Testicular cancer natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
==Germ cell testicular tumor== | ===Germ cell testicular tumor=== | ||
===Seminoma=== | ====Seminoma==== | ||
*Seminoma tends to occur in middle aged people | *Seminoma tends to occur in middle aged people | ||
*Rarely metastasize<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | *Rarely metastasize<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | ||
*Affects people in their 15 and 35 years old | *Affects people in their 15 and 35 years old | ||
===Embryonal Carcinoma=== | ====Embryonal Carcinoma==== | ||
*Median age is 30 years old<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | *Median age is 30 years old<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | ||
*Has most of the component of mixed non seminoma germ tumor<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | *Has most of the component of mixed non seminoma germ tumor<ref name="pmid26612222">{{cite journal |vauthors=Howitt BE, Berney DM |title=Tumors of the Testis: Morphologic Features and Molecular Alterations |journal=Surg Pathol Clin |volume=8 |issue=4 |pages=687–716 |date=December 2015 |pmid=26612222 |doi=10.1016/j.path.2015.07.007 |url=}}</ref> | ||
*Tend to metastasize early to lungs, retroperitomeun, and liver<ref name="pmid19066212">{{cite journal |vauthors=Ishida M, Hasegawa M, Kanao K, Oyama M, Nakajima Y |title=Non-palpable testicular embryonal carcinoma diagnosed by ultrasound: a case report |journal=Jpn. J. Clin. Oncol. |volume=39 |issue=2 |pages=124–6 |date=February 2009 |pmid=19066212 |doi=10.1093/jjco/hyn141 |url=}}</ref> | *Tend to metastasize early to lungs, retroperitomeun, and liver<ref name="pmid19066212">{{cite journal |vauthors=Ishida M, Hasegawa M, Kanao K, Oyama M, Nakajima Y |title=Non-palpable testicular embryonal carcinoma diagnosed by ultrasound: a case report |journal=Jpn. J. Clin. Oncol. |volume=39 |issue=2 |pages=124–6 |date=February 2009 |pmid=19066212 |doi=10.1093/jjco/hyn141 |url=}}</ref> | ||
===Choriocarcinoma=== | ====Choriocarcinoma==== | ||
*Patient presents with early symptoms if there are metastatic lesions<ref name="pmid26504875">{{cite journal |vauthors=Lowe K, Paterson J, Armstrong S, Walsh S, Groome M, Mowat C |title=Metastatic Testicular Choriocarcinoma: A Rare Cause of Upper GI Bleeding |journal=ACG Case Rep J |volume=3 |issue=1 |pages=36–8 |date=October 2015 |pmid=26504875 |pmc=4612755 |doi=10.14309/crj.2015.94 |url=}}</ref> | *Patient presents with early symptoms if there are metastatic lesions<ref name="pmid26504875">{{cite journal |vauthors=Lowe K, Paterson J, Armstrong S, Walsh S, Groome M, Mowat C |title=Metastatic Testicular Choriocarcinoma: A Rare Cause of Upper GI Bleeding |journal=ACG Case Rep J |volume=3 |issue=1 |pages=36–8 |date=October 2015 |pmid=26504875 |pmc=4612755 |doi=10.14309/crj.2015.94 |url=}}</ref> | ||
*Early metastasis through hematogenous route | *Early metastasis through hematogenous route | ||
*Tends to metastasize to lungs, brain, liver, peritoneum, and others | *Tends to metastasize to lungs, brain, liver, peritoneum, and others | ||
*Affects most male patients in the second and third decade of their life<ref name="pmid20057969">{{cite journal |vauthors=Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH |title=Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy |journal=Cancer Res Treat |volume=41 |issue=4 |pages=229–32 |date=December 2009 |pmid=20057969 |pmc=2802842 |doi=10.4143/crt.2009.41.4.229 |url=}}</ref> | *Affects most male patients in the second and third decade of their life<ref name="pmid20057969">{{cite journal |vauthors=Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH |title=Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy |journal=Cancer Res Treat |volume=41 |issue=4 |pages=229–32 |date=December 2009 |pmid=20057969 |pmc=2802842 |doi=10.4143/crt.2009.41.4.229 |url=}}</ref> | ||
===Yolk Sac tumor=== | ====Yolk Sac tumor==== | ||
*Mostly seen in children less than 2 years old<ref name="pmid8127257">{{cite journal |vauthors=Coppes MJ, Rackley R, Kay R |title=Primary testicular and paratesticular tumors of childhood |journal=Med. Pediatr. Oncol. |volume=22 |issue=5 |pages=329–40 |date=1994 |pmid=8127257 |doi= |url=}}</ref> | *Mostly seen in children less than 2 years old<ref name="pmid8127257">{{cite journal |vauthors=Coppes MJ, Rackley R, Kay R |title=Primary testicular and paratesticular tumors of childhood |journal=Med. Pediatr. Oncol. |volume=22 |issue=5 |pages=329–40 |date=1994 |pmid=8127257 |doi= |url=}}</ref> | ||
