Testicular germ cell tumors and human immunodeficiency virus infection: a report of 26 cases. Italian Cooperative Group on AIDS and Tumors.

PURPOSE Besides tumors that are diagnostic of AIDS, such as non-Hodgkin's lymphoma, Kaposi's sarcoma, and invasive carcinoma of the cervix, other tumors have been described in the human immunodeficiency virus (HIV) setting. Some case reports on testicular cancer in HIV-infected patients have appeared in the literature. We present a retrospective study on 26 cases of testicular germ cell tumors (TGCTs) observed within the Italian Cooperative Group on AIDS and Tumors (GICAT) between November 1986 and September 1994. PATIENTS AND METHODS Twenty-six patients with TGCT and HIV-infection from the GICAT were retrospectively analyzed. RESULTS Fourteen patients had seminoma and 12 had nonseminoma. Four patients underwent only orchidectomy, one patient received only chemotherapy, nine patients were treated with postsurgical chemotherapy, 10 patients (38%) received postsurgical radiotherapy, one patient received postsurgical chemotherapy plus radiotherapy, and one patient was lost for follow-up evaluation immediately after diagnosis. The complete response (CR) rate was 95%. Relapse occurred in 32% of patients. The median follow-up time was 33 months. The mortality rate was 37%. Causes of death were neoplasia in three of nine patients, AIDS in five of nine patients, and fortuitous event in one of nine patients. The overall 3-year survival rate was 65%, and the 3-year disease-free survival rate was 65%. Severe hematologic toxicity was observed in seven of 15 patients. CONCLUSION HIV-infected patients with testicular cancer should be offered standard oncologic therapy, irrespective of their HIV status, since the majority can be cured of their tumor and have a good quality of life. Use of concomitant prophylaxis for opportunistic infections is recommended.

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Testicular germ cell tumors in patients with human immunodeficiency virus infection

Cancer ◽

10.1002/(sici)1097-0142(19960515)77:10<2109::aid-cncr22>3.0.co;2-y ◽

1996 ◽

Vol 77 (10) ◽

pp. 2109-2116 ◽

Cited By ~ 30

Author(s):

Marcus U. Hentrich ◽

Norbert G. Brack ◽

Peter Schmid ◽

Tobias Schuster ◽

Christoph Clemm ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Germ Cell ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Immunodeficiency Virus

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Importance of a new tumor market TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors

Annals of Surgical Oncology ◽

10.1007/bf02303582 ◽

1997 ◽

Vol 4 (4) ◽

pp. 321-327 ◽

Cited By ~ 15

Author(s):

Mariël E. Gels ◽

Jan Marrink ◽

Petra Visser ◽

Dirk Th. Sleijfer ◽

Jos H. J. Droste ◽

...

Keyword(s):

Germ Cell ◽

Clinical Stage ◽

Germ Cell Tumors ◽

Stage I ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell

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Evidence for Altered Hypothalamic-Hypophyseal-Gonadal Axis in Untreated Patients with Testicular Germ-Cell Tumor

Tumori Journal ◽

10.1177/030089168907500523 ◽

1989 ◽

Vol 75 (5) ◽

pp. 505-509

Author(s):

Sergio Crispino ◽

Gabriele Tancini ◽

Sandro Barni ◽

Paolo Lissoni

Keyword(s):

Testicular Cancer ◽

Germ Cell ◽

Germ Cell Tumor ◽

Venous Blood ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Significant Difference

To investigate the function of the hypothalamic-hypophyseal-gonadal axis in testicular germ cell tumors, we evaluated gonadotropin responses to gonadotropin-releasing hormone (GnRH) in 12 untreated patients with testicular cancer (5 seminomas and 7 non-seminomas). GnRH was given i.v. at a dose of 100 μg as a bolus, and venous blood samples were collected at 0, 20, 60, and 120 min. As controls, 14 healthy males were studied. Basal levels of testosterone, estradiol and prolactin were also detected in each patient. Hormonal serum concentrations were measured by the radioimmunoassay. Mean basal testosterone, estradiol and prolactin levels were not significantly different from those of controls. Patients had a lower FSH and LH peak after GnRH than controls, without, however, any significant difference. As regards histology, nonseminoma patients lacked an FSH response to GnRH and had statistically lower mean peak levels than controls. Moreover, non-seminoma patients had statistically lower mean peak values of LH after GnRH than controls. These data show that patients with testicular germ cell tumor, and more particularly those with non-seminomas, have an altered function of the hypothalamic-hypophyseal-gonadal axis, which is already present prior to therapy. Further studies, particularly in stage I patients treated only with orchiectomy, should be performed to confirm and better define the Physiopathologic significance of the altered hypothalamic-hypophyseal-gonadal axis in testicular cancer and to clarify the alteration of fertility, which is frequently present before treatment.

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☆Corrigendum to “Recommendations for surveillance and follow-up of men with testicular germ cell tumors: A multidisciplinary consensus conference by the Italian Germ cell cancer Group and the Associazione Italiana di Oncologia Medica” [Crit. Rev. Oncol. Hematol. 137 (2019) (May) 154–164]

Critical Reviews in Oncology/Hematology ◽

10.1016/j.critrevonc.2020.102865 ◽

2020 ◽

Vol 146 ◽

pp. 102865

Author(s):

Giuseppe Luigi Banna ◽

Nicola Nicolai ◽

Giovannella Palmieri ◽

Margaret Ottaviano ◽

Luca Balzarini ◽

...

