Non-seminoma Testicular Cancer Research Articles

The CDK Inhibitor Dinaciclib Improves Cisplatin Response in Nonseminomatous Testicular Cancer: A Preclinical Study.

Most patients with testicular germ cell tumors (GCTs) are treated with cisplatin (CP)-based chemotherapy. However, some of them may develop CP resistance and therefore represent a clinical challenge. Cyclin-dependent kinase 5 (CDK5) is involved in chemotherapy resistance in different types of cancer. Here, we investigated the possible role of CDK5 and other CDKs targeted by dinaciclib in nonseminoma cell models (both CP-sensitive and CP-resistant), evaluating the potential of the CDK inhibitor dinaciclib as a single/combined agent for the treatment of advanced/metastatic testicular cancer (TC). The effects of dinaciclib and CP on sensitive and resistant NT2/D1 and NCCIT cell viability and proliferation were evaluated using MTT assays and direct count methods. Flow cytometry cell-cycle analysis was performed. The protein expression was assessed via Western blotting. The in vivo experiments were conducted in zebrafish embryos xenografted with TC cells. Among all the CDKs analyzed, CDK5 protein expression was significantly higher in CP-resistant models. Dinaciclib reduced the cell viability and proliferation in each cell model, inducing changes in cell-cycle distribution. In drug combination experiments, dinaciclib enhances the CP effect both in vitro and in the zebrafish model. Dinaciclib, when combined with CP, could be useful for improving nonseminoma TC response to CP.

Postchemotherapy Retroperitoneal Lumpectomy in Patients with Nonseminoma Testicular Cancer: A Nationwide Study

Background and objectiveOptimal treatment outcomes in patients with metastatic nonseminoma testicular cancer are achieved with chemotherapy and subsequent surgery in cases with residual tumor. In Denmark, postchemotherapy retroperitoneal lumpectomy (RPLP) is performed in patients with residual tumors >1 cm. There is a need to clarify whether this surgical method provides acceptable treatment results. Our objective was to describe morbidity and oncological outcomes of postchemotherapy RPLP. MethodsThis was a retrospective population-based multicenter study including patients with nonseminoma testicular cancer and postchemotherapy RPLP performed in Denmark between 1990 and 2015. A total of 219 patients were eligible, with median follow-up of 19 yr. Postoperative complications were evaluated according to the Clavien-Dindo classification. The cumulative incidence of recurrence inside or outside the borders of a bilateral surgical template, progression-free survival (PFS), and overall survival estimates were calculated using the Kaplan-Meier method. Key findings and limitationsAfter median follow-up of 19 yr, 31/219 patients (14%) experienced a surgical complication, of which 5% were Clavien-Dindo grade ≥III. In total, 37 patients experienced a recurrence. The 5-yr, 10-yr, and 20-yr cumulative risk of recurrence inside a bilateral template was 4.3%, 5.9%, and 5.9%, respectively. The 10-yr PFS rate was 83% and the 10-yr overall survival rate was 96%. The main limitation of the study is the retrospective design. Conclusions and clinical implicationsWith few patients experiencing a major postoperative complication and a 10-yr cumulative rate of 5.9% for recurrence inside a bilateral surgical template, postchemotherapy RPLP appears to be a safe alternative to template surgery for disseminated nonseminoma. Patient summaryWe looked at minimal surgery to remove tumor tissue remaining after chemotherapy in patients with testicular cancer. We found a low frequency of complications, tumor recurrence, and death.

5-YEAR RELATIVE SURVIVAL RATE BETWEEN SEMINOMA AND NON-SEMINOMA TESTICULAR CANCER IN SINGLE CENTER

ABSTRACT
 Objective: This study was conducted to provide data about the survival rate of testicular cancer patients with different histology in the year 2013 – 2017 in Adam Malik General Hospital and to compare these estimates with other studies conducted in another center. Material & Methods: Medical records of testicular cancer patients from 2013 to 2017 in Adam Malik General Hospital were collected. We measured 5-year relative survival between the histology group of seminoma and non-seminoma estimated using Kaplan-Meier survival analysis. Also, using Kaplan-Meier for survival analysis estimated, 5-year relative survival between metastatic and non-metastatic was estimated. Results: 63 male patients (mean age 27.5 ± 17.6 years old) were included in this study. The distribution of histology were non-seminoma (53.9%), seminoma (39.9%), non-Hodgkin lymphoma (4.7%), and gonadoblastoma (1.5%). The 5-year relative survival rate was 82.5% for the seminoma group and 80.9 % for the non-seminoma group. The 5-year survival rate in the seminoma group with metastatic was 77.8% and in the non-metastatic group was 87.3 %. The 5-year survival rate in the non-seminoma group with metastatic was 74.6 % and in the non-metastatic group was 88.9 %. Conclusion: 5-year relative survival was better for the seminoma group than the non-seminoma group. Moreover, non-metastasis seminoma was found to have a better outcome than the metastatic group. Despite that, in the non-metastatic group, it is found that non-seminoma testicular cancer has a better survival rate than seminoma testicular cancer.
 Keywords: 5-year relative survival rate, seminoma, non-seminoma, testicular cancer.