*Patients are usually asymptomatic at onset<ref name="pmid25547829">{{cite journal |vauthors=Wei Y, Wu S, Lin T, He D, Li X, Liu J, Liu X, Hua Y, Lu P, Wei G |title=Testicular yolk sac tumors in children: a review of 61 patients over 19 years |journal=World J Surg Oncol |volume=12 |issue= |pages=400 |date=December 2014 |pmid=25547829 |pmc=4326497 |doi=10.1186/1477-7819-12-400 |url=}}</ref> | *Patients are usually asymptomatic at onset<ref name="pmid25547829">{{cite journal |vauthors=Wei Y, Wu S, Lin T, He D, Li X, Liu J, Liu X, Hua Y, Lu P, Wei G |title=Testicular yolk sac tumors in children: a review of 61 patients over 19 years |journal=World J Surg Oncol |volume=12 |issue= |pages=400 |date=December 2014 |pmid=25547829 |pmc=4326497 |doi=10.1186/1477-7819-12-400 |url=}}</ref> | ||
*Tends to have elevated alpha fetoproteins (AFP) | *Tends to have elevated alpha fetoproteins (AFP) | ||
===Spermatocytic tumor=== | ====Spermatocytic tumor==== | ||
*Seen in old men | *Seen in old men | ||
*Barely metastasize<ref name="pmid9227931">{{cite journal |vauthors=Bosl GJ, Motzer RJ |title=Testicular germ-cell cancer |journal=N. Engl. J. Med. |volume=337 |issue=4 |pages=242–53 |date=July 1997 |pmid=9227931 |doi=10.1056/NEJM199707243370406 |url=}}</ref> | *Barely metastasize<ref name="pmid9227931">{{cite journal |vauthors=Bosl GJ, Motzer RJ |title=Testicular germ-cell cancer |journal=N. Engl. J. Med. |volume=337 |issue=4 |pages=242–53 |date=July 1997 |pmid=9227931 |doi=10.1056/NEJM199707243370406 |url=}}</ref> | ||
==Sex cord stromal testicular tumor== | ===Sex cord stromal testicular tumor=== | ||
===Leydig cell tumor=== | ====Leydig cell tumor==== | ||
*Seen mostly in any age | *Seen mostly in any age | ||
*Benign in boys aged 5 to 10 years old and malignant in adults aged 30 to 60 years old<ref name="pmid17284120">{{cite journal |vauthors=Al-Agha OM, Axiotis CA |title=An in-depth look at Leydig cell tumor of the testis |journal=Arch. Pathol. Lab. Med. |volume=131 |issue=2 |pages=311–7 |date=February 2007 |pmid=17284120 |doi=10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2 |url=}}</ref> | *Benign in boys aged 5 to 10 years old and malignant in adults aged 30 to 60 years old<ref name="pmid17284120">{{cite journal |vauthors=Al-Agha OM, Axiotis CA |title=An in-depth look at Leydig cell tumor of the testis |journal=Arch. Pathol. Lab. Med. |volume=131 |issue=2 |pages=311–7 |date=February 2007 |pmid=17284120 |doi=10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2 |url=}}</ref> | ||
===Sertoli cell tumor=== | ====Sertoli cell tumor==== | ||
===Granulosa cell tumor=== | ====Granulosa cell tumor==== | ||
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{| style="cellpadding=0; cellspacing= 0; width: 600px;" | {| style="cellpadding=0; cellspacing= 0; width: 600px;" | ||
|- | |- | ||
! style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align="center" |'''Stage'''!! style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align="center" | '''5-year relative survival (%), (2004-2010)''' | |||
|- | |- | ||
! style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |'''All stages''' | |||
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |95.3% | |||
|- | |- | ||
! style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |'''Localized''' | |||
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |99.2% | |||
|- | |- | ||
! style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |'''Regional''' | |||
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |96% | |||
|- | |- | ||
! style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |'''Distant''' | |||
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |73.1% | |||
|- | |- | ||
! style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |'''Unstaged''' | |||
| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align="left" |78.8% | |||
|} | |} | ||
Revision as of 02:39, 21 May 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2],Rim Halaby, M.D. [3] Shanshan Cen, M.D. [4]
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Overview
Prognosis of testicular cancer is generally good, and the 5-year survival rate is approximately 96.6% (2004-2010).Common complications of testicular cancer include metastasis, bleeding, infection, and infertility.
