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Testicular cancer is most common cancer in men between 15 to 35 years old. There are two broad types: seminoma and nonseminoma histologies. The nonseminoma group of cancers includes embryonal carcinoma, teratoma, yolk sac carcinoma and choriocarcinoma. The two testicles (or testis) produce sperm and male hormones. Men who have an undescended testicle (a testicle that didn't move down into the scrotum) are at higher risk of developing testicular cancer.
In 2010, 2,286 men in the UK were diagnosed with testicular cancer (Source: Cancer Research UK).
This page shows only UK resources. For a more extensive list of resources from around the world see CancerIndex: Testicular Cancer Information for Patients and the Public
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- PubMed search for publications about Testicular Cancer - Limit search to: [Reviews]
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MeSH term: Testicular Neoplasms
US National Library of Medicine
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Showing publications with corresponding authors from the UK (Source: PubMed).
Well-differentiated Papillary Mesothelioma of the Tunica Vaginalis.
Urology. 2016; 90:e7-8 [PubMed] Related Publications
Identification of Novel Fusion Genes in Testicular Germ Cell Tumors.
Cancer Res. 2016; 76(1):108-16 [PubMed] Free Access to Full Article Related Publications
Defining a New Prognostic Index for Stage I Nonseminomatous Germ Cell Tumors Using CXCL12 Expression and Proportion of Embryonal Carcinoma.
Clin Cancer Res. 2016; 22(5):1265-73 [PubMed] Free Access to Full Article Related Publications
EXPERIMENTAL DESIGN: Immunohistochemistry for tumor expression of CXCL12 was assessed as a biomarker of relapse alongside vascular invasion, histology (percentage embryonal carcinoma), and MIB1 staining for proliferation in formalin-fixed paraffin-embedded orchidectomy samples from patients enrolled in the Medical Research Council's TE08/22 prospective trials of surveillance in stage I NSGCTs.
RESULTS: TE08/TE22 trial patients had a 76.4% 2-year relapse-free rate, and both CXCL12 expression and percentage embryonal carcinoma provided prognostic value independently of vascular invasion (stratified log rank test P = 0.006 for both). There was no additional prognostic value for MIB1 staining. A model using CXCL12, percentage embryonal carcinoma, and VI defines three prognostic groups that were independently validated.
CONCLUSIONS: CXCL12 and percentage embryonal carcinoma both stratify patients' relapse risk over and above vascular invasion alone. This is anticipated to improve the stratification of patients and identify high-risk cases to be considered for adjuvant therapy.
Testicular Microlithiasis: Is Sonographic Surveillance Necessary? Single Centre 14 Year Experience in 442 Patients with Testicular Microlithiasis.
Ultraschall Med. 2016; 37(1):68-73 [PubMed] Related Publications
MATERIALS AND METHODS: A retrospective analysis of subjects with underlying US diagnosis of TM between 1998 and 2012. One-yearly US follow-up was offered to all patients with TM and a database maintained. Any co-existing tumour at presentation with TM was recorded. TM was divided into limited (< 5 microliths/field), classical (≥ 5 microliths/field) and florid ('snowstorm' appearance). Patient demographics, follow-up details and the development of any scrotal abnormalities were recorded. The radiological and histological findings were documented when a testicular lesion occurred during the follow-up period.
RESULTS: 20 224 patients were examined: 867/20 224 (4.3 %) had TM. 21/867 (2.4 %) patients had histology proven malignant tumours at presentation. All TM patients consented to follow-up with 442/867 (51.0 %) achieving this and entering into a follow-up program (mean duration 28 months, range 8 - 165 months). Two patients developed primary GCT during the follow up period. One patient (limited TM) had undergone a previous orchiectomy for contralateral GCT and developed a palpable mass at follow up month 21. The other (limited TM) had an atrophic testis; a tumour was found on US at follow up month 62.
CONCLUSION: Two patients of 442 (0.5 %) followed up for all forms of TM in a single centre developed a GCT over a mean duration of 28 months, both had independent risk factors for the development of GCT. These findings suggest that US surveillance is not required when TM is the only abnormality in the absence of any clinical risk factors for the development of GCT.
Recruiting long-term survivors of European Organisation for Research and Treatment of Cancer phase III clinical trials into quality of life studies: challenges and opportunities.
Eur J Cancer. 2014; 50(11):1957-63 [PubMed] Related Publications
METHODS: In this cross-sectional study, we recruited long-term, disease-free survivors from two mature EORTC clinical trials in testicular and prostate cancer from centres in Northern and Southern Europe, and the United Kingdom (UK).