Somatic hits in mismatch repair genes in colorectal cancer among non-seminoma testicular cancer survivors.

Non-seminoma testicular cancer survivors (TCS) have an increased risk of developing colorectal cancer (CRC) when they have been treated with platinum-based chemotherapy. Previously we demonstrated that among Hodgkin lymphoma survivors (HLS) there is enrichment of rare mismatch repair (MMR) deficient (MMRd) CRCs with somatic hits in MMR genes. We speculate that this phenomenon could also occur among other cancer survivors. We therefore aim to determine the MMR status and its underlying mechanism in CRC among TCS (TCS-CRC). Thirty TCS-CRC, identified through the Dutch pathology registry, were analysed for MMR proteins by immunohistochemistry. Next-generation sequencing was performed in MMRd CRCs without MLH1 promoter hypermethylation (n = 4). Data were compared with a male cohort with primary CRC (P-CRC, n = 629). MMRd was found in 17% of TCS-CRCs vs. 9% in P-CRC (p = 0.13). MMRd was more often caused by somatic double or single hit in MMR genes by mutation or loss of heterozygosity in TCS-CRCs (3/30 (10%) vs. 11/629 (2%) in P-CRCs (p < 0.01)). MMRd CRCs with somatic double or single hit are more frequent in this small cohort of TCS compared with P-CRC. Exposure to anticancer treatments appears to be associated with the development of these rare MMRd CRC among cancer survivors.

Sentinel lymph node mapping in post chemotherapy nonseminoma testicular cancer patients undergoing retroperitoneal lymph node dissection: A series of nine cases.

Objective(s):Testicular germ cell cancers are the most common solid malignancy among young men at the age ranging between 14 and 35 years. In this study, we evaluated the feasibility of sentinel lymph node mapping using intraoperative injection of radiotracer in nonseminomatous testicular cancer patients with history of orchiectomy who were candidate for retroperitoneal lymph node dissection (RPLND) in post-chemotherapy setting.Methods:Nine consecutive cases were included in the study. Technetium-99m-labelled phytate was injected in two divided doses in the stump of the spermatic cord, through transabdominal approach. A hand-held gamma probe was used for radio-guided retroperitoneal sentinel lymph node detection intraoperatively and confirming the location of the sentinel lymph nodes.Results: Detection rate and the false negative rate were estimated as the main indices. The detection rate was 6/9 (66%) and the false negative rate was 0/2 (0%). Location of the dissected sentinel lymph nodes were interaortocaval (2 patients), internal iliac (1 patient), external iliac (1 patient), common iliac (2 patients), and paraaortic (1 patient).Conclusion:Sentinel lymph node mapping technique seems to be feasible and promising in post chemotherapy non-seminoma testis cancer patients who are candidate for RPLND; however, further larger studies are needed to increase and standardize the detection rate.

