2021, Number 1
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Rev Mex Urol 2021; 81 (1)
Correlation study of histologic pattern and clinical stage of testicular tumors with tumor markers
Rodríguez-Valle ED, Maldonado-Ávila M, Rodríguez-Sánchez Y, Arévalo-García F, Jaspersen-Gastelum J, López-Alvarenga JC, Reading-Bernal A, Nava-Palacios J, Rico-Frontana E, Almanza-González MS, Berber-Deseusa AD, Moreno CJC, De los Santos-González JA, Magaña-González JE, Cabrera-Mora NA, Hernández-Hernández RA, Sánchez-Núñez JE
Language: Spanish
References: 23
Page: 1-11
PDF size: 214.23 Kb.
ABSTRACT
Background: Testicular tumor is the most frequent solid tumor in men between 20 and
34 years of age. Testicular tumors can be histologically divided into germ cell tumors,
which present in 90–95% of cases, and non-germ cell tumors, which present in around
5%. Tumor markers are crucial for the diagnosis, classification, and prognosis of testicular
tumors, as well as for surveillance after treatment.
Objective: To know the actual prevalence of testicular cancer at our service, determine
the clinical and pathologic characteristics of testicular cancer, and correlate tumor marker
levels with histologic pattern and clinical stage of the disease.
Methodology: A cross-sectional study analyzed the case records of patients with testicular
cancer seen at the urology service, within the time frame of January 1, 2014 and
December 31, 2018.
Results: Ninety-nine patients with a mean age of 29±8.5 years were included. The most
frequent tumors were germ cell tumors, reported in 99% of cases: 50 were mixed germ
cell tumors (50.51%), 42 were seminoma (42.42%), and 5 were teratoma (5.05%). The
most common TNM combination was T1 N0 M0. The most frequent clinical stage was
stage I, followed by stage II, and then stage III. Alpha-fetoprotein was the only tumor
marker that was associated with histologic pattern and possible disseminated disease.
Limitations: Small sample size and a low incidence of some of the types of tumor were
study limitations.
Originality: Our analysis provides information on testicular cancer in a Latin American
population, an infrequently studied cohort.
Conclusions: The most frequent histologic pattern in our patients was mixed germ cell
tumor and the most common TNM classification was T1a, N0, M0 and clinical stage I.
Alpha-fetoprotein was the only predictive marker for histologic pattern and possible disseminated
disease.
REFERENCES
La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P, et al. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol. 2010;21(6):1323–60. doi: 10.1093/annonc/mdp530
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30. doi: 10.3322/caac.21332
Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol. 2003;170(1):5–11. doi: 10.1097/01.ju.0000053866.68623.da
Verhoeven RHA, Gondos A, Janssen-Heijnen MLG, Saum KU, Brewster DH, Holleczek B, et al. Testicular cancer in Europe and the USA: survival still rising among older patients. Ann Oncol. 2013 Feb;24(2):508–13. doi: 10.1093/ annonc/mds460
Sarıcı H, Telli O, Eroğlu M. Bilateral testicular germ cell tumors. Turk J Urol. 2013;39(4):249– 52. doi: 10.5152/tud.2013.062
Turnbull C, Rahman N. Genome-wide association studies provide new insights into the genetic basis of testicular germ-cell tumour. International Journal of Andrology. 2011;34(4pt2):e86–97. doi: https://doi. org/10.1111/j.1365-2605.2011.01162.x
Greene MH, Kratz CP, Mai PL, Mueller C, Peters JA, Bratslavsky G, et al. Familial testicular germ cell tumors in adults: 2010 summary of genetic risk factors and clinical phenotype. Endocr Relat Cancer. 2010;17(2):R109–21. doi: 10.1677/ ERC-09-0254
Bertuccio P, Malvezzi M, Chatenoud L, Bosetti C, Negri E, Levi F, et al. Testicular cancer mortality in the Americas, 1980-2003. Cancer. 2007;109(4):776–9. doi: 10.1002/cncr.22473
Vasdev N, Moon A, Thorpe AC. Classification, epidemiology and therapies for testicular germ cell tumours. Int J Dev Biol. 2013;57(2–4):133– 9. doi: 10.1387/ijdb.130031nv
Ferraro S, Trevisiol C, Gion M, Panteghini M. Human Chorionic Gonadotropin Assays for Testicular Tumors: Closing the Gap between Clinical and Laboratory Practice. Clin Chem. 2018 Feb;64(2):270–8. doi: 10.1373/ clinchem.2017.275263
Lempiäinen A, Hotakainen K, Blomqvist C, Alfthan H, Stenman U-H. Increased human chorionic gonadotropin due to hypogonadism after treatment of a testicular seminoma. Clin Chem. 2007;53(8):1560–1. doi: 10.1373/ clinchem.2007.088518
Morris MJ, Bosl GJ. Recognizing abnormal marker results that do not reflect disease in patients with germ cell tumors. J Urol. 2000;163(3):796–801.
Nazeer T, Ro JY, Amato RJ, Park YW, Ordonez NG, Ayala AG. Histologically pure seminoma with elevated alpha-fetoprotein: a clinicopathologic study of ten cases. Oncol Rep. 1998;5(6):1425–9. doi: 10.3892/or.5.6.1425
Kundu SD, Carver BS, Sheinfeld J. Retroperitoneal histologic findings of patients with elevated serum alpha-fetoprotein and pure seminoma at orchiectomy. Urology. 2011;78(4):844–7. doi: 10.1016/j. urology.2011.02.002
Salem M, Gilligan T. Serum tumor markers and their utilization in the management of germ-cell tumors in adult males. Expert Rev Anticancer Ther. 2011;11(1):1–4. doi: 10.1586/era.10.219
Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, et al. American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol. 2010;28(20):3388–404. doi: 10.1200/ JCO.2009.26.4481
Matei DV, Vartolomei MD, Renne G, Tringali VML, Russo A, Bianchi R, et al. Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn? Clin Genitourin Cancer. 2017;15(4):e689–96. doi: 10.1016/j.clgc.2017.01.012
Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC Cancer Staging Manual. 8th ed. Springer International Publishing; 2017
Barlow LJ, Badalato GM, McKiernan JM. Serum tumor markers in the evaluation of male germ cell tumors. Nat Rev Urol. 2010;7(11):610–7. doi: 10.1038/nrurol.2010.166
Dieckmann K-P, Richter-Simonsen H, Kulejewski M, Ikogho R, Zecha H, Anheuser P, et al. Testicular Germ-Cell Tumours: A Descriptive Analysis of Clinical Characteristics at First Presentation. UIN. 2018;100(4):409–19. doi: 10.1159/000488284
Miki T, Kamoi K, Fujimoto H, Kanayama H, Ohyama C, Suzuki K, et al. Clinical characteristics and oncological outcomes of testicular cancer patients registered in 2005 and 2008: the first large-scale study from the Cancer Registration Committee of the Japanese Urological Association. Int J Urol. 2014;21(8):S1-6. doi: 10.1111/iju.12441
Powles TB, Bhardwa J, Shamash J, Mandalia S, Oliver T. The changing presentation of germ cell tumours of the testis between 1983 and 2002. BJU Int. 2005;95(9):1197–200. doi: 10.1111/j.1464-410X.2005.05504.x
Cooper DE, L’esperance JO, Christman MS, Auge BK. Testis cancer: a 20-year epidemiological review of the experience at a regional military medical facility. J Urol. 2008;180(2):577–81; discussion 581-582. doi: 10.1016/j.juro.2008.04.032