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Clinical Genitourinary Cancer Jun 2023Germ-cell tumors (GCTs) are the most common malignancy in young men. There is a paucity of data on GCTs in developing countries. LACOG 0515 study aimed to evaluate...
INTRODUCTION
Germ-cell tumors (GCTs) are the most common malignancy in young men. There is a paucity of data on GCTs in developing countries. LACOG 0515 study aimed to evaluate clinical characteristics and treatment outcomes in patients with GCTs from Brazilian cancer centers.
MATERIALS AND METHODS
This is a retrospective cohort study evaluating male patients diagnosed with GCTs from 2000 to 2018 in 13 Brazilian hospitals. We described baseline characteristics, progression-free survival (PFS), and overall survival (OS).
RESULTS
A total of 1232 patients were included, with a median age of 30 years. Histology was seminoma in 47.1% and non-seminoma GCT (NSGCT) in 52.9%. The primary tumor site was testis in 96.5%. At diagnosis, clinical stage I was present in 68.1% and 34.7% and clinical stages IS/II/III in 31.9% and 65.2% of patients with seminoma and NSCGT, respectively. Following orchiectomy, 55.2% of patients with clinical stage I were managed with surveillance. The 5-year disease-free survival rates among patients with stage I were 98.0% in seminoma and 92.3% in NSGCT, with 5-year OS of 99.6% and 97.6%, respectively. Among patients with advanced disease (IS, II, and III), the 5-year PFS were 88.7% in seminoma and 68.7% in NSGCT, with 5y-OS of 97.6% and 82.8%, respectively.
CONCLUSION
This is the largest Brazilian cohort of GCTs. Our results show a high rate of adjuvant chemotherapy in patients with clinical stage I. Although our data demonstrate slightly inferior PFS compared with the International Germ Cell Cancer Collaborative Group and other contemporary series, the OS rates were similar.
Topics: Humans; Male; Adult; Retrospective Studies; Latin America; Testicular Neoplasms; Neoplasms, Germ Cell and Embryonal; Seminoma; Registries
PubMed: 36509612
DOI: 10.1016/j.clgc.2022.11.004 -
PloS One 2020Testicular germ cell tumors (TGCTs) are common in young males, and seminoma accounts for a large proportion of TGCTs. However, there are limited records on the...
Testicular germ cell tumors (TGCTs) are common in young males, and seminoma accounts for a large proportion of TGCTs. However, there are limited records on the exploration of novel biomarkers for seminoma. Hence, we aimed to identify new biomarkers associated with overall survival in seminoma. mRNA-seq and clinical traits of TGCTs were downloaded from UCSC XENA and analyzed by weighted gene co-expression network analysis. After intersection with differentially expressed genes in GSE8607, common genes were subjected to protein-protein interaction (PPI) network construction and enrichment analyses. Then, the top 10 common genes were investigated by Kaplan-Meier (KM) survival analyses and univariate Cox regression analyses. Ultimately, TYROBP, CD68, and ITGAM were considered three prognostic biomarkers in seminoma. Based on correlation analysis between these genes and immune infiltrates, we suggest that the three biomarkers influence the survival of seminoma patients, possibly through regulating the infiltration of immune cells. In conclusion, our study demonstrated that TYROBP, CD68, and ITGAM could be regarded as prognostic biomarkers and therapeutic targets for seminoma patients.
Topics: Adaptor Proteins, Signal Transducing; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; CD11b Antigen; Computational Biology; Databases, Genetic; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; Male; Membrane Proteins; Prognosis; Seminoma; Sequence Analysis, RNA; Survival Analysis; Testicular Neoplasms
PubMed: 33104706
DOI: 10.1371/journal.pone.0240943 -
Oncology Reports May 2021The aim of the present study was to explore and verify the potential mechanism of seminoma progression. Data on 132 RNA‑seq and 156 methylation sites from...
