
A 24-year-old man presented to the emergency department with worsening dyspnea and fever of 1 day’s duration. About 3 years earlier, he had been treated for testicular cancer (leiomyosarcoma) with orchidectomy, chemotherapy, and radiation. He had no significant social or family history. Temperature was 38.6°C (101.4°F); blood pressure, 119/80 mm Hg;...
More »The first randomized trial to evaluate the long-term outcome of treatment with a single dose of chemotherapy for early-stage testicular tumors has found that the approach is safe, effective, and less toxic compared to radiation therapy, the current standard of care. The study, the largest ever in testicular cancer, also showed that after 5 years, patients receiving chemotherapy had a decreased risk of developing a second tumor in the other testicle, though longer follow-up is needed. The data...
More »MILAN—Some men with nonseminoma germ cell tumor (NSGCT) testicular cancer have a normalization of tumor markers and minimal or no residual masses in the retroperitoneum after chemotherapy. What then? Should all of them undergo retroperitoneal lymph node dissection (RPLND) to be on the safe side, or should the procedure be reserved for selected cases? Leading researchers in urology debated this topic at the 23rd Annual Congress of the European Association of Urology (plenary session 1).
More »High-dose combination chemotherapy followed by autologous peripheral-blood stem cell transplant produced durable remissions in metastatic testicular cancer patients who relapsed or failed to respond to traditional therapy
More »INDIANAPOLIS -- When metastatic testicular cancer progresses despite initial chemotherapy, including a cisplatin-based combination, a high-dose salvage regimen with stem-cell rescue can lead to relapse-free complete responses.
More »Most testicular tumors are malignant and of germ-cell origin. They constitute only 1% of cancers in
males overall but are the most common malignant neoplasm in men aged 15 to 35 years. Testicular
cancers frequently present at an early stage, are very sensitive to chemotherapy, and are variably
sensitive to radiotherapy.
More »Testicular cancer, although an uncommon malignancy, is the most frequently
occurring cancer in young men. In the year 2005, an estimated 8,010 cases of
testicular cancer will be diagnosed in the United States. For unknown reasons,
the incidence of this cancer has increased since the turn of the century, from 2
cases per 100,000 population in the 1930s, to 3.7 cases per 100,000 population
from 1969 to 1971, to 5.4 cases per 100,000 population from 1995-1999. This
trend seems greatest for the...
More »The management of germ cell tumors has advanced dramatically,
with cure rates approaching 90% to 95%. Treatment of stage I/A
seminomas generally includes orchiectomy and adjuvant radiotherapy.
Treatment of stage I/A nonseminomatous germ cell tumors involves
orchiectomy followed by retroperitoneal lymph node dissection or
active surveillance. One of the major advances has been the introduction
of cisplatin-based chemotherapy for metastatic disease and the
development of a system of risk...
More »Dr. Raghavan is to be commended
for a concise and
comprehensive overview of
the management of germ cell tumors.
As he suggests, given the demographics
of this relatively uncommon disease
and the high cure rate that can
be achieved with proper treatment
and follow-up, it behooves us to maintain
these excellent results, even while
striving to reduce the toxicity of treatment.
We will highlight a few additional
points to complement this
superb review.
More »As Dr. Raghavan has emphasized
in his excellent overview
of the current therapy
for testis cancer, it is critical that the
success of therapy for this disease
not be compromised by a desire to
avoid the complications of therapy.
We would wholeheartedly agree with
his assertion that modifications in
therapy must be introduced with a
thoughtful and structured approach
to minimize the risk to efficacy.
More »
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