Objective: This study was undertaken to estimate the epidemiological characteristics, histological types, and subtypes of testicular neoplasm according to the WHO classification in our patient group. Material & Methods: This was a retrospective study done over a period of ten years from January 2010 - December 2020 in our institution. Histopathological slides were retrieved and reviewed for tumour. Testicular Neoplasm patients who underwent orchidectomy and chemotherapy clinical data including the patient’s age, tumor location, tumor side, pathological finding, tumor marker, chemotherapy regiment, prognosis, chemotherapy response, and side effect were observed. All the data were analyzed descriptively and using SPSS 17.0. Results: A total of 31 cases of testicular and paratesticular neoplasm were encountered in our study with a mean age of 32.516.2 years. The highest incidence was 15-35 years old (48.3). Scrotum mass was the most frequent clinical presentation (70.96%) and left side became the predominant area (52%). Most of the patients come in late stage T3 (51.61%) and N3 (67.74%) with no metastatic process (70.96). The major pathological finding was Seminoma (64.51%), Teratoma (16.12), Yolk Sac (12.9%), Embryonal, and Mixed (3.22%). AFP, B-HCG, and LDH were elevated in some Seminoma, Teratoma, and Yolk Sac groups. The most wide chemotherapy used was 4 series BEP (87.09%). Patient prognosis highest incidence were Intermediate (70.96%). Most of the patients showed complete response (67.74) of chemotherapy. Nausea, vomiting, alopecia, and mucositis were observed as chemotherapy side effect in all patients. Conclusion: Testicular neoplasm peak incidence appears in young male. Most patients come to health care service in late stage. Seminoma become the highest testicular neoplasm incidence in our study. Elevated tumor markers were found in some patients. Four cycle BEP chemotherapy regiment showed great outcome for these patients. Keywords: Epidemiological, histological, testicular neoplasm.
Epidemiological, histological, testicular neoplasm
Rajpert-De Meyts E, McGlynn KA, Okamoto K, Jewett MA, Bokemeyer C. Testicular germ cell tumours. Lancet (London, England). 2016; 387(10029): 1762–1774.
Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. European urology. 2016; 70(1): 93–105.
Znaor A, Lortet-Tieulent J, Jemal A, Bray F. International variations and trends in testicular cancer incidence and mortality. European urology. 2014; 65(6): 1095–1106.
Stang A, Bray F, Dieckmann KP, Lortet-Tieulent J, Rusner C. Mortality of Testicular Cancer in East and West Germany 20 Years after Reunification: A Gap Not Closed Yet. Urologia internationalis. 2015; 95(2): 160–166.
Sobin LH, Gospodariwicz M, Wittekind C (eds). TNM classification of malignant tumors. UICC International Union Against Cancer, 7th edn. Wiley-Blackwell, 2009 Dec. pp 249-254.
MP Laguna, P Albers, F Algaba, C Bokemeyer, JL Boormans, S Fischer, K Fizazi, H Gremmels (Patient advocate), R Leão, D Nicol, N Nicolai, J Oldenburg, T Tandstad. EAU Guideline on Testicular Cancer Part 5. Diagnostic Evaluation. ISBN 978-94-92671-11-0. EAU Guidelines Office, Arnhem, The Netherlands. 2020.
Chia, Victoria & Quraishi, Sabah & Devesa, Susan & Purdue, Mark & Cook, Michael & Mcglynn, Katherine. International Trends in the Incidence of Testicular Cancer, 1973-2002. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2010; 19; 1151-9.
Purdue MP, Devesa SS, Sigurdson AJ, McGlynn KA. International patterns and trends in testis cancer incidence. International journal of cancer. 2005; 115(5): 822–827.
Bray F, Ferlay J, Devesa SS, McGlynn KA, Møller H. Interpreting the international trends in testicular seminoma and nonseminoma incidence. Nature clinical practice. Urology. 2006; 3(10): 532–543.
Palmer RD, Barbosa-Morais NL, Gooding EL, Muralidhar B, Thornton CM, Pett MR, Roberts I, Schneider DT, Thorne N, Tavaré S, Nicholson JC, Coleman N, Children's Cancer and Leukaemia Group. Pediatric malignant germ cell tumors show characteristic transcriptome profiles. Cancer research. 2008; 68(11): 4239–4247.
Gurney JK, Sarfati D, Stanley J. Obscure etiology, unusual disparity: the epidemiology of testicular cancer in New Zealand. Cancer causes & control : CCC. 2015; 26(4): 561–569.
Hanson HA, Anderson RE, Aston KI, Carrell DT, Smit KR, Hotaling JM. Subfertility increases risk of testicular cancer: evidence from population-based semen samples. Fertility and sterility. 2016; 105(2): 322–8.
Faouzi, Sara & Ouguellit, Siham & Loriot, Yohann. Tumeurs germinales de stade I. Bulletin du Cancer. 2019.
Germà-Lluch JR, Garcia del Muro X, Maroto P, Paz-Ares L, Arranz JA, Gumà, J, Alba E, Sastre J, Aparicio J, Fernández A, Barnadas A, Terrassa J, Sáenz A, Almenar D, López-Brea M, Climent MA, Sánchez MA, Lasso de la Vega R, Berenguer G, Pérez X, Spanish Germ-Cell Cancer Group (GG). Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG). European urology. 2002: 42(6); 553–563.
Cools M, Pleskacova J, Stoop H, Hoebeke P, Van Laecke E, Drop SL, Lebl J, Oosterhuis J. W, Looijenga LH, Wolffenbuttel KP, Mosaicism Collaborative GrouP. Gonadal pathology and tumor risk in relation to clinical characteristics in patients with 45,X/46,XY mosaicism. The Journal of clinical endocrinology and metabolism. 2011; 96(7): E1171–E1180.
Mir MC, Pavan N, Gonzalgo ML. Current Clinical Applications of Testicular Cancer Biomarkers. The Urologic clinics of North America. 2016; 43(1): 119–125.
Dunzendorfer U, Jurincic C. Quantification of alpha-fetoprotein and beta-HCG in testis tumor patients. Urologia internationalis. 1987; 42(4): 248–253.
Leão R, Ahmad AE, Hamilton RJ. Testicular Cancer Biomarkers: A Role for Precision Medicine in Testicular Cancer. Clinical genitourinary cancer. 2019; 17(1): e176–e183.
Masterson TA, Rice KR, Beck SD. Current and future biologic markers for disease progression and relapse in testicular germ cell tumors: a review. Urologic oncology. 2014; 32(3): 261–271.
Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, Stephenson AJ, Vaughn DJ, Cosby R, Hayes DF, American Society of Clinical Oncology American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2010; 28(20): 3388–3404.
Ehrlich Y, Beck SD, Foster RS, Bihrle R, Einhorn LH. Serum tumor markers in testicular cancer. Urologic oncology. 2013; 31(1): 17–23.
Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. The New England journal of medicine. 1987; 316(23): 1435–1440.
Hoffmann R, Plug I, McKee M, Khoshaba B, Westerling R, Looman C, Rey G, Jougla E, Lang K, Pärna K, Mackenbach JP. Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005. International journal of public health. 2014; 59(2): 341–350.
Budaya TN, Daryanto B. Keganasan Traktus Urinarius (1st ed., Vol. 3). Malang UB Press. 2019.
de Wit R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Fosså SD, Cook P, de Prijck L, Stenning S, Collette L. Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2001; 19(6): 1629–1640.