Keyword(s):

Germ Cell ◽

Cell Cancer ◽

Germ Cell Tumors ◽

Consensus Conference ◽

Germ Cell Cancer ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Cancer Group

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Evaluation of Circulating miRNA Biomarkers of Testicular Germ Cell Tumors during Therapy and Follow-up―A Copenhagen Experience

Cancers ◽

10.3390/cancers12030759 ◽

2020 ◽

Vol 12 (3) ◽

pp. 759

Author(s):

Nina Mørup ◽

Ewa Rajpert-De Meyts ◽

Anders Juul ◽

Gedske Daugaard ◽

Kristian Almstrup

Keyword(s):

Germ Cell ◽

Tumor Markers ◽

Germ Cell Tumors ◽

Primary Diagnosis ◽

University Hospital ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Circulating Mirna ◽

Serum Tumor Markers

New microRNA-based serum biomarkers (miRNA-367-3p, -371a-3p, -372-3p, and -373-3p) have shown great potential for the detection of testicular germ cell tumors (TGCTs), but few studies have investigated the clinical utility and performance of these tests in treatment monitoring. In this study, circulating miRNA levels were measured, together with serum tumor markers alpha-fetoprotein (AFP), β-subunit of human chorionic gonadotropin (β-HCG) and lactate dehydrogenase (LDH) in 406 consecutive blood samples obtained during the treatment and follow-up of 52 TGCT patients at the Copenhagen University Hospital. After testing three different methods of RNA isolation from peripheral blood and PCR quantification in a subset of samples (n = 15), the best performing setup of targeted isolation of miRNAs inside and outside exosomes was selected to analyze all samples. At primary diagnosis, the miRNAs significantly outperformed the serum tumor markers, with a sensitivity and specificity of 78% and 100% (based on 40 patients), respectively. The picture was not as clear when patient trajectories were investigated, with both positive and negative signals for miRNAs and serum tumor markers. To establish whether measuring miRNAs adds value beyond the primary diagnosis, large prospective clinical trials comparing miRNAs and classical tumor markers during the treatment and follow-up of TGCT patients are needed.

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Excellent outcomes in bilateral testicular germ cell tumors over four decades.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.523 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 523-523

Author(s):

Ning-Ning Lu ◽

Aaron Richard Hansen ◽

Philippe L. Bedard ◽

Padraig Richard Warde ◽

Joan Sweet ◽

...

Keyword(s):

Testicular Cancer ◽

Germ Cell ◽

Germ Cell Tumors ◽

Patient Characteristics ◽

Stage I ◽

Second Primary ◽

Time Interval ◽

Testicular Germ Cell ◽

Prior Therapy

523 Background: Bilateral testicular germ cell tumours (BTC) form a small minority of testicular cancer and detailed management data are sparse. Methods: Bilateral testicular cancer (BTC) patients managed at a single cancer centre were retrospectively analyzed. Synchronous BTC was defined as uni+contralateral presentation within 3 months. Patient characteristics, treatment and outcomes were collected. Kaplan-Meier method was used to calculate the overall survival (OS) and relapse-free survival (RFS). Results: Between Jan 1971 to Jun 2018, 118 pts were included. Nine patients (7.6%) had cryptorchidism. Twenty-two patients (18.6%) had synchronous BTC at median age of 30(21-54) years, 11 presented with concordant histology (10-seminoma). Median follow-up time was 96(1-220) months. Two of 14 patients (14%) with stage I disease on surveillance had retroperitoneal nodal recurrence, other 3 (21%) had testicular recurrence after partial orchiectomy alone. No recurrence occurred for 8 stage II/III patients (36%) who received stage-appropriate treatment. All patients were alive without disease at last follow-up. For metachronous BTC, the median age was 27(16-68) and 37(19-78) years for first and second diagnosis, respectively. The median time interval was 88 (8-352) months, with shorter interval when second primary was non-seminoma, median 69 vs. 92 months. Concordant histology was present in 58 (38-seminoma) patients and discordant in 38 patients. There were 66, 23, 7 and 84, 9, 3 patients with stage I, II, III disease for first and second testicular cancer (TC), respectively. For all stage I disease, 69% of non-seminoma (n = 33) and 79% of seminoma (n = 81) were on surveillance, of whom the crude relapse rate was 15%. The median follow-up time after second diagnosis was 87 months. In all, 35 patients (30%) with recurrence except 1 were successfully salvaged. The 10-year OS and RFS for whole cohort was 99% and 69.8%, respectively. Conclusions: In our series, seminoma was the more common pathology, and management based on pathology and stage yielded excellent outcomes regardless of prior therapy. Metachronous BTC may occur at extremely long time intervals such that longer follow-up is needed to capture the majority of contralateral primary TC.