212P Stage I non-seminoma testicular cancer: Adjuvant management and outcomes

212P Stage I non-seminoma testicular cancer: Adjuvant management and outcomes

Abstract C053: Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California

Abstract Background: Hispanic men in the U.S. experience the second-highest incidence rate of testicular cancer, behind non-Hispanic (NH) White men. Incidence of testicular cancer is increasing in the U.S., despite reports of a plateau during the 1990’s, and increases are especially steep in the Hispanic population. To date, the literature does not address whether the incidence of testicular cancer or the observed increases in incidence differ according to neighborhood factors. Purpose: We examined incidence rates and changes in incidence over time for testicular cancer histologic subtypes (i.e., seminoma and nonseminoma) according to neighborhood socioeconomic status (nSES) among Hispanic and, for comparison, NH White men, and according to neighborhood ethnic enclave among Hispanic men, using California Cancer Registry Data. Methods: We conducted a population-based study of 12,228 Hispanic and NH White men diagnosed with testicular cancer in California during three pericensal periods 1988-1992, 1998-2002, and 2008-2012. We calculated incidence rates according to nSES and, among Hispanics, according to ethnic enclave. Incidence rate ratios were calculated to compare incidence rates across nSES and ethnic enclave and to examine changes in incidence rates over time. Results: Hispanic men residing in high SES neighborhoods, compared to low SES neighborhoods, had greater incidence of both seminoma and nonseminoma testicular cancer across pericensal periods (2008-2012, high to low nSES, seminoma IRR, 1.67; 95% CI, 1.38-2.02 and nonseminoma IRR, 1.22; 95% CI, 1.00-1.48). Hispanic men residing in low ethnic enclave neighborhoods also had higher incidence of both seminoma and nonseminoma across pericensal periods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced increased incidence of seminoma (IRR, 2008-2012 compared to 1998-2002, 1.39; 95% CI, 1.17-1.65) while those residing in both low and middle SES neighborhood experienced increased incidence of nonseminoma (IRR, 2008-2012 compared to 1998-2002 for low nSES, 1.87; 95% CI, 1.57-2.20 and for middle nSES, 1.48; 95% CI, 1.21-1.79). Conclusions: While Hispanic men residing in neighborhoods with higher SES and lower enclave status have greater incidence of both seminoma and nonseminoma testicular cancer, recent increases in incidence are driven by Hispanic men residing in lower SES neighborhoods, particularly for the nonseminoma histologic subtype. Citation Format: Mindy C DeRouen, Meg McKinley, Sumit A Shah, Hala T Borno, Rhonda Aoki, Daphne Y Lichtensztajn, John T Leppert, James D Brooks, Benjamin Chung, Scarlett L Gomez, Iona Cheng. Testicular cancer in Hispanics: Incidence of subtypes over time according to neighborhood sociodemographic factors in California [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C053.

Testicular cancer in Hispanics: incidence of subtypes over time according to neighborhood sociodemographic factors in California.

Hispanic men in the USA experience the second-highest incidence rate of testicular germ cell tumors (TGCTs), behind non-Hispanic (NH) White men, and have experienced steep increases in TGCT in recent decades. It is unknown whether increases in incidence differ according to neighborhood sociodemographic factors. We conducted a population-based study of n = 3759 Hispanic and n = 8469 NH White men (n = 12,228 total) diagnosed with TGCT in California during the three most recent pericensal periods. We calculated incidence rates according to neighborhood socioeconomic status (nSES) and among Hispanics, according to ethnic enclave. We calculated incidence rate ratios to compare rates across nSES and ethnic enclave and to examine changes in rates over pericensal time periods according to these neighborhood factors for major histologic types (i.e., seminoma and nonseminoma). Hispanic men residing in high SES, compared to low SES, neighborhoods had greater incidence of seminoma and nonseminoma testicular cancer across pericensal periods, as did Hispanic men in low enclave (less ethnic), compared to high enclave, neighborhoods. Between the periods 1998-2002 and 2008-2012, Hispanic men residing in low SES neighborhoods experienced a 39% increased incidence of seminoma, while those residing in low and middle SES neighborhoods experienced 87% and 48% increased incidence of nonseminoma, respectively. While TGCT incidence has increased among all Hispanic men, incidence increases appear to be driven disproportionately by those residing in lower SES and lower enclave neighborhoods, particularly for nonseminoma.

Re: New Insights on the Mechanisms Affecting Fertility in Men with Non-Seminoma Testicular Cancer before Cancer Therapy.

Re: New Insights on the Mechanisms Affecting Fertility in Men with Non-Seminoma Testicular Cancer before Cancer Therapy.

New Insights on the Mechanisms Affecting Fertility in Men with Non-Seminoma Testicular Cancer before Cancer Therapy.