RESULTS: A number of challenges were encountered in recruiting participating centres, obtaining medical ethical approval and in recruiting survivors and collecting the health-related quality of life (HRQoL) data in a timely manner. The efficiency with which the study could be conducted varied widely across centres and countries. Time to obtain medical ethical approval for the study ranged from 1.5 to 25 months. We encountered most problems with ethical approval in the UK, Italy and Belgium. In most cases, data collection was completed within 3 months (range 10 weeks-1 year). Completed questionnaires were obtained from 68% and 56%, respectively, of the testicular and prostate cancer survivors who were approached.
CONCLUSIONS: HRQoL research among long-term survivors of EORTC phase III clinical trials is possible, but the process of ethical approval and data collection is a lengthy one. To minimise many of the logistical problems, long-term follow-up of patients should be an integral part of future clinical trials. Moreover, regulations governing medical ethical approval for clinical research within the EU should be carefully evaluated to facilitate long-term follow-up of cancer survivors in Europe.
Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma.
Eur J Cancer. 2014; 50(5):944-52 [PubMed] Related Publications
METHODS: We studied consecutive subjects receiving adjuvant carboplatin for stage 1 seminoma at our institution between 2007 and 2012. Subjects underwent 51Cr-ethylene diamine tetra-acetic acid (EDTA) measurement of GFR with carboplatin dose calculated using the Calvert formula. Theoretical carboplatin doses were calculated from estimated GFR using Chronic Kidney Disease-Epidemiology (CKD-EPI), Management of Diet in Renal Disease (MDRD) and Cockcroft-Gault (CG) formulae with additional correction for actual body surface area (BSA). Carboplatin doses calculated by formulae were compared with dose calculated by isotopic GFR; a difference <10% was considered acceptable.
RESULTS: 115 patients were identified. Mean isotopic GFR was 96.9 ml/min/1.73 m(2). CG and CKD-EPI tended to overestimate GFR whereas MDRD tended to underestimate GFR. The CKD-EPI formula had greatest accuracy. The CKD-EPI formula, corrected for actual BSA, performed best; 45.9% of patients received within 10% of correct carboplatin dose. Patients predicted as underdosed (13.5%) by CKD-EPI were more likely to be obese (p=0.013); there were no predictors of the 40.5% receiving an excess dose.
CONCLUSIONS: Our data support further evaluation of the CKD-EPI formula in this patient population but clinically significant variances in carboplatin dosing occur using non-isotopic methods of GFR estimation. Isotopic determination of GFR should remain the recommended standard for carboplatin dosing when accuracy is essential.
Classification, epidemiology and therapies for testicular germ cell tumours.
Int J Dev Biol. 2013; 57(2-4):133-9 [PubMed] Related Publications
Paratesticular liposarcoma of the spermatic cord: a case report and a review of the literature.
West Afr J Med. 2011 Nov-Dec; 30(6):447-52 [PubMed] Related Publications
OBJECTIVE: To report a case of paratesticular liposarcoma, a rare tumour and to review the literature on paratesticular liposarcoma.
METHODS AND RESULTS: A 77-years old man with paratesticular liposarcoma originating from the left spermatic cord is reported. This patient noticed the lump eight years prior to its excision. The tumour was originally thought to be benign lipoma and was left alone and its management was based upon the principle of watchful waiting. The tumour was excised as an additional procedure when the patient underwent trans urethral resection of prostate following lower urinary tract symptoms and retention of urine and at this stage the 'lipomatous' lump was noticed to have grown bigger over recent months. The patient underwent a successful surgical excision (a radical excision of the testis and surrounding mass) and has remained under surveillance by the Regional Oncologists. Literature review revealed that 109 cases of para-testicular liposarcoma had previously been reported and radical excision with a wide resection margin is the recommended surgical approach to its management.
CONCLUSION: Radical surgical excision with wide resection margins is the most appropriate approach to the management of para-testicular liposarcoma and the patients should be referred to the Oncologist.
Analysis of genetic interactions involving maternal and offspring genotypes at different Loci: power simulation and application to testicular cancer.
Genet Epidemiol. 2012; 36(6):612-21 [PubMed] Free Access to Full Article Related Publications
Comparative incidence patterns and trends of gonadal and extragonadal germ cell tumors in England, 1979 to 2003.
Cancer. 2012; 118(17):4290-7 [PubMed] Related Publications
METHODS: All malignant GCTs and all central nervous system (CNS) GCTs with benign and uncertain behavior that were registered in England in the age group 0 to 84 years from 1979 to 2003 were included in the current study. Incidence rates were calculated and adjusted to the world standard population.