The aim of the present study was to explore and verify the potential mechanism of seminoma progression. Data on 132 RNA‑seq and 156 methylation sites from stage II/III and I seminoma specimens were downloaded from The Cancer Genome Atlas database. An initial filter of |fold‑change| >2 and false discovery rate <0.05 were used to identify differentially expressed genes (DEGs) which were associated with differential methylation site genes; these genes were considered potential candidates for further investigation by survival analysis. Potassium voltage‑gated channel subfamily C member 1 () expression was verified in seminoma human tissues and three seminoma cell lines. The invasive, proliferative and apoptotic abilities of the human testicular tumor Ntera‑2 and normal human testis Hs1.Tes cell lines were assessed following aberrant expression. was identified as a DEG, in which hypermethylation inhibited its expression and it was associated with poor overall survival in patients with seminoma. The present results demonstrated that is negatively correlated with methylation. Due to the abnormal expression of in seminoma cells, it was suggested that could be used as a diagnostic indicator and therapeutic target for the progression of seminoma.
Topics: Adult; Apoptosis; Cell Proliferation; DNA Methylation; Gene Knockout Techniques; Humans; Immunohistochemistry; Male; Neoplasm Invasiveness; Neoplasm Metastasis; RNA, Messenger; RNA, Small Interfering; Reverse Transcriptase Polymerase Chain Reaction; Seminoma; Shaw Potassium Channels; Survival Rate; Testicular Neoplasms; Transfection
PubMed: 34105734
DOI: 10.3892/or.2021.8024 -
Cancer Reports (Hoboken, N.J.) Feb 2021Malignant mediastinal germ cell tumor (MGCT) is rare and has poor outcomes even after multimodality treatment. Data from resource-poor countries are scarce in the...
BACKGROUND
Malignant mediastinal germ cell tumor (MGCT) is rare and has poor outcomes even after multimodality treatment. Data from resource-poor countries are scarce in the literature.
AIMS
To evaluate the clinicopathologic features and treatment outcome of primary malignant MGCT at our center.
METHODS AND RESULTS
Single institutional data review of patients aged ≥18 years, treated with a diagnosis of malignant MGCT between Nov'2013 and Nov'2019. Risk stratification was done as per International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Patients were treated with platinum based chemotherapy and surgical resection for the residual disease was performed in non-seminomatous histology.28 patients had MGCT with a median age of 25 years (range:18-36) and all were male. Seven patients had superior vena cava obstruction (SVCO) at diagnosis and pre-treatment histological diagnosis was available in 23 (82%) patients. Seven (25%) patients had seminoma histology, all were of good risk as per IGCCCG risk criteria, whereas others had non-seminoma histology with poor-risk group. Seven patients with seminoma histology achieved a complete response after initial treatment. Six patients with non-seminoma histology underwent complete resection of residual disease post-chemotherapy and five revealed residual viable tumors. After a median follow-up of 10.8 months (range:2.9-75), 3-year progression-free survival (PFS) and overall survival (OS) estimate was 61.2% and 94.7% in the whole cohort, respectively and 3-year PFS and OS estimate was 100% in patients with seminoma histology.
CONCLUSIONS
This is the largest data set of MGCT patients' outcomes reported from India with multi-modality treatment. All patients were male and one-fourth had SVCO at presentation. Seminoma histology patients had a 100% outcome after initial platinum based chemotherapy. But, those with non-seminoma histology had a poor outcome even with chemotherapy and surgery.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Female; Humans; Male; Mediastinal Neoplasms; Mediastinum; Neoplasm, Residual; Neoplasms, Germ Cell and Embryonal; Progression-Free Survival; Retrospective Studies; Risk Factors; Young Adult
PubMed: 33029924
DOI: 10.1002/cnr2.1306 -
Frontiers in Oncology 2020Testicular germ cell tumors (GCTs) are malignancies with a unique biology, pathology, clinical appearance, and excellent outcomes. A correct radiographic assessment of... (Review)
Review