PurposePatients with non-seminoma testicular cancer (NSTC) cancer can be subfertile or infertile, and present reduced sperm quality, but the underlying mechanisms are unknown. The aim of this study was to compare the sperm proteome of patients with NSTC, who cryopreserved their sperm before starting cancer treatment, with that from healthy fertile men.Materials and MethodsSemen volume, sperm motility and sperm concentration were evaluated before the cryopreservation of samples from patients with NSTC (n=15) and the control group (n=15). Sperm proteomic analysis was performed by liquid chromatography-tandem mass spectrometry and the differentially expressed proteins (DEPs) between the two groups were identified using bioinformatic tools.ResultsA total of 189 DEPs was identified in the dataset, from which five DEPs related to sperm function and fertilization were selected for validation by Western blot. We were able to validate the underexpression of the mitochondrial complex subunits NADH:Ubiquinone Oxidoreductase Core Subunit S1 (NDUFS1) and ubiquinol-cytochrome C reductase core protein 2 (UQCRC2), as well as the underexpression of the testis-specific sodium/potassium-transporting ATPase subunit alpha-4 (ATP1A4) in the NSTC group.ConclusionsOur results indicate that sperm mitochondrial dysfunction may explain the observed decrease in sperm concentration, total sperm count and total motile count in NSTC patients. The identified DEPs may serve as potential biomarkers for the pathophysiology of subfertility/infertility in patients with NSTC. Our study also associates the reduced fertilizing ability of NSTC patients with the dysregulation of important sperm molecular mechanisms.

Thromboembolic events after high-intensity training during cisplatin-based chemotherapy for testicular cancer.

4551 Background: Physical activity (PA) is believed to reduce acute side-effects as deconditioning, fatigue and nausea during chemotherapy and enhance post-treatment physical and psychosocial recovery. The national multicenter randomized TAST-trial (clinicaltrial.gov: NCT02577172) aimed to determine the effect of high-intensity training (HIT) during chemotherapy for testicular cancer (TC) on acute and post-treatment physical- and psychosocial outcomes. Methods: Patients aged 18 – 60 years with newly diagnosed metastatic TC, planned for 3 or 4 cisplatin-based chemotherapy cycles in combination with etoposide (EP) or etoposide plus bleomycin (BEP), were randomized to HIT during 9 or 12 weeks of chemotherapy or to one lifestyle counseling session (LCS) during first cycle. The HIT included two supervised endurance interval sessions per week, of which 10-15 minutes per session at 85 – 95 % of peak heart rate. The intensity, duration and number of the intervals were predetermined, but adjusted in accordance to the patients’ daily condition. Thromboembolic (TE) complications were registered consecutively. Results: Among the first 9 patients randomized to HIT, 33% (3 patients aged 22, 30 and 44 years) developed severe TE complications; 2 cases of pulmonary embolism (respectively at day 9 and 7 of BEP cycle 2) and 1 myocardial infarction (at day 7 of BEP cycle 3). Common for these patients were non-seminoma TC, clinical stage IIA, good prognosis group and no known risk factors for TE events. TE complications were not observed among the 10 patients randomized to the LCS. Conclusions: Since TC patients within good prognosis group are expected to have about 5 % risk of TE complications during or shortly after cisplatin-based chemotherapy, we cannot exclude that the HIT may have contributed to the unexpected high number of TE events. Until possible mechanisms explaining our observations have been explored, we discourage high-intensity endurance training during cisplatin-based chemotherapy for TC. These observations led to closure of the TAST-trial after inclusion of 19 of 94 planned patients. Clinical trial information: NCT02577172.

Retroperitoneal hematoma following radical orchiectomy: Two cases.

Treatment of testicular cancer is dependent on the stage of disease at presentation. Stage 1 testicular cancer is treated with radical orchiectomy, followed by active surveillance, radiotherapy, or chemotherapy. Occasionally, unusual and unexpected postoperative changes can be seen on computed tomography (CT), and may raise concern for metastatic disease. Here, we present two cases of testicular cancer patients who developed retroperitoneal hematomas post-radical orchiectomy, one as a classical clinical presentation, and the other as an atypical radiological entity only. The first is a case of a 38-year-old male with a non-seminoma testicular cancer, who developed severe flank pain, hemodynamic instability, and progressive anemia from a retroperitoneal hematoma in the immediate (<24 hours) postoperative period, requiring urgent surgical evacuation. The second is a case of a 33-year-old male with a testicular seminoma who had a large, suspicious retroperitoneal mass on a staging CT scan concerning for metastatic disease, which was later diagnosed as a retroperitoneal hematoma. These cases reveal the clinical variability with which a retroperitoneal hematoma post-radical orchiectomy may present. In addition, the second case demonstrates the importance of recognizing radiological postoperative changes and ensuring that these findings are not mistaken for and treated as metastatic disease.

Multiple secondary malignancies following radiation therapy for testicular cancer.

Testicular germ cell tumours (TGCT) are a rare malignancy that affect primarily young men. We present an interesting case of non-seminoma testicular cancer treated with external beam radiation therapy (RT), which subsequently resulted in two separate secondary malignancies decades after initial treatment.

