Treatment Of Testicular Tumors Research Articles

Εmerging Biomarkers in the Diagnosis and Treatment of Testicular Tumors.

Testicular germ cell tumors (TGCT) are the leading cause of cancer-related death in young males between the ages of 20-40. Surgical resection and cisplatin-based chemotherapy can achieve a cure for the majority of patients with TGCTs, with survival rates of up to 97% for patients diagnosed at an early stage. The use of serum biomarkers, such as alpha-fetoprotein (AFP), β-HCG, and LDH, plays a significant role in both diagnosis and evaluation of response to treatment, and despite their low sensitivity and specificity levels, they are an integral part of the current tumor staging system and daily practice. Molecular biomarkers, including micro-RNAs and gene-expression profiles, are currently being developed in TGCTs and could potentially hold a prominent place in the future diagnosis, treatment selection, surveillance, and prognostication of these tumors. This review discusses how current advances in our understanding of the underlying biology of TGCTs have helped biomarker discovery, with a focus on the recognition of key molecular alterations that could serve as potential indicators of disease onset, response to systemic or/and surgical therapies, and overall clinical course.

Organ-Sparing Surgery for Testicular Germ Cell Tumors: A Current Perspective.

Background and Objectives: We aimed to evaluate the oncological and functional outcomes of organ-sparing surgery for testicular germ cell tumors, a procedure that seeks to strike a balance between effective cancer control and organ preservation, in the treatment of testicular tumors. We aimed to discuss the surgical technique and complications, and determine the appropriate candidate selection for this approach. Material and Methods: A comprehensive literature search was conducted to identify relevant studies on organ-sparing surgery for testicular tumors. Various databases, including PubMed, Embase, and Cochrane Library, were used. Studies reporting on surgical techniques, complications, and oncologic and functional outcomes were included for analysis. Results: Current evidence suggests that organ-sparing surgery for testicular germ cell tumors can be considered a safe and efficacious alternative to radical orchiectomy. The procedure is associated with adequate oncological control, as indicated by low recurrence rates and low complication rates. Endocrine testicular function can be preserved in around 80-90% of patients and paternity can be achieved in approximately half of the patients. Candidate selection for this surgery is typically based on the following criteria: pre-surgery normal levels of testosterone and luteinizing hormone, synchronous or metachronous bilateral tumors, tumor in a solitary testis, and tumor size less than 50% of the testis. Conclusions: Organ-sparing surgery for testicular germ cell tumors offers a promising approach that balances oncological control and preservation of testicular function. Further research, including large-scale prospective studies and long-term follow-ups, is warranted to validate the effectiveness and durability of organ-sparing surgery and to identify optimal patient selection criteria.

Feasibility of one-lung ventilation using two ventilators in a bleomycin treated patient under normoxic conditions: A case report

Bleomycin is a chemotherapeutic agent that has been applied successfully for decades in the treatment of testicular tumors. Case reports and studies in animal models suggest that bleomycin increases the lifelong toxicity of lungs to increased oxygen concentrations, which may trigger ARDS. Therefore, the general recommendation is to keep oxygen levels as low as possible in the context of medical procedures, which opposes the necessity of high oxygen application during one-lung ventilation (OLV).

Testis Sparing Surgery in Pediatric Testicular Tumors.

Simple SummaryTestis sparing surgery (TSS) is a safe treatment option in selected cases of testicular tumors in adults, focusing on technical feasibility, oncologic safety, preserving of testicular function, and long-term outcome. This surgical technique is also increasingly being considered in children, as benign tumors are more common in this population. With this systematic review, we aim to evaluate outcome of TSS and to investigate under which circumstances TSS can be considered safe in boys with testicular tumors. Based on the current practice described in this systematic review, combined with the outcome of TSS, we would like to suggest an algorithm to guide clinicians in determining the appropriate surgical treatment in prepubertal patients less than 12 years of age with a testicular tumor. TSS may lead to improved testicular function and quality of life in boys with testicular tumors. Objective: The purpose of this review is to evaluate the outcomes of testis sparing surgery (TSS) and to investigate under which circumstances TSS can be considered a safe treatment option in pediatric patients with testicular tumors. Methods: A database search was performed in Cochrane, Pubmed, and Embase for studies that focused on TSS as treatment for testicular tumors in the pediatric population, excluding reviews and single case reports. Results: Twenty studies, describing the surgical treatment of 777 patients with testicular tumors, were included in the analysis. The majority of pediatric patients with benign germ cell tumors (GCTs) (mean age: 3.7 years) and sex cord-stromal tumors (SCSTs) (mean age: 6.6 years) were treated with TSS, 61.9% and 61.2%, respectively. No cases of testicular atrophy occurred. Four of the benign GCTs, i.e., three teratomas and one epidermoid cyst, recurred. No cases of recurrence were reported in patients with SCSTs. Of the 243 malignant GCTs (mean age: 4.2 years), only one patient had TSS (0.4%). Conclusion: TSS is a safe treatment option for prepubertal patients less than 12 years of age with benign GCTs and low grade SCSTs.

