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Epidemiology, Risk Factors, and Histopathology in Testicular Cancer

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Urologic Oncology

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Abstract

Though germ cell tumor of the testis (GCT) is rare in general, it is the most common cancer of man aged 20–45 years. It is more common in Europe and the United States with an increase in northern parts. Since the introduction of platinum-based chemotherapy, cure rates are excellent, also in metastasized patients.

The most important and validated risk factors for GCT are history of a contralateral tumor, cryptorchidism, genetic predisposition, infertility, or height.

Accurate pathological diagnostic is mandatory for a correct staging and therapy recommendation according to the current WHO and TNM classification. Metastasized patients should be risk stratified by the IGCCCG classification which influences the therapy. Therefore, this chapter will provide information concerning the basic pathologic work-up and information about different types of GCT.

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References

  • Abratt RP, Reddi VB, Sarembock LA. Testicular cancer and cryptorchidism. Br J Urol. 1992;70(6):656–9.

    Article  CAS  PubMed  Google Scholar 

  • Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP, Nicolai N, Oldenburg J. EAU Guidelines Office, Arnhem, The Netherlands; 2018.

    Google Scholar 

  • Banerji JS, Odem-Davis K, Wolff EM, Nichols CR, Porter CR. Patterns of care and survival outcomes for malignant sex cord stromal testicular cancer: results from the National Cancer Data Base. J Urol. 2016;196(4):1117–22.

    Article  PubMed  Google Scholar 

  • Banks K, Tuazon E, Berhane K, Koh CJ, De Filippo RE, Chang A, et al. Cryptorchidism and testicular germ cell tumors: comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics. Front Endocrinol (Lausanne). 2012;3:182.

    Google Scholar 

  • Batata MA, Chu FC, Hilaris BS, Whitmore WF, Golbey RB. Testicular cancer in cryptorchids. Cancer. 1982;49(5):1023–30.

    Article  CAS  PubMed  Google Scholar 

  • Brierley JD, Gospodarowicz MK, Wittekind C. The TNM classification of malignant tumours. 8th ed. UICC, Oxford UK and Hoboken, NJ, USA Wiley; 2016.

    Google Scholar 

  • Callaghan RC, Allebeck P, Akre O, McGlynn KA, Sidorchuk A. Cannabis use and incidence of testicular cancer: a 42-year follow-up of Swedish Men between 1970 and 2011. Cancer Epidemiol Biomark Prev. 2017;26(11):1644–52.

    Article  CAS  Google Scholar 

  • Chan E, Wayne C, Nasr A, Resource FfCAoPSE-B. Ideal timing of orchiopexy: a systematic review. Pediatr Surg Int. 2014;30(1):87–97.

    Article  PubMed  Google Scholar 

  • Cook MB, Akre O, Forman D, Madigan MP, Richiardi L, McGlynn KA. A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer--experiences of the son. Int J Epidemiol. 2010;39(6):1605–18.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dieckmann KP, Hartmann JT, Classen J, Ludde R, Diederichs M, Pichlmeier U. Tallness is associated with risk of testicular cancer: evidence for the nutrition hypothesis. Br J Cancer. 2008;99(9):1517–21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Einhorn LH, Donohue J. Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med. 1977;87(3):293–8.

    Article  CAS  PubMed  Google Scholar 

  • Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.

    Article  CAS  PubMed  Google Scholar 

  • Force USPST. Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2011;154(7):483–6.

    Article  Google Scholar 

  • Ghazarian AA, Trabert B, Graubard BI, Schwartz SM, Altekruse SF, McGlynn KA. Incidence of testicular germ cell tumors among US men by census region. Cancer. 2015;121(23):4181–9.

    Article  PubMed  Google Scholar 

  • Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, et al. American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol. 2010;28(20):3388–404.

    Article  CAS  PubMed  Google Scholar 

  • Giwercman A, Grindsted J, Hansen B, Jensen OM, Skakkebaek NE. Testicular cancer risk in boys with maldescended testis: a cohort study. J Urol. 1987;138(5):1214–6.

    Article  CAS  PubMed  Google Scholar 

  • Greene MH, Mai PL, Loud JT, Pathak A, Peters JA, Mirabello L, et al. Familial testicular germ cell tumors (FTGCT) – overview of a multidisciplinary etiologic study. Andrology. 2015;3(1):47–58.