Outcomes of laparoscopic retroperitoneal lymph node dissection in patients with nonseminoma testicular cancer

Outcomes of laparoscopic retroperitoneal lymph node dissection in patients with nonseminoma testicular cancer

MP24-04 USE OF RPLND IN TESTICULAR CANCER IN THE UNITED STATES: RESULTS FROM THE NATIONAL CANCER DATA BASE (1998-2011)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness III1 Apr 2015MP24-04 USE OF RPLND IN TESTICULAR CANCER IN THE UNITED STATES: RESULTS FROM THE NATIONAL CANCER DATA BASE (1998-2011) Brian Hu, Claudio Jeldres, Katherine Odem-Davis, Claire Sadler, Craig Nichols, Christopher Porter, and Siamak Daneshmand Brian HuBrian Hu More articles by this author , Claudio JeldresClaudio Jeldres More articles by this author , Katherine Odem-DavisKatherine Odem-Davis More articles by this author , Claire SadlerClaire Sadler More articles by this author , Craig NicholsCraig Nichols More articles by this author , Christopher PorterChristopher Porter More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1146AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of testicular cancer has evolved worldwide and indications for local therapies, such as retroperitoneal lymph node dissection (RPLND) are currently more limited. Differences in patterns of care and utilization of RPLND may exist between different types of hospital and may also reflect accessibility to this treatment modality and/or compliance to national guidelines. Since there are no population-based reports in the US that measure the utilization of RPLND, we sought to characterize its use and stratify according to the type of hospital. METHODS The National Cancer Data Base (NCDB) was queried for patients with seminoma or non-seminoma (includes mixed histology) testicular cancer, between 1998 and 2011. The rates of RPLND were calculated for each stage of the disease and were later stratified according to the treatment facility type, namely, community, comprehensive and academic centers. Results were obtained by cross-tabulation, proportions were compared with the chi-square test, and trends were assessed with the Cochran-Armitage test. RESULTS Within the NCDB, of 59,652 patients with testicular cancer, 5475 (9.2%) underwent RPLND. The utilization of RPLND varied significantly different between the types of facility across all stages of non-seminoma (Figure) with the highest rates of use recorded in academic centers (all p<0.001). For example, in Stage III non-seminoma, RPLND rates for community, comprehensive and academic centers were 8, 10 and 25%, respectively. There was no significant difference in the utilization of RPLND among hospital types in seminoma. Trends over time have shown an increase use of RPLND in academic centers and a significant decrease in community centers, especially for stage I and stage III non-seminoma (p=0.032 and p<0.01, respectively). CONCLUSIONS In the US, use of RPLND varies significantly according to type of treatment facility, and these differences increased during the last decade. Further studies are needed to address the potential effect of these differences on survival outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e276-e277 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Hu More articles by this author Claudio Jeldres More articles by this author Katherine Odem-Davis More articles by this author Claire Sadler More articles by this author Craig Nichols More articles by this author Christopher Porter More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Surveillance for stage I nonseminoma testicular cancer: outcomes and long-term follow-up in a population-based cohort.

To describe treatment results in a large cohort with stage I nonseminoma germ cell cancer (NSGCC) treated in a surveillance program. From January 1, 1984, to December 31, 2007, 1,226 patients with stage I NSGCC, including high-risk patients with vascular invasion, were observed in a surveillance program. The relapse rate after orchiectomy alone was 30.6% at 5 years. Presence of vascular invasion together with embryonal carcinoma and rete testis invasion in the testicular primary identified a group with a relapse risk of 50%. Without risk factors, the relapse risk was 12%. Eighty percent of relapses were diagnosed within the first year after orchiectomy. The median time to relapse was 5 months (range, 1 to 308 months). Early relapses were mainly detected by increase in tumor markers, and late relapses were detected by computed tomography scans. Relapses after 5 years were seen in 0.5% of the whole cohort or in 1.6% of relapsing patients. The majority of relapses (94.4%) belonged to the good prognostic group according to the International Germ Cell Cancer Collaborative Group classification. The disease-specific survival at 15 years was 99.1%. A surveillance policy for patients with stage I NSGCC is a safe approach associated with an excellent cure rate and an overall low treatment burden despite a high relapse rate in a small group of patients. We recommend surveillance for patients with stage I NSGCC with immediate systemic treatment at relapse. Clearly defined risk factors for relapse are presented if an option of risk-adapted treatment is preferred.