Testicular germ cell tumors (GCTs) are malignancies with a unique biology, pathology, clinical appearance, and excellent outcomes. A correct radiographic assessment of GCTs is extremely important for the clinical management in several typical scenarios. Advancements in the field of diagnostic medicine bring an increasing number of sophisticated imaging methods to increase the performance of imaging studies. The conventional computed tomography (CT) remains the mainstay of diagnostic imaging in the management of GCTs. While certain improvements in the sensitivity and specificity are suggested with magnetic resonance (MR) imaging with lymphotrophic nanoparticles in evaluating retroperitoneal lymph nodes during the staging procedure, further exploration in larger prospective studies is needed. A common diagnostic dilemma is assessing the post-chemotherapy residual disease in GCTs. Several studies have consistently shown advantages in the utility of positron emission tomography (PET) scanning in post-chemotherapy residual retroperitoneal lymph nodes in patients with seminoma, but not with non-seminoma. Recommendations suggest that seminoma patients with a residual disease in the retroperitoneum larger than 3 cm should be subjected for PET scanning with 18-fluorodeoxyglucose. Relatively high sensitivity, specificity and a negative predictive value (80-95%) may guide clinical decision to spare these patients of high morbidity of an unnecessary surgery. However, a positive predictive value of around 50% renders PET scanning difficult to interpret in the case of positive finding. These patients often require extremely difficult surgical procedures with the high risk of post-operative morbidity. Therefore, seminoma patients with PET positive residual masses larger than 3 cm still remain a serious challenge in the decision making of nuclear medicine specialist, oncologists, and urologic surgeons. In this article, we aim to summarize data on controversial dilemmas in staging procedures, active surveillance, and post-chemotherapy assessment of GCTs based on the available published literature.
PubMed: 33585206
DOI: 10.3389/fonc.2020.587523 -
Hellenic Journal of Nuclear Medicine 2022Positron emission tomography/computed tomography using fluorine-18 fluoro-deoxyglucose (F-FDG PET/CT) is not routinely used for diagnosis of testicular carcinoma. Unlike...
OBJECTIVE
Positron emission tomography/computed tomography using fluorine-18 fluoro-deoxyglucose (F-FDG PET/CT) is not routinely used for diagnosis of testicular carcinoma. Unlike CT which cannot confirm with certainty the nature of the lesions, especially in post-therapy setting, F-FDG PET/CT detects active disease by showing increased glucose metabolism within the lesions.
AIM
Determination of F-FDG PET/CT usefulness in detection of seminoma, therapy response evaluation and comparison to CT findings and tumor marker levels.
MATERIAL AND METHODS
Eighty-two men (age 39.8±10.1) after orchiectomy and histopathological confirmation of seminoma were included in this study. Indications for F-FDG PET/CT were initial staging, restaging after chemo/radiotherapy with positive/uncertain CT, suspected recurrence on CT, elevated tumor markers. All patients had clinical follow-up of up to 8 years (median 33.5) after the first F-FDG PET/CT examination. Degree of metabolic activity was analyzed visually and semi-quantitatively using maximum standardized uptake value(SUVmax).
RESULTS
Fluorine-18-FDG PET/CT was true positive in 36 patients (43.9%) with average SUVmax of 7.9±4.8.Recurrence was mostly found in retroperitoneal lymph nodes and distant metastases in lungs, bones, liver. Six findings were false positive and 3 false negative. Sensitivity, specificity, accuracy of F-FDG PET/CT were 92.3%, 86.0%, 89.0% and of CT 60.8%, 66.6%, 63.4%. Pearson Chi-square test showed statistically significant difference between the results of F-FDG PET/CT and CT (P=0.016). Significant correlation was found between positive F-FDG PET/CT findings and levels of LDH (P=0.043), while non-significant between AFP, β-hCG (P>0.05).
CONCLUSION
Fluorine-18-FDG PET/CT was superior to CT in evaluation of therapy response, active disease in residual tissue and normal size lymph nodes, as well as when CT was negative and tumor markers were elevated. Elevated lactate dehydrogenase (LDH) contributes to positive F-FDG PET/CT findings.
Topics: Adult; Biomarkers, Tumor; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Retrospective Studies; Seminoma; Sensitivity and Specificity
PubMed: 35388800
DOI: 10.1967/s002449912432 -
British Journal of Cancer Jun 2023Both testicular germ cell tumours (TGCT) and neurodevelopmental disorders are associated with urogenital malformations. Few studies have investigated the association...