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Recommendations for surveillance and follow-up of men with testicular germ cell tumors: a multidisciplinary consensus conference by the Italian Germ cell cancer Group and the Associazione Italiana di Oncologia Medica

Critical Reviews in Oncology/Hematology ◽

10.1016/j.critrevonc.2019.03.006 ◽

2019 ◽

Vol 137 ◽

pp. 154-164 ◽

Cited By ~ 1

Author(s):

Giuseppe Luigi Banna ◽

Nicola Nicolai ◽

Giovannella Palmieri ◽

Margaret Ottaviano ◽

Luca Balzarini ◽

...

Keyword(s):

Germ Cell ◽

Cell Cancer ◽

Germ Cell Tumors ◽

Consensus Conference ◽

Germ Cell Cancer ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Cancer Group

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Clinical characteristics and treatment adherence among men with testicular germ cell tumors: Real-world data from a referral center in Mexico.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.393 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 393-393

Author(s):

Carlos Eduardo Salazar-Mejía ◽

Omar Zayas-Villanueva ◽

Adriana González Gutiérrez ◽

Rolando Jacob Martinez ◽

ABRAHAM GUERRA CEPEDA ◽

...

Keyword(s):

Germ Cell ◽

Median Time ◽

Treatment Adherence ◽

Clinical Characteristics ◽

Germ Cell Tumors ◽

Collaborative Group ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Referral Center

393 Background: Notwithstanding excellent oncological outcomes reported by pivotal trials in patients with testicular germ cell tumors (TGCT), adherence to medical treatment and follow-up remains a major issue in developing countries. Studies that describe the clinical characteristics and treatment adherence of Mexican men with TGCT are lacking. Methods: We performed a retrospective analysis of all men with newly diagnosed TGCT treated at an oncology referral center in Northeast Mexico from 2014 to 2018. Results: In the analysis, 195 patients were included. Median age at diagnosis was 28 years; median time from diagnosis to first evaluation by an oncologist was 26 days. Distribution according to the laterality of the primary tumor was right, 56%; left, 43%; and bilateral, 1%. There were 14 oncological emergencies at presentation; the most frequent was choriocarcinoma syndrome, described in 5 patients. Thirty-five percent of cases were seminomatous germ cell tumors (SGCT) and 65% nonseminomatous germ cell tumors (NSGCT). The clinical stages at diagnosis were I, 36%; IS, 8%; II, 18%; and III, 38%. After risk stratification according to the International Germ Cell Cancer Collaborative Group (IGCCCG), 90% of SGCT had a good risk and 10% an intermediate risk. In NSGCT, the risk distribution was 65, 10, and 25% for good, intermediate, and poor-risk disease, respectively. After proposing treatment, the adherence rate was 81%. Of the total, 58% were lost to medical follow-up with a median time of adherence of 11.5 months. Conclusions: Despite coverage by the Mexican public health insurance system “Seguro Popular”, treatment adherence and medical follow-up abandonment is a problem among men with TGCT, which could negatively impact their prognosis. Measures must be implemented to optimize adherence in this group of patients.

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Multicenter Study of Human Immunodeficiency Virus–Related Germ Cell Tumors

Journal of Clinical Oncology ◽

10.1200/jco.2003.09.107 ◽

2003 ◽

Vol 21 (10) ◽

pp. 1922-1927 ◽

Cited By ~ 36

Author(s):

T. Powles ◽

M. Bower ◽

G. Daugaard ◽

J. Shamash ◽

A. De Ruiter ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Germ Cell ◽

Multicenter Study ◽

Highly Active Antiretroviral Therapy ◽

Germ Cell Tumors ◽

Hiv Treatment ◽

Testicular Germ Cell ◽

Immunodeficiency Virus ◽

Negative Population ◽

Hiv Negative

Purpose: Testicular germ cell tumors (GCT) occur at increased frequency in men with human immunodeficiency virus (HIV). This multicenter study addresses the characteristics of these tumors.Patients and Methods: Patients with HIV-related GCT were identified from six HIV treatment centers. The incidence was calculated from the center with the most complete linked oncology and HIV databases.Results: Thirty-five patients with HIV-related GCT were identified. The median age at GCT diagnosis was 34 years (range, 27 to 64 years). The median CD4 cell count was 315/mm3(range, 90 to 960/mm3) at this time. The histologic classification was seminoma in 26 patients (74%) and nonseminomatous GCT in nine patients (26%). Twenty-one patients (60%) had stage I disease and 14 patients had metastatic disease. Overall six patients relapsed, three died from GCT, and seven died from HIV disease, resulting in a 2-year overall survival rate of 81%. HIV-related seminoma occurred more frequently than in the age- and sex-matched HIV-negative population, with a relative risk of 5.4 (95% confidence interval, 3.35 to 8.10); however, nonseminomatous GCT did not occur more frequently, and there was no change in the incidence of GCT since the introduction of highly active antiretroviral therapy.Conclusion: Testicular seminoma occurs significantly more frequently in HIV-positive men than in the matched control population. Patients with HIV-related GCTs present and should be treated in a similar manner to those in the HIV-negative population. After a median follow-up of 4.6 years, 9% of the patients died from GCT. Most of the mortality relates to HIV infection.

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