Markedly increased incidence and improved survival of testicular cancer in the Netherlands

Background. Worldwide marked changes have been observed in the incidence and survival of testicular cancer (TC) during the last decades. We conducted a study on trends in TC incidence, treatment, survival, and mortality in the Netherlands during the period 1970–2009 with specific focus on trends according to age, histology and stage of disease. Methods. Data from the Eindhoven cancer registry, the Netherlands cancer registry and Statistics Netherlands was used. Age-standardized incidence and mortality rates and five-year relative survival were calculated. Treatment was categorized into five major groups. Results. TC incidence showed a substantial annual increase of 3.9% in the period 1989–2009. The incidence increased for all stages of both seminoma and non-seminoma TC. Stage distribution for the non-seminoma patients shifted towards more localized disease. Most patients received primary treatment according to the guidelines. Five-year relative survival improved (non-significantly) for most groups of stage and histology. TC mortality dropped sharply in the 1970s and 1980s and remained relatively stable thereafter. Conclusion. This study shows that incidence of TC has increased sharply in the Netherlands. Relative survival is high and improved in most disease stages. There is a growing demand for medical care of newly diagnosed TC patients and for the rapidly increasing number of prevalent TC patients.

ANN as a prognostic tool after treatment of non-seminoma testicular cancer

Abstract Testicular cancer is rare but is the most common cancer in males between 15 and 34 years of age. Two principal types of testicular cancer are distinguished: seminomas and non-seminomas. If detected early, the overall cure rate for testicular cancer exceeds 90%. In this study, artificial neural network (ANN) analysis as a prognostic tool was demonstrated regard to five year recurrence after the non-seminoma treatment. Data from 202 patients treated for non-seminoma were available for evaluation and comparison. A total of 32 variables were analysed using the ANN. The ANN approach, as an advanced multivariate data processing method, was demon-strated to provide objective prognostic data. Some of these prognostic factors are consistent or even imperceptible with previously evaluated by other statistical methods.

Testicular cancer survivors' supportive care needs and use of online support: a cross-sectional survey

The supportive care needs of testicular cancer survivors have not been comprehensively studied. Likewise, there is limited research on their use of the Internet or social media applications--tools that are popular among young adults and which could be used to address their needs. Two hundred and four testicular cancer patients receiving care at an urban cancer center completed a questionnaire assessing supportive care needs and the use and preferences for online support. We examined the associations between patient characteristics and met or unmet supportive care needs and the use of testicular cancer online communities. Respondents had more met (median 8.0, interquartile range (IQR) 10.0) than unmet (median 2.0, IQR 7.0) needs. The majority (62.5%) reported at least one unmet need, most commonly (25%) concerning financial support, body image, stress, being a cancer survivor, and fear of recurrence. Patients who were younger, had nonseminoma testicular cancer, or received treatment beyond surgery had more needs, and those who were unemployed had more unmet needs. The majority of respondents (71.5%) were social media users (e.g., Facebook), and 26% had used a testicular cancer online support community. Reasons for nonuse were lack of awareness (34.3%), interest (30.9%), trust (4.9%), and comfort using computers (2.5%). Users were more likely to speak English as a first language and have more needs. At least one in four testicular cancer survivors has unmet needs related to financial support, body image, stress, being a cancer survivor, and fear of recurrence. A web-based resource may be a useful strategy to consider given the high prevalence of social media use in this sample and their desire for online support. Efforts are needed to raise awareness about online peer support resources and to overcome barriers to their use.

Maternal Epstein‐Barr virus and cytomegalovirus infections and risk of testicular cancer in the offspring: a nested case‐control study

During recent decades the incidence of testicular cancer (TC) has increased rapidly around the world. Associated exogenous etiological factors might therefore be identifiable. We performed a case-control study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of congenital or neonatal infections with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) as risk factors of TC in the offspring. For each case-index mother pair, three or four matched control-control mother pairs were identified using national population registries. First trimester sera were retrieved from the index mothers of 66 TC cases and 258 matched control mothers, and were tested for antibodies to EBV and CMV. High level of maternal EBV IgG antibodies was associated with significantly increased risk of TC in the offspring (odds ratio (OR), 2.50; 95% confidence interval (CI), 1.15, 5.40), especially with risk of non-seminoma TC (OR, 2.73; 950% CI, 1.25, 5.99) and non-seminoma TC diagnosed under 8 years of age (OR, 2.72; 95% CI, 1.05, 7.04). In contrast, offspring of CMV IgG-seropositive mothers had a decreased risk of TC diagnosed under 8 years of age (OR, 0.35; 95% CI, 0.14, 0.89). Our results suggest that EBV and CMV infections may be associated with TC.