MicroRNA-199a-3p functions as tumor suppressor by regulating glucose metabolism in testicular germ cell tumors

microRNA (miR)-199a-3p serves critical roles in cancer development and progression. In order to improve knowledge of the functional mechanism of miR‑199a‑3p in testicular tumors, the present study characterized the regulation of aerobic glycolysis by miR‑199a‑3p and its impact on metabolism. Using3‑4,5‑dimethylthiazol‑2‑yl‑2,5diphenyl tetrazolium bromide, wound healing and flow cytometry assays, it was determined that overexpression of miR‑199a‑3p in Ntera‑2cells caused suppression of cell growth and migration. Further biochemical methods and high‑throughput quantitative polymerase chain reaction array of metabolic genes showed that inhibition of miR‑199a‑3p markedly elevated lactate production and12differentially expressed genes, including2upregulated and10downregulated genes, were identified following treatment with miR‑199a‑3p in Ntera‑2cells. In clinical samples, four selected genes, lactate dehydrogenaseA, monocarboxylate transporter1, phosphoglycerate kinase1 and TP53‑inducible glycolysis and apoptosis regulator, were significantly overexpressed in malignant testicular germ cell tumor, and their expression inversely correlated with the expression of miR‑199a‑3p, suggesting that these four genes may be affected by miR‑199a‑3p. Using bioinformatics analysis, the transcription factor Sp1binding site was identified in the promoter region of the four selected genes. In addition, miR‑199a‑3p was predicted to bind to conservative target sequences in the 3'‑untranslated region of Sp1mRNA, suggesting that miR-199a-3p may downregulate these four metabolic genes through Sp1. It was demonstrated the dysregulated expression and activation of miR‑199a‑3p may serve important roles in aerobic glycolysis and tumorigenesis in patients with testicular cancer. Therefore, miR-199a-3p may be a potential biomarker in the prognosis and treatment of testicular tumors.

Testicular tumors in children

Testicular tumors in children are rare. Teratomas and yolk sacs tumor are most testicular tumors in children. Masses of testicular tumors are often painless. These may be misdiagnosed as a hydrocel. Tumor markers and Ultrasound used in diagnosed. These tumors are more benign than malign. Inguinal orchiectomy is gold standart in treatment of testicular tumors.

Tumores testiculares en la infancia

Introductionprepubertal testicular tumours are different from those that appear during adulthood. Traditionally, they were considered to be malignant, however benign testicular tumours are actually more frequent at this age. Materials and methodswe analysed our experience in the treatment of testicular tumours in children ≤ 13, with the intention of evaluating the use of partial orchiectomy. From 1984 to 2008, we diagnosed and treated 15 testicular tumours in children at our centre. We examined the therapeutic approach employed, underlining the possibility of testicular conservation in selected patients and we have analysed the results. Resultsthe clinical presentation in 80% of the cases was an increase in testicle size with palpable mass. We performed 4 radical orchiectomies (27%) and 11 tumourectomies (73%). All the benign lesions in the final pathological anatomy were treated with tumourectomy: four epidermoid cysts, one hemangioma, one lipoma, one fibrous hamartoma, one juvenile granulosa tumour and one splenogonadal fusion. We also successfully and conservatively treated two cases of teratoma. The cases that received radical treatment were a yolk sac tumour (Stage I), two mixed germ cell tumours and one gonadoblastoma. Conclusionsthere are more cases of benign testicular tumours than malignant tumours during puberty. In the event of a palpable testicular mass with negative tumour markers, conservative treatment by means of a tumourectomy may be considered. However, the lesion must be removed completely to prevent recurrence.

