotherapy- Induced Toxicities and Molecular Signal Transduction. Curr Top Med Chem 2021; 20:1824-1838. [PMID: 32552648 DOI: 10.2174/1568026620666200618112205] [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: 01/31/2020] [Revised: 04/08/2020] [Accepted: 05/07/2020] [Indexed: 12/15/2022]
Abstract
Testicular cancer is an aggressive malignancy with a rising incidence rate across the globe. Testicular germ cell tumors are the most commonly diagnosed cancers, and surgical removal of the testes is often a radical necessity along with chemotherapy and radiotherapy. While seminomas are receptive to radiotherapy as well as chemotherapy, non-seminomatous germ cell tumors respond to chemotherapy only. Due to the singular nature of testicular cancers with associated orchiectomy and mortality, it is important to study the molecular basis and genetic underpinnings of this group of cancers across male populations globally. In this review, we shed light on the population pharmacogenetics of testicular cancer, pediatric and adult tumors, current clinical trials, genetic determinants of chemotherapy-induced toxicity in testicular cancer, as well as the molecular signal transduction pathways operating in this malignancy. Taken together, our discussions will help in enhancing our understanding of genetic factors in testicular carcinogenesis and chemotherapy-induced toxicity, augment our knowledge of this aggressive cancer at the cellular and molecular level, as well as improve precision medicine approaches to combat this disease.
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Affiliation(s)
- Aman Vasistha
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS University, V. L. Mehta Road, Vile Parle (West), Mumbai - 400 056, India
| | - Rishi Kothari
- SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, V. L. Mehta Road, Vile Parle (West), Mumbai - 400 056, India
| | - Adarsh Mishra
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS University, V. L. Mehta Road, Vile Parle (West), Mumbai - 400 056, India
| | - Fernando De Andrés
- CICAB Clinical Research Centre at Extremadura University Hospital and Medical School, Universidad de Extremadura, Badajoz, Spain
| | - Adrián LLerena
- CICAB Clinical Research Centre at Extremadura University Hospital and Medical School, Universidad de Extremadura, Badajoz, Spain
| | - Sujit Nair
- SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, V. L. Mehta Road, Vile Parle (West), Mumbai - 400 056, India
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England T, England M, Clay T, England P. Metastatic seminoma in a 77-year-old man with a regressed primary tumour and concurrent high-grade superficial bladder cancer. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211002709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas England
- Sir Charles Gairdner Hospital, Nedlands, Western Australia
| | | | - Timothy Clay
- Department of Medical Oncology, St John of God Subiaco Hospital, Australia
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Peter England
- Department of Urology, St John of God Subiaco Hospital, Australia
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Bhambhvani HP, Greenberg DR, Kasman AM, Eisenberg ML. Clinicopathologic features, outcomes, and prognostic factors of testicular sarcoma: a population-based study. Int Urol Nephrol 2020; 53:257-267. [PMID: 32895865 DOI: 10.1007/s11255-020-02634-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/31/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe clinical characteristics and identify prognostic factors among men with testicular sarcoma, and to compare survival with other testicular cancers. METHODS The surveillance, epidemiology, and end results (SEER) database (1975-2016) was queried to identify adults with testicular sarcoma. Multivariable Cox proportional hazards, Fine and Gray competing-risks regression, propensity score matching, and Kaplan-Meier analyses were used. RESULTS 230 men were included in this study. Median age at diagnosis was 58 years (range 18-94), and median OS was 10.3 years. Patients with tumors larger than 8 cm in size had worse OS (HR 1.88, p = 0.016) compared to patients with tumors < 8 cm. Disease with distant metastasis was associated with worse OS (HR 4.70, p < 0.0001) and worse CSS (HR 11.41, p < 0.0001) as compared to disease localized to the testis. Men with rhabdomyosarcoma had worse CSS (HR 3.25, p = 0.03) as compared to men with liposarcoma. Testicular sarcoma patients had worse OS than matched patients with either seminomatous germ cell tumors (GCTs, p < 0.0001) or nonseminomatous GCTs (p = 0.0019), and similar survival to matched patients with sex cord stromal tumors, testicular lymphoma, or sarcomas of the lower limb-the most common anatomic site of origin of soft tissue sarcomas. CONCLUSIONS In the largest cohort of men with testicular sarcoma to date, we identified tumor size, disease extent, and rhabdomyosarcoma histology as independent predictors of worse survival. Stage-adjusted survival was worse as compared to men with GCTs, and similar to men with sex cord stromal tumors, testicular lymphoma, and sarcomas of other primary sites.