    Article  CAS  PubMed  Google Scholar 

  • Gurney J, Shaw C, Stanley J, Signal V, Sarfati D. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer. 2015;15:897.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Harland SJ, Cook PA, Fossa SD, Horwich A, Parkinson MC, Roberts JT, et al. Risk factors for carcinoma in situ of the contralateral testis in patients with testicular cancer. An interim report. Eur Urol. 1993;23(1):115–8. discussion 9

    Article  CAS  PubMed  Google Scholar 

  • Hasle H, Friedman JM, Olsen JH, Rasmussen SA. Low risk of solid tumors in persons with Down syndrome. Genet Med. 2016;18(11):1151–7.

    Article  PubMed  Google Scholar 

  • Hoffmann R, Plug I, McKee M, Khoshaba B, Westerling R, Looman C, et al. Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005. Int J Public Health. 2014;59(2):341–50.

    Article  PubMed  Google Scholar 

  • Kharazmi E, Hemminki K, Pukkala E, Sundquist K, Tryggvadottir L, Tretli S, et al. Cancer risk in relatives of testicular cancer patients by histology type and age at diagnosis: a joint study from five nordic countries. Eur Urol. 2015;68(2):283–9.

    Article  PubMed  Google Scholar 

  • Kvammen O, Myklebust TA, Solberg A, Moller B, Klepp OH, Fossa SD, et al. Long-term relative survival after diagnosis of testicular germ cell tumor. Cancer Epidemiol Biomark Prev. 2016;25(5):773–9.

    Article  CAS  Google Scholar 

  • La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P, et al. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol. 2010;21(6):1323–60.

    Article  PubMed  Google Scholar 

  • Latif T, Kold Jensen T, Mehlsen J, Holmboe SA, Brinth L, Pors K, et al. Semen Quality as a predictor of subsequent morbidity: a Danish cohort study of 4,712 men with long-term follow-up. Am J Epidemiol. 2017;186(8):910–7.

    Article  PubMed  Google Scholar 

  • Le Cornet C, Lortet-Tieulent J, Forman D, Beranger R, Flechon A, Fervers B, et al. Testicular cancer incidence to rise by 25% by 2025 in Europe? Model-based predictions in 40 countries using population-based registry data. Eur J Cancer. 2014;50(4):831–9.

    Article  PubMed  Google Scholar 

  • Lerro CC, McGlynn KA, Cook MB. A systematic review and meta-analysis of the relationship between body size and testicular cancer. Br J Cancer. 2010;103(9):1467–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lip SZ, Murchison LE, Cullis PS, Govan L, Carachi R.A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life. Arch Dis Child. 2013;98(1):20–6.

    Article  PubMed  Google Scholar 

  • Litchfield K, Shipley J, Turnbull C. Common variants identified in genome-wide association studies of testicular germ cell tumour: an update, biological insights and clinical application. Andrology. 2015;3(1):34–46.

    Article  CAS  PubMed  Google Scholar 

  • Mai PL, Friedlander M, Tucker K, Phillips KA, Hogg D, Jewett MA, et al. The International Testicular Cancer Linkage Consortium: a clinicopathologic descriptive analysis of 461 familial malignant testicular germ cell tumor kindred. Urol Oncol. 2010;28(5):492–9.

    Article  PubMed  Google Scholar 

  • Mead GM, Stenning SP. The International Germ Cell Consensus Classification: a new prognostic factor-based staging classification for metastatic germ cell tumours. Clin Oncol (R Coll Radiol). 1997;9(4):207–9.

    Article  CAS  Google Scholar 

  • Moch H, Humphrey PA, Ulbright TM, Reuter V. WHO classification of tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer; 2016a.

    Google Scholar 

  • 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. Eur Urol. 2016b;70(1):93–105.

    Article  PubMed  Google Scholar 

  • Moller H, Prener A, Skakkebaek NE. Testicular cancer, cryptorchidism, inguinal hernia, testicular atrophy, and genital malformations: case-control studies in Denmark. Cancer Causes Control. 1996;7(2):264–74.

    Article  CAS  PubMed  Google Scholar 

  • Nigam M, Aschebrook-Kilfoy B, Shikanov S, Eggener S. Increasing incidence of testicular cancer in the United States and Europe between 1992 and 2009. World J Urol. 2015;33(5):623–31.

    Article  PubMed  Google Scholar 

  • Olesen IA, Andersson AM, Aksglaede L, Skakkebaek NE, Rajpert-de Meyts E, Joergensen N, et al. Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility. Fertil Steril. 2017;107(1):74–82 e7.