BACKGROUND
Both testicular germ cell tumours (TGCT) and neurodevelopmental disorders are associated with urogenital malformations. Few studies have investigated the association between psychiatric disorders and TGCT. We investigated whether history of any psychiatric or neurodevelopmental disorder is associated with increased risk or mortality of TGCT.
METHOD
This is a nested case-control study including 6166 TGCT patients diagnosed during 1992-2014, individually matched for age and calendar period to 61,660 controls. We calculated odds ratios (ORs) for the association between type of psychiatric diagnoses and TGCT risk. Among the cases, we used a cohort design and calculated hazard ratios (HRs) of the association between psychiatric diagnose and all-cause and TGCT-specific death.
RESULTS
History of a neurodevelopmental disorder (attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disabilities) was associated with an increased risk of seminoma (OR: 1.54; 1.09-2.19). Seminoma patients with neurodevelopmental disorders were younger (34 versus 38 years, p = 0.004) and had more stage IV disease (5.4% versus 1.2%) than those without. Psychiatric history overall was not associated with TGCT. Patient history of any psychiatric disorder was associated with an increased all-cause and TGCT-specific death.
CONCLUSIONS
We report an association between neurodevelopmental disorders and testicular seminoma, and an increased TGCT-specific mortality for TGCT patients with psychiatric disorders.
Topics: Male; Humans; Testicular Neoplasms; Autism Spectrum Disorder; Seminoma; Case-Control Studies; Mental Disorders; Neoplasms, Germ Cell and Embryonal
PubMed: 37088800
DOI: 10.1038/s41416-023-02260-8 -
International Cancer Conference Journal Oct 2023Testicular abscesses are rarer than epididymitis and orchitis. Here, we report a case of testicular seminoma with testicular abscess caused by . A 41-year-old male was...
Testicular abscesses are rarer than epididymitis and orchitis. Here, we report a case of testicular seminoma with testicular abscess caused by . A 41-year-old male was referred for painful enlargement of the right scrotal content and fever for 1 week. With the diagnosis of epididymitis, he was administered levofloxacin (LVFX) but the fever and painful enlargement persisted. Because of the poor response to antimicrobial agents and the undeniable complications of testicular malignancy, radical orchiectomy was performed. The testis was enlarged to 7 cm, weighed approximately 100 g, and was filled with pus. A substantial portion of the tumor was seminoma, and pus culture revealed . Although testicular tumors are the most common differential diseases for testicular abscess, there are few reports of testicular abscess accompanying testicular tumors. Here, we report a case of testicular seminoma with testicular abscess caused by .
PubMed: 37577346
DOI: 10.1007/s13691-023-00609-7 -
British Journal of Cancer Nov 2023Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.
BACKGROUND
Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.
PATIENTS AND METHODS
In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.
RESULTS
A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem.
CONCLUSION
Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.
Topics: Male; Humans; Testicular Neoplasms; Prognosis; Neoplasms, Germ Cell and Embryonal; Progression-Free Survival; Seminoma; Neoplasms, Second Primary; Recurrence
PubMed: 37777577
DOI: 10.1038/s41416-023-02443-3 -
Translational Andrology and Urology May 2021Treatment of testicular cancer has made significant progress in the past decades in terms of reduction of treatment-associated morbidity and preventing over-treatment.... (Review)
Review
Treatment of testicular cancer has made significant progress in the past decades in terms of reduction of treatment-associated morbidity and preventing over-treatment. At the forefront of this progression is utilization of the da Vinci robot to perform retroperitoneal lymph node dissections (RPLNDs) via a minimally invasive approach. The robot offers multiple potential advantages such as smaller incisions, improved 3D visualization, more precise dissection, and faster convalescence, leading to its increased usage the past several years. In this chapter, we summarize the recent progress made in robotic surgery for testicular cancer and its potential in the future. Promising preliminary data has also renewed interest in defining the role of primary RPLND in patients with seminoma, potentially sparing patients of the harmful long-term radiation and cisplatin-based chemotherapy. SEMS and PRIMETEST trials are ongoing trials that will provide significant insight into this area and potentially expand the role of robotic RPLND.
PubMed: 34159101
DOI: 10.21037/tau.2020.03.14