Natural History
Germ cell testicular tumor
Seminoma
- Seminoma tends to occur in middle aged people
- Rarely metastasize[1]
- Affects people in their 15 and 35 years old
Embryonal Carcinoma
- Median age is 30 years old[1]
- Has most of the component of mixed non seminoma germ tumor[1]
- Tend to metastasize early to lungs, retroperitomeun, and liver[2]
Choriocarcinoma
- Patient presents with early symptoms if there are metastatic lesions[3]
- Early metastasis through hematogenous route
- Tends to metastasize to lungs, brain, liver, peritoneum, and others
- Affects most male patients in the second and third decade of their life[4]
Yolk Sac tumor
- Mostly seen in children less than 2 years old[5]
- Patients are usually asymptomatic at onset[6]
- Tends to have elevated alpha fetoproteins (AFP)
Spermatocytic tumor
- Seen in old men
- Barely metastasize[7]
Sex cord stromal testicular tumor
Leydig cell tumor
- Seen mostly in any age
- Benign in boys aged 5 to 10 years old and malignant in adults aged 30 to 60 years old[8]
Sertoli cell tumor
Granulosa cell tumor
Complications
Common complications of testicular cancer include:
- Abdomen
- Lungs
- Retroperitoneal area
- Brain
- Post-surgery complications
Prognosis
- Between 2004 and 2010, the 5-year relative survival of patients with testicular cancer was 96.6%.[9]
- When stratified by age, the 5-year relative survival of patients with testicular cancer was 95.4% and 86.4% for patients <65 and ≥ 65 years of age respectively.[9]
- The survival of patients with testicular cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of testicular cancer:[9]
| Stage | 5-year relative survival (%), (2004-2010) |
|---|---|
| All stages | 95.3% |
| Localized | 99.2% |
| Regional | 96% |
| Distant | 73.1% |
| Unstaged | 78.8% |
- Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of testicular cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[9]
References
- ↑ 1.0 1.1 1.2 Howitt BE, Berney DM (December 2015). "Tumors of the Testis: Morphologic Features and Molecular Alterations". Surg Pathol Clin. 8 (4): 687–716. doi:10.1016/j.path.2015.07.007. PMID 26612222.
- ↑ Ishida M, Hasegawa M, Kanao K, Oyama M, Nakajima Y (February 2009). "Non-palpable testicular embryonal carcinoma diagnosed by ultrasound: a case report". Jpn. J. Clin. Oncol. 39 (2): 124–6. doi:10.1093/jjco/hyn141. PMID 19066212.
- ↑ Lowe K, Paterson J, Armstrong S, Walsh S, Groome M, Mowat C (October 2015). "Metastatic Testicular Choriocarcinoma: A Rare Cause of Upper GI Bleeding". ACG Case Rep J. 3 (1): 36–8. doi:10.14309/crj.2015.94. PMC 4612755. PMID 26504875.
- ↑ Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH (December 2009). "Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy". Cancer Res Treat. 41 (4): 229–32. doi:10.4143/crt.2009.41.4.229. PMC 2802842. PMID 20057969.
- ↑ Coppes MJ, Rackley R, Kay R (1994). "Primary testicular and paratesticular tumors of childhood". Med. Pediatr. Oncol. 22 (5): 329–40. PMID 8127257.
- ↑ Wei Y, Wu S, Lin T, He D, Li X, Liu J, Liu X, Hua Y, Lu P, Wei G (December 2014). "Testicular yolk sac tumors in children: a review of 61 patients over 19 years". World J Surg Oncol. 12: 400. doi:10.1186/1477-7819-12-400. PMC 4326497. PMID 25547829.
- ↑ Bosl GJ, Motzer RJ (July 1997). "Testicular germ-cell cancer". N. Engl. J. Med. 337 (4): 242–53. doi:10.1056/NEJM199707243370406. PMID 9227931.
- ↑ Al-Agha OM, Axiotis CA (February 2007). "An in-depth look at Leydig cell tumor of the testis". Arch. Pathol. Lab. Med. 131 (2): 311–7. doi:10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2. PMID 17284120.
- ↑ 9.0 9.1 9.2 9.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.