RESULTS: There were 33,364 GCTs (92.5% testes, 3.9% ovary, 3.2% extragonadal) in individuals aged 0 to 84 years. The CNS was the most common extragonadal site. An initial peak in incidence at ages 0 to 4 years of nongerminomas was observed at all sites except ovary. Second incidence peaks between ages 10 to 39 years that were more marked among males also were observed at all sites. The ages at these incidence peaks varied by site and were 10 to 14 years (CNS), 15 to 19 years (ovary), 25 to 29 years (other extragonadal sites), and 30 to 34 years (testes). A statistically significant increase in incidence over time was observed in germinomas (testes, CNS) and nongerminomas (testes, ovary).
CONCLUSIONS: The age-incidence patterns observed suggested a common initiation of GCTs in embryonic/fetal life with variable rates of tumor progression as a result of subsequent events that may be site specific. The authors concluded that future genetic studies should consider GCTs from all sites to enable a better understanding of their etiology.
Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214).
J Clin Oncol. 2011; 29(8):957-62 [PubMed] Related Publications
PATIENTS AND METHODS: Random assignment was between RT and one infusion of carboplatin dosed at 7 × (glomerular filtration rate + 25) on the basis of EDTA (n = 357) and 90% of this dose if determined on the basis of creatinine clearance (n = 202). The trial was powered to exclude a doubling in RFRs assuming a 96-97% 2-year RFR after radiotherapy (hazard ratio [HR], approximately 2.0).
RESULTS: Overall, 1,447 patients were randomly assigned in a 3-to-5 ratio (carboplatin, n = 573; RT, n = 904). RFRs at 5 years were 94.7% for carboplatin and 96.0% for RT (RT-C 90% CI, 0.7% to 3.5%; HR, 1.25; 90% CI, 0.83 to 1.89). One death as a result of seminoma (in RT arm) occurred. Patients receiving at least 99% of the 7 × AUC dose had a 5-year RFR of 96.1% (95% CI, 93.4% to 97.7%) compared with 92.6% (95% CI, 88.0% to 95.5%) in those who received lower doses (HR, 0.51; 95% CI, 0.24 to 1.07; P = .08). There was a clear reduction in the rate of contralateral GCTs (carboplatin, n = 2; RT, n = 15; HR, 0.22; 95% CI, 0.05 to 0.95; P = .03), and elevated pretreatment follicle-stimulating hormone (FSH) levels (> 12 IU/L) was a strong predictor (HR, 8.57; 95% CI, 1.82 to 40.38).
CONCLUSION: These updated results confirm the noninferiority of single dose carboplatin (at 7 × AUC dose) versus RT in terms of RFR and establish a statistically significant reduction in the medium term of risk of second GCT produced by this treatment.
Maternal body mass index and risk of testicular cancer in male offspring: a systematic review and meta-analysis.
Cancer Epidemiol. 2010; 34(5):509-15 [PubMed] Free Access to Full Article Related Publications
METHODS: Search strategies were conducted in Ovid Medline (1950-2009), Embase (1980-2009), Web of Science (1970-2009), and CINAHL (1937-2009) using keywords for maternal weight (BMI) and testicular cancer.
RESULTS: The literature search produced 1689 hits from which 63 papers were extracted. Only 7 studies met the pre-defined criteria. Random effects meta-analyses were conducted. The combined unadjusted OR (95% CI) of testicular cancer in the highest reported category of maternal BMI compared with the moderate maternal BMI was 0.82 (0.65-1.02). The Cochran's Q P value was 0.82 and the corresponding I(2) was 0%, both indicating very little variability among studies. The combined unadjusted OR (95% CI) for testicular cancer risk in the lowest reported category of maternal BMI compared to a moderate maternal BMI category was 0.88 (0.65-1.20). The Cochran's Q P value was 0.05 and the corresponding I(2) was 54%, indicating evidence of statistical heterogeneity. The combined unadjusted OR (95% CI) of testicular cancer risk per unit increase in maternal BMI was 1.01 (0.97-1.06). The Cochran's Q test had a P value of 0.05 and the corresponding I(2) was 55% indicating evidence of statistical heterogeneity.
CONCLUSION: This meta-analysis, which included a small number of studies, showed that a higher maternal weight does not increase the risk of testicular cancer in male offspring. Though an inverse association between high maternal BMI and testicular cancer risk was detected, it was not statistically significant. Further primary studies with adjustment for appropriate confounders are required.
Late solitary testicular metastasis from rectal cancer.