Testicular tumours in infancy and children

IntroductionPrepubertal testicular tumours are different from those that appear during adulthood. Traditionally, they were considered to be malignant, however benign testicular tumours are actually more frequent at this age. Materials and methodsWe analysed our experience in the treatment of testicular tumours in children ≤13, with the intention of evaluating the use of partial orchiectomy. From 1984 to 2008, we diagnosed and treated 15 testicular tumours in children at our centre. We examined the therapeutic approach employed, underlining the possibility of testicular conservation in selected patients and we have analysed the results. ResultsThe clinical presentation in 80% of the cases was an increase in testicle size with palpable mass. We performed 4 radical orchiectomies (27%) and 11 tumourectomies (73%). All the benign lesions in the final pathological anatomy were treated with tumourectomy: four epidermoid cysts, one hemangioma, one lipoma, one fibrous hamartoma, one juvenile granulosa tumour and one splenogonadal fusion. We also successfully and conservatively treated two cases of teratoma. The cases that received radical treatment were a yolk sac tumour (Stage I), two mixed germ cell tumours and one gonadoblastoma. ConclusionsThere are more cases of benign testicular tumours than malignant tumours during puberty. In the event of a palpable testicular mass with negative tumour markers, conservative treatment by means of a tumourectomy may be considered. However, the lesion must be removed completely to prevent recurrence.

Testicular Tumors In Children: A Single Institution Experience

PURPOSE Testicular tumors account for 1-2% of all paediatric solid tumors. We describe a single center experience in the diagnosis and surgical treatment of testicular tumors in a paediatric population. MATERIAL AND METHODS Research Ethics Board approved retrospective chart review of testicular tumors treated at our institution from 1990-2008. RESULTS Twenty-six patients with 27 tumors, 15 prepubertal and 12 post-pubertal. Median age 7.4 years (Quartiles 1st: 0.7; 3rd: 15.4). Median follow up 36 months (Quartiles 1st: 14.1; 3rd: 80.7). Painless testicular mass in 52%(14/27). Alpha-fetoprotein(AFP) was high in 80%(8/10) and 12% (2/17) of malignant and benign tumors respectively. Human Chorionic Gonadotropin(HCG) was high in 20%(2/10) of the malignant tumors, and both patients were post-pubertal. Benign and malignant tumors were 63%(17/27) and 37%(10/27) respectively. Benign lesions were present in 73%(11/15) of prepubertal and 50%(6/12) of post-pubertal. AFP was normal in 82%(9/11) of benign and high in 100%(4/4) of malignant prepubertal patients (p=0.011). Pathology: 82%(22/27) germ cell tumors, 15%(4/27) gonadal stromal and 3%(1/27) cystic dysplasia. Radical and partial orchiectomy was performed in 89%(24/27) and 11%(3/27) respectively. Stage I was found in 88.9%(24/27) and II, III and IV in 3.7 %(1/27) each. There was no death during the follow up. CONCLUSIONS Benign testicular tumors were more frequent in our series. As most prepubertal tumors were benign (73%) and AFP was high in all prepubertal malignant tumors, partial orchiectomy in patients younger than 12 years with a normal AFP could be considered. HGC had no value on assessment of tumors in prepubertal age.

CURRENT MANAGEMENT OF PREPUBERTAL YOLK SAC TUMORS OF THE TESTIS

Over the last 3 decades, the management of pediatric yolk sac tumors of the testis has changed significantly. These changes reflect improvement in the treatment of testicular tumors in adults and children, such as the advent of platinum-based chemotherapy regimens. They also reflect increased understanding of the biology and natural history of prepubertal yolk sac tumors of the testis as a unique disease entity.

Cutaneous toxicity of autologous bone marrow transplantation in nonseminomatous germ cell tumors

High doses of carboplatin or cisplatin combined with cyclophosphamide and etoposide followed by autologous bone marrow transplantation (ABMT) rescue have been used in the treatment of testicular tumors that have had a bad prognosis. Unusual cutaneous complications, evoking radiation-induced dermatitis, have been seen in two of eight patients with the same regimen. This new type of toxicity seems to be related to high-dose combination chemotherapies. Good results in the treatment of patients with testicular tumors on relapse who continue to respond to chemotherapy lead to the extension of this type of schedule and cutaneous toxicity will probably develop.

Delay in treatment of testicular tumours in the Army.

Modern drug treatment, added to our previous experience of surgery and radiotherapy, is currently producing nearly 90% cure of all patients with testicular tumours. Most of the failures of treatment today occur in patients with a large mass of diseased tissue which has accumulated due to delayed diagnosis. A retrospective study of 23 Servicemen with testicular tumours, treated at the QEMH Woolwich, shows that the blame for this delay is shared by the patient, his medical practitioner, and surprisingly enough the hospital specialist. Recommendations for improvement are discussed.