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Affiliation(s)
- Hriday P Bhambhvani
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA, 94305, USA.
| | - Daniel R Greenberg
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA, 94305, USA
| | - Alex M Kasman
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA, 94305, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA, 94305, USA
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18
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Ghazarian AA, McGlynn KA. Increasing Incidence of Testicular Germ Cell Tumors among Racial/Ethnic Minorities in the United States. Cancer Epidemiol Biomarkers Prev 2020; 29:1237-1245. [PMID: 32385118 DOI: 10.1158/1055-9965.epi-20-0107] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/22/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The incidence of testicular germ cell tumors (TGCT) has been rising in the United States and is notably higher among white men. Previously, our group reported that rates were rising among Hispanic men in certain areas. This study sought to determine whether the patterns noted in our prior publication remained evident in more recent years and to determine whether any new patterns have emerged. METHODS Data from 51 U.S. cancer registries were examined. Racial/ethnic-specific incidence rates per 100,000 man-years were calculated overall and by census region. Annual percent changes (APC) were estimated, and joinpoint models were fit. Differences in regional incidence were examined using the Wald test. RESULTS During the time period 2001 to 2016, 126,575 TGCTs were recorded. TGCT incidence was highest among non-Hispanic whites (NHW; 6.63/100,000), followed by Hispanics (4.20), American Indian/Alaska Natives (AI/AN; 3.27), Asian/Pacific Islanders (A/PI; 1.72), and non-Hispanic blacks (NHB; 1.27). TGCT incidence increased significantly among all men; the greatest increase was experienced by A/PIs (APC: 2.47), followed in order by Hispanics (2.10), AI/ANs (1.71), NHBs (1.28), and NHWs (0.41). Significant differences in rates by region were seen for all men except NHBs, with the highest rates among Hispanics (5.38/100,000), AI/ANs (4.47), and A/PIs (2.37) found in the West, and among NHWs (7.60) and NHBs (1.51) found in the Northeast. CONCLUSIONS Although TGCT incidence remained highest among NHWs between 2001 and 2016, the greatest increase was experienced by A/PI men. IMPACT Rising rates of TGCTs among men of all racial/ethnic backgrounds in the United States suggest that future attention is warranted.
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Affiliation(s)
- Armen A Ghazarian
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Katherine A McGlynn
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
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19
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Sukswai N, Lyapichev K, Khoury JD, Medeiros LJ. Diffuse large B-cell lymphoma variants: an update. Pathology 2019; 52:53-67. [PMID: 31735345 DOI: 10.1016/j.pathol.2019.08.013] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 02/07/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma, representing approximately one-third of all cases worldwide. In the World Health Organization (WHO) classification of lymphomas, most cases of DLBCL are designated as not otherwise specified (NOS). About 20% of cases, however, are designated as specific variants of DLBCL. These variants, 13 in total, are specified on the basis of distinctive morphological or immunophenotypic findings or distinctive biological or clinical issues associated with their diagnoses. In this review we discuss the following variants: T-cell/histiocyte-rich large B-cell lymphoma; ALK-positive large B-cell lymphoma; plasmablastic lymphoma; intravascular large B-cell lymphoma; large B-cell lymphoma with IRF4 rearrangement; primary mediastinal large B-cell lymphoma; primary cutaneous diffuse large B-cell lymphoma, leg type; primary diffuse large B-cell lymphoma of the central nervous system; diffuse large B-cell lymphoma associated with chronic inflammation; lymphomatoid granulomatosis; primary effusion lymphoma; and HHV8-positive diffuse large B-cell lymphoma, NOS. Two additional variants recognised in the WHO classification, EBV-positive diffuse large B-cell lymphoma and EBV-positive mucocutaneous ulcer are discussed elsewhere in another review within this issue of Pathology. Although not recognised as a specific variant in the current WHO classification, primary testicular diffuse large B-cell lymphoma also has unique biological features and requires some modification of the standard treatment approach for patients with DLBCL. Therefore, we suggest that primary testicular diffuse large B-cell lymphoma also should be recognised as a specific variant of DLBCL in a future version of the WHO classification.
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Affiliation(s)
- Narittee Sukswai
- Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kirill Lyapichev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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