J Cancer Res Ther. 2010 Jan-Mar; 6(1):89-91 [PubMed] Related Publications
Long-term neurologic and peripheral vascular toxicity after chemotherapy treatment of testicular cancer.
Cancer. 2010; 116(10):2322-31 [PubMed] Related Publications
METHODS: Seven hundred thirty-nine patients who were treated between 1982 and 1992 gave consent to enter the study. Patients were classified according to the receipt of C (n = 384) or no C (n = 355). Patients completed a general health questionnaire and a quality-of-life form (the European Organization for Research and Treatment of Cancer Quality-of-Life C30 questionnaire with testicular module). Symptom scores of 3 or 4 were considered clinically significant. Patients were assessed in the clinic, and clinical history was used to diagnose Raynaud phenomenon (RP) and tinnitus. Examinations included peripheral nerve function testing for light touch and vibration sense. Five hundred seventy-seven patients underwent audiometry.
RESULTS: On physician assessment, peripheral neuropathy and RP were more common after C (21.7% vs 9.1% [P<.001] and 20.3% vs 1.7% [P<.001], respectively). Similar results were obtained for symptom scores (12.5% vs 5.5% [P = .002] and 9.7% vs 3.7% [P<.001], respectively). On multivariate analysis, for peripheral neuropathy, the significant predictors were cisplatin dose, carboplatin dose, and age. For RP, the significant predictor was bleomycin. Significant differences in hearing thresholds were noted at 8000 hertz only and, on multivariate analysis, were related to age, cisplatin dose, and vincristine dose. Auditory symptom scores did not differ between groups.
CONCLUSIONS: With long-term follow-up, peripheral neuropathy and RP remained detectable in approximately 20% of patients and caused significant symptoms in 10% of patients. Detectable effects on high frequency remained but caused little symptomatic problem. These effects persisted and were related to the cumulative chemotherapy dose.
Public perceptions of the harms and benefits of testicular cancer education: a qualitative study.
Cancer Epidemiol. 2010; 34(2):212-9 [PubMed] Related Publications
METHODS: One-to-one, in-depth interviews with 37 men and women were completed. Participants included TC patients, men with no prior diagnosis of TC, and parents and teachers of adolescent boys. Verbatim transcripts were analysed using the Framework approach to produce a thematic description of views expressed.
RESULTS: Participants were unanimously in favour of TC education. Key perceived benefits included earlier cancer detection through increasing knowledge of symptoms leading to better treatment outcomes, and motivating help-seeking by reducing emotional barriers such as fear of cancer or embarrassment. Anxiety was acknowledged as a possible harm but was not expected to be widespread or serious.
CONCLUSION: TC education is viewed favourably by members of the public likely to be interested in its provision. Education's potential to cause anxiety was not considered a disincentive to promoting disease awareness.
Paratesticular müllerian-type papillary serous tumor in a child.
Pediatr Dev Pathol. 2009 Jul-Aug; 12(4):297-300 [PubMed] Related Publications
Prospective study of factors predicting adherence to medical advice in men with testicular cancer.
J Clin Oncol. 2009; 27(13):2144-50 [PubMed] Free Access to Full Article Related Publications
RESULTS: Thirty-two participants (17%) were classified as nonattenders. No significant differences were found between attenders and nonattenders in the majority of psychosocial and medical variables that might have predicted nonadherence to medical advice. There was a highly significant association between nonattendance and a patient's perception of an unsatisfactory affective relationship with his clinician (P = .005; hazard ratio, 3.1; 95% CI, 1.4 to 6.6).
CONCLUSION: Patients who perceived an unsatisfactory affective relationship with their clinician that included an inability to trust the clinician and a perception that they were not being treated as "a person" were subsequently more likely to disregard medical advice regarding follow-up. Attention to the ways young men may wish to communicate with their clinicians is important, bearing in mind that they may not necessarily adhere to stereotypical images of masculine self-dependence.
Sex cord stromal testicular tumors: a clinical series--uniformly stage I disease.
J Urol. 2009; 181(5):2090-6; discussion 2096 [PubMed] Related Publications
MATERIALS AND METHODS: We retrospectively reviewed the records of all 38 men older than 18 years with sex cord stromal testicular tumors who were referred to the Wessex regional cancer center for treatment or pathological review during the 25-year period of 1982 to 2006. We then compared our series with a malignant sex cord stromal testicular tumor database generated from the world literature.
RESULTS: All Wessex patients were treated with excision of the primary tumor alone and metastatic disease developed in none. All remained disease-free with an overall median survival of 6.8 years (range 1.4 to 25). Features in the literature favoring malignant behavior, ie metastatic disease, included larger tumors (mean 6.43 vs 1.71 cm), a high mitotic rate, tumor necrosis, angiolymphatic invasion, infiltrative margins and extratesticular extension (each p <0.0001). The malignant group had an overall median survival of 2.3 years (range 0.02 to 17.3).
