INTRATUBULAR GERM CELL NEOPLASIA OF THE CONTRALATERAL TESTIS IN TESTICULAR CANCER: DEFINING A HIGH RISK GROUP

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1998INTRATUBULAR GERM CELL NEOPLASIA OF THE CONTRALATERAL TESTIS IN TESTICULAR CANCER: DEFINING A HIGH RISK GROUP S.J. HARLAND, P.A. COOK, S.D. FOSSA, A. HORWICH, G.M. MEAD, M.C. PARKINSON, J.T. ROBERTS, and S.P. STENNING S.J. HARLANDS.J. HARLAND , P.A. COOKP.A. COOK , S.D. FOSSAS.D. FOSSA , A. HORWICHA. HORWICH , G.M. MEADG.M. MEAD , M.C. PARKINSONM.C. PARKINSON , J.T. ROBERTSJ.T. ROBERTS , and S.P. STENNINGS.P. STENNING View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62535-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We define a group of testis cancer patients who are at high risk for carcinoma in situ of the contralateral testis and, therefore, a second germ cell tumor. Materials and Methods: The histology was reviewed in 186 testis cancer patients who underwent contralateral testicular biopsy either because of a history of testicular maldescent or an atrophic contralateral testis (defined as a volume of 12 ml. or less). Testicular volume, semen analysis, serum gonadotropin levels, serum testosterone and estradiol levels were assessed in the majority of patients. Results: Univariate analyses identified contralateral testicular atrophy, low sperm density, young age at presentation and low Johnsen score as factors associated with increased risk of a positive biopsy. A history of maldescent in the absence of atrophy was associated with carcinoma in situ prevalence of only 4%. Multivariate analysis identified only testicular atrophy and age at presentation as independent determinants of a positive biopsy. Testis cancer patients with a small contralateral testis had a 20% and those presenting at age 30 years or younger had a 34% prevalence, respectively, of carcinoma in situ on contralateral testis biopsy (95% confidence interval 20 and 46%, respectively). Conclusions: Testis cancer patients with an atrophic contralateral testis who present before the age of 31 years are at high risk for carcinoma in situ of the contralateral testis and, therefore, a second germ cell tumor. It is estimated that this group comprises 6% of all testis cancer patients. We predict that a policy of performing contralateral testicular biopsy will produce positive results for carcinoma in situ in a third of these patients and will detect contralateral carcinoma in situ in approximately 40% of all testis cancer patients. References 1 : Diagnosis and management of carcinoma in situ of the testis. In: Testicular Cancer. Clinical Investigation and Management.. Edited by . New York: Chapman and Hall Medical1991: 319. chapt 24. Google Scholar 2 : Carcinoma in situ of the contralateral testis in patients with testicular germ cell cancer. A study of 27 cases in 500 patients. Brit. Med. J.1986; 293: 1398. Google Scholar 3 : Carcinoma in situ of the contralateral testis (Letter to the Editor). Brit. Med. J.1987; 294: 121. Google Scholar 4 : Prevalence of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms. J. Clin. Oncol.1996; 14: 3126. Google Scholar 5 : Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer. Brit. Med. J.1982; 285: 1683. Google Scholar 6 : Testicular biopsy score count-a method for registration of spermatogenesis in human testes: normal values and results in 335 hypogonadal males. Hormones1970; 1: 2. Google Scholar 7 : Testicular ultrasonography and 18G biopty biopsy for clinically undetected cancer or carcinoma in situ in patients with germ cell tumours. Brit. J. Urol.1993; 71: 214. Google Scholar 8 : Teratoma. In: Pathology of the Testis. Edited by . Oxford: Blackwell Scientific Publications1976: 