HF01-17 MOBILIZE THE TROOPS! MILITARY INVOLVEMENT IN THE HISTORY OF TESTICULAR CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023HF01-17 MOBILIZE THE TROOPS! MILITARY INVOLVEMENT IN THE HISTORY OF TESTICULAR CANCER Kit Yuen, Alexis Steinmetz, Phillip Rappold, and Ronald Rabinowitz Kit YuenKit Yuen More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , Phillip RappoldPhillip Rappold More articles by this author , and Ronald RabinowitzRonald Rabinowitz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003243.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular cancer is a rare malignancy that has become a manageable disease, assisted by the study of the large number of such tumors found in World War II (WWII) soldiers. METHODS: A literature review of textbook chapters, manuscripts, online texts, and peer-reviewed articles was performed for historical descriptions of testis tumors and its treatments. RESULTS: Saint Donat in 1696 described a testis teratoid tumor as a “fetal monstrosity”. Testicular tumor pathology was first documented by British physicians Percival Pott and Astley Cooper in the mid to late 1700s. In 1794, Scottish surgeon Benjamin Bell described the presentation of a testis tumor as a firm painless fleshy enlargement. If treatment with mercury failed, orchiectomy was done. It wasn’t until 1910 that French urologist Maurice Chevassu reported radical orchiectomy. Diagnosis, staging, and evaluation of response to therapy was propelled forward with the discovery of tumor marker human chorionic gonadotropin in 1927. Radiation was introduced to treat testicular cancer in the 1940s. Testis cancer, a tumor of young men, was found in high frequency in the military. Prior to WWII, case series of more than 50 subjects were rare. From examining more than 900 soldiers with testis tumors, the histopathology was established in 1946. In 1950, two large military studies reported that RPLND improved survival compared to orchiectomy alone. In 1952, a modified classification system was published by Frank Dixon and Robert Moore in the first Armed Forces Institute of Pathology (AFIP) tumor atlas. Fathollah Mostofi, along with other military pathologists, contributed greatly to the field; in 1972 he led a group to devise a standardized World Health Organization (WHO) classification system. Until the advent of platinum combination chemotherapy, metastatic disease was bleak and uniformly fatal, with a 90% mortality rate within 1 year. Chemosensitivity was first demonstrated in the 1950s with actinomycin combined with methotrexate. In 1974, a regimen of cisplatin, vinblastine with bleomycin was introduced by Lawrence Einhorn and John Donahue at Indiana University for advanced testicular cancer with greatly improved survival. RPLND templates were further refined with lymph node mapping studies, which decreased morbidity significantly. CONCLUSIONS: World War II brought together young men with testis cancer, a rare disease that ignited fifty years of basic and clinical research resulting in one of the greatest oncological success stories. The military contributed greatly to the diagnosis, histopathology and management of testicular cancer. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e261 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kit Yuen More articles by this author Alexis Steinmetz More articles by this author Phillip Rappold More articles by this author Ronald Rabinowitz More articles by this author Expand All Advertisement PDF downloadLoading ...