CONCLUSIONS: No patient had disease progression in our study, which is to our knowledge the largest reported United Kingdom series of sex cord stromal testicular tumors. Our data suggest that malignancy is uncommon and prophylactic retroperitoneal lymph node dissection is unjustified for clinical stage I disease.
Sarcoidosis and testicular cancer: A case series and literature review.
Urol Oncol. 2010 Jul-Aug; 28(4):350-4 [PubMed] Related Publications
Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197--the National Cancer Research Institute Testis Cancer Clinical Studies Group.
J Clin Oncol. 2007; 25(11):1310-5 [PubMed] Related Publications
METHODS: Patients with clinical stage I NSGCT opting for surveillance were randomly assigned to chest and abdominal CT scans at either 3 and 12 or 3, 6, 9, 12, and 24 months, with all other investigations identical in the two arms. Three of five patients were allocated to the two-scan schedule. Four hundred patients were required.
RESULTS: Two hundred forty-seven patients were allocated to a two-scan and 167 to five-scan policy. With a median follow-up of 40 months, 37 relapses (15%) have occurred in the two-scan arm and 33 (20%) in the five-scan arm. No patients had poor prognosis at relapse, but two (0.8%) of those relapsing in the two-scan arm had intermediate prognosis compared with 1 (0.6%) in the five-scan arm, a difference of 0.2% (90% CI, -1.2% to 1.6%). No deaths have been reported.
CONCLUSION: This study can rule out with 95% probability an increase in the proportion of patients relapsing with intermediate- or poor-prognosis disease of more than 1.6% if they have two rather than five CT scans as part of their surveillance protocol. CT scans at 3 and 12 months after orchidectomy should be considered a reasonable option in low-risk patients.
Incidence and survival for testicular germ cell tumor in young males: a report from the Northern Region Young Person's Malignant Disease Registry, United Kingdom.
Urol Oncol. 2007 Jan-Feb; 25(1):32-7 [PubMed] Related Publications
Testicular metastasis from gastric carcinoma.
Urology. 2006; 68(4):890.e7-8 [PubMed] Related Publications
A salutary tale of mistaken identity in testicular cancer.
Urol Oncol. 2006 Sep-Oct; 24(5):407-9 [PubMed] Related Publications
Adult leydig cell tumors of the testis caused by germline fumarate hydratase mutations.
J Clin Endocrinol Metab. 2006; 91(8):3071-5 [PubMed] Related Publications
OBJECTIVE: Our objective was to investigate the role of FH mutations in predisposition to LCTs.
DESIGN: We tested for pathogenic effects of the N64T mutation and screened an additional 29 unselected adult LCTs for FH alterations. We also tested these LCTs for mutations in two genes, the LH/choriogonadotropin receptor (LHCGR) and the guanine nucleotide-binding protein alpha (GNAS) that had been implicated in LCT tumorigenesis.
RESULTS: No mutations were found in GNAS, and one tumor had a LHCGR somatic substitution. In addition to the HLRCC case with the N64T germline FH mutation, we identified one other LCT with a previously unreported FH mutation (M411I). Both LCTs from these patients showed loss of the wild-type FH allele. Immunohistochemical and in situ hybridization analyses demonstrated activation of the hypoxia/angiogenesis pathway not only in the tumors belonging to the FH mutation carriers but also in several other mutation-negative LCTs.
CONCLUSIONS: Our study shows that some LCTs are caused by FH mutations and represents one of the first reports of germline mutations in any type of adult testicular tumor.
Bilateral testicular metastases from prostatic carcinoma.
Int J Urol. 2006; 13(4):476-7 [PubMed] Related Publications
Testicular calcification and microlithiasis: association with primary intra-testicular malignancy in 3,477 patients.
Eur Radiol. 2007; 17(2):363-9 [PubMed] Related Publications
Space-time clustering analyses of testicular cancer amongst 15-24-year-olds in Northern England.
Eur J Epidemiol. 2006; 21(2):139-44 [PubMed] Related Publications
Primary carcinoid tumour of the testis.
J Pak Med Assoc. 2005; 55(12):561-3 [PubMed] Related Publications
Association between large-scale genomic homozygosity without chromosomal loss and nonseminomatous germ cell tumor development.
Cancer Res. 2005; 65(20):9137-41 [PubMed] Related Publications
See publications from around the world in CancerIndex: Testicular Cancer