199. Google Scholar 9 : Risk of a second germ cell cancer after treatment of a primary germ cell cancer in 2201 Norwegian male patients. Eur. J. Cancer1997; 33: 244. Google Scholar 10 : Management of the contralateral testis in patients with testicular germ cell cancer. Brit. J. Urol.1990; 65: 290. Google Scholar 11 : Inheritance and testicular cancer. Brit. J. Cancer1995; 71: 421. Google Scholar 12 : Bilateral germ cell testicular tumors in New Zealand: experience in Auckland and Christchurch 1978-1994. J. Clin. Oncol.1996; 14: 2061. Google Scholar 13 : Risk of bilateral testicular germ cell cancer in Denmark 1960-1984. J. Natl. Cancer Inst.1991; 83: 1391. Google Scholar 14 : Clinical aspects of testicular carcinoma in situ. Int. J. Androl.1981; 4: 153. Google Scholar 15 : A review of testicular intratubular germ cell neoplasia in infertile men. J. Androl.1994; 15: 14. Google Scholar 16 : Serum testosterone, LH, and FSH in patients with testicular cancer before and after radio- and chemotherapy. Scand. J. Urol. Nephrol.1983; 17: 287. Google Scholar 17 : Effect of irradiation treatment on gonadal function in men treated for germ cell cancer. Eur. Urol.1993; 23: 148. Google Scholar 18 : Possible carcinoma-in-situ of the testis. Lancet19782; 2: 516. Google Scholar 19 : Management of contralateral testicular intraepithelial neoplasia in patients with testicular germ-cell tumor. World J. Urol.1994; 12: 131. Google Scholar From the Medical Research Council Testicular Tumour Working Party, London, United Kingdom© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byGupta M, Cheaib J, Patel H, Sharma R, Zhang A, Bass E and Pierorazio P (2020) Diagnosis and Management of Intratubular Germ Cell Neoplasia In Situ: A Systematic ReviewJournal of Urology, VOL. 204, NO. 1, (33-41), Online publication date: 1-Jul-2020.Stephenson A, Eggener S, Bass E, Chelnick D, Daneshmand S, Feldman D, Gilligan T, Karam J, Leibovich B, Liauw S, Masterson T, Meeks J, Pierorazio P, Sharma R and Sheinfeld J (2019) Diagnosis and Treatment of Early Stage Testicular Cancer: AUA GuidelineJournal of Urology, VOL. 202, NO. 2, (272-281), Online publication date: 1-Aug-2019.Rud C, Daugaard G, Rajpert-De Meyts E, Skakkebæk N, Petersen J and Jørgensen N (2013) Sperm Concentration, Testicular Volume and Age Predict Risk of Carcinoma In Situ in Contralateral Testis of Men with Testicular Germ Cell CancerJournal of Urology, VOL. 190, NO. 6, (2074-2080), Online publication date: 1-Dec-2013.LINKE J, LOY V and DIECKMANN K (2018) PREVALENCE OF TESTICULAR INTRAEPITHELIAL NEOPLASIA IN HEALTHY MALESJournal of Urology, VOL. 173, NO. 5, (1577-1579), Online publication date: 1-May-2005.TABERNERO J, PAZ-ARES L, SALAZAR R, LIANES P, GUERRA J, BORRÁS J, VILLAVICENCIO H, LEIVA O and CORTÉS-FUNES H (2018) Incidence of Contralateral Germ Cell Testicular Tumors in South Europe:: Report of the Experience at 2 Spanish University Hospitals and Review of the LiteratureJournal of Urology, VOL. 171, NO. 1, (164-167), Online publication date: 1-Jan-2004.DIECKMANN K, SOUCHON R, HAHN E and LOY V (2018) FALSE-NEGATIVE BIOPSIES FOR TESTICULAR INTRAEPITHELIAL NEOPLASIAJournal of Urology, VOL. 162, NO. 2, (364-368), Online publication date: 1-Aug-1999. Volume 160Issue 4October 1998Page: 1353-1357 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information S.J. HARLAND More articles by this author P.A. COOK More articles by this author S.D. FOSSA More articles by this author A. HORWICH More articles by this author G.M. MEAD More articles by this author M.C. PARKINSON More articles by this author J.T. ROBERTS More articles by this author S.P. STENNING More articles by this author Expand All Advertisement PDF downloadLoading ...