Studies of testicular function after treatment for testicular tumors. III. The influence of chemotherapy on pituitary-testicular axis in patients with testicular tumor

Studies of testicular function after treatment for testicular tumors. III. The influence of chemotherapy on pituitary-testicular axis in patients with testicular tumor

Treatment of testicular tumors.

A total of 145 consecutive primary testicular tumors were treated with radiation therapy at the University of Michigan Hospital from 1955 through 1974. In patients with seminoma, the 5-year survival rate was 98% for Stage I and 88% for Stage II regardless of whether retroperitoneal lymph node dissection was done. The 5-year survival rate for embryonal carcinoma was 63% for Stage I and 66% for Stage II. For teratocarcinoma it was 100% for Stage I and 54% for Stage II. Adjuvant chemotherapy appeared to be beneficial for patients with Stage II teratocarcinoma but made no difference in patients with embryonal carcinoma.

TESTICULAR TUMOURS: TREATMENT BY SURGERY AND RADIOTHERAPY

The treatment of testicular tumours, particularly teratomas, remains controversial. The results of treatment in 146 such tumours treated by surgery and radiotherapy are discussed. A case is made for a selective policy towards retroperitoneal lymph node dissection in teratomatous tumours. Where isolated pulmonary metastases occur, resection of these is well worth while.

Sexual function and fecundity after treatment for testicular tumors

Questionnaires were mailed to patients who had undergone either radiotherapy, lymphadenectomy, or a combination of both as treatment for malignant disease of the testis in an attempt to define the effects of their therapy on sexual function, ejaculation, and fecundity. The forms returned by 29 patients with seminoma treated with irradiation alone indicated that little change had occurred in their sexual performance or sex drive. Diminished semen volume was reported by 10 patients but was severe in only 1. Two of 3 patients who desired children after therapy were successful. In patients with nonseminomatous testis tumor treated surgically, 42 of 50 reported a significant decrease in semen volume, but 7 of 12 who desired children following therapy were successful. The physiology of ejaculation is reviewed, and comments are offered on the means by which retroperitoneal lymphadenectomy may disrupt normal ejaculation.

ICRF-159 in treatment of germinal testicular tumor in animals

A comparison of therapeutic regimens used in the treatment of testicular tumor was carried out utilizing a murine genital ridge graft model (Stevens) which provides an unlimited number of tumor foci of precisely known age, histologically similar to germinal testis tumor in human beings, and highly predictable in size and degree of differentiation. They arise de novo in vivo. The four drug combination of 5- fluorouracil, cyclophosphamide, methotrexate, and vincristine gave the greatest objective response of currently used regimens. The use of ICRF-159 was suggested by the incidental findings of damage to the spermatogenic cell line in early laboratory experiments. It was shown to be considerably more effective against murine testicular tumor using the Stevens model than all other regimens and acted synergistically with the four-drug regimen.

Treatment of testicular tumors.

Treatment of testicular tumors.

Mithramycin (Mithracin)

It is recommended that Mithracin (mithramycin) be administered only to hospitalized patients by or under the supervision of a qualified physician who is experienced in the use of cancer chemotherapeutic agents, because of the possibility of severe reactions. Facilities for the determination of necessary laboratory studies must be available.Severe thrombocytopenia, a hemorrhagic tendency and even death may result from the use of Mithracin. Although severe toxicity is more apt to occur in patients who have far‐advanced disease or are otherwise considered poor risks for therapy, serious toxicity may also occasionally occur even in patients who are in relatively good condition.In the treatment of each patient, the physician must weigh carefully the possibility of achieving therapeutic benefit versus the risk of toxicity which may occur with Mithracin therapy. The following data concerning the use of Mithracin in the treatment of testicular tumors, hypercalcemic and/or hypercalciuric conditions associated with various advanced malignancies, should be thoroughly reviewed before administering this compound.

Current Concepts in Cancer—No. 29

In the CCC communication entitled "The Place of Chemotherapy in the Treatment of Testicular Tumors" by Robert B. Golby, MD, in the July 6 issue (<b>213</b>:101-106, 1970), an error occurred in the statement of dosage for dactinomycin in combination with chlorambucil in the treatment of embryonal carcinoma and teratocarcinoma. On page 103, the second sentence in the first column should read, correctly: "We favor the combination of chlorambucil at dosages prescribed here plus dactinomycin at a dosage<b>of 0.03 mg/kg</b>intravenously once weekly."