    Article  PubMed  Google Scholar 

  • Patel KV, Navaratne S, Bartlett E, Clarke JL, Muir GH, Sellars ME, et al. Testicular microlithiasis: is sonographic surveillance necessary? Single centre 14 year experience in 442 patients with testicular microlithiasis. Ultraschall Med. 2016;37(1):68–73.

    CAS  PubMed  Google Scholar 

  • Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835–41.

    Article  CAS  PubMed  Google Scholar 

  • Raman JD, Nobert CF, Goldstein M. Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis. J Urol. 2005;174(5):1819–22. discussion 22

    Article  PubMed  Google Scholar 

  • Richenberg J, Belfield J, Ramchandani P, Rocher L, Freeman S, Tsili AC, et al. Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee. Eur Radiol. 2015;25(2):323–30.

    Article  PubMed  Google Scholar 

  • RKI. Krebs in Deutschland 2013/2014. Berlin: Robert Koch-Institut; 2017.

    Google Scholar 

  • Rosen A, Jayram G, Drazer M, Eggener SE. Global trends in testicular cancer incidence and mortality. Eur Urol. 2011;60(2):374–9.

    Article  PubMed  Google Scholar 

  • Rovito MJ, Cavayero C, Leone JE, Harlin S. Interventions Promoting Testicular Self-Examination (TSE) performance: a systematic review. Am J Mens Health. 2015;9(6):506–18.

    Article  PubMed  Google Scholar 

  • Ruf CG, Isbarn H, Wagner W, Fisch M, Matthies C, Dieckmann KP. Changes in epidemiologic features of testicular germ cell cancer: age at diagnosis and relative frequency of seminoma are constantly and significantly increasing. Urol Oncol. 2014;32(1):33 e1–6.

    Article  Google Scholar 

  • Saab MM, Landers M, Hegarty J. Promoting testicular cancer awareness and screening: a systematic review of interventions. Cancer Nurs. 2016;39(6):473–87.

    Article  PubMed  Google Scholar 

  • Skakkebaek NE. Testicular dysgenesis syndrome: new epidemiological evidence. Int J Androl. 2004;27(4):189–91.

    Article  PubMed  Google Scholar 

  • 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. Urol Int. 2015;95(2):160–6.

    Article  PubMed  Google Scholar 

  • Strohsnitter WC, Noller KL, Hoover RN, Robboy SJ, Palmer JR, Titus-Ernstoff L, et al. Cancer risk in men exposed in utero to diethylstilbestrol. J Natl Cancer Inst. 2001;93(7):545–51.

    Article  CAS  PubMed  Google Scholar 

  • Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH. Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults: a meta-analysis and systematic review. Cancer. 2010;116(19):4520–32.

    Article  PubMed  Google Scholar 

  • Trabert B, Chen J, Devesa SS, Bray F, McGlynn KA. International patterns and trends in testicular cancer incidence, overall and by histologic subtype, 1973-2007. Andrology. 2015;3(1):4–12.

    Article  CAS  PubMed  Google Scholar 

  • Ulbright TM, Tickoo SK, Berney DM, Srigley JR. Members of the IIiDUPG. Best practices recommendations in the application of immunohistochemistry in testicular tumors: report from the International Society of Urological Pathology consensus conference. Am J Surg Pathol. 2014;38(8):e50–9.

    Article  PubMed  Google Scholar 

  • van Casteren NJ, Looijenga LH, Dohle GR. Testicular microlithiasis and carcinoma in situ overview and proposed clinical guideline. Int J Androl. 2009;32(4):279–87.

    Article  PubMed  Google Scholar 

  • Wang T, Liu L, Luo J, Liu T, Wei A. A meta-analysis of the relationship between testicular microlithiasis and incidence of testicular cancer. Urol J. 2015;12(2):2057–64.

    PubMed  Google Scholar 

  • Williamson SR, Delahunt B, Magi-Galluzzi C, Algaba F, Egevad L, Ulbright TM, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017;70(3):335–46.

    Article  PubMed  Google Scholar 

  • Znaor A, Lortet-Tieulent J, Jemal A, Bray F. International variations and trends in testicular cancer incidence and mortality. Eur Urol. 2014;65(6):1095–106.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University Hospital Cologne, Cologne, Germany

    Tim Nestler

  2. Department of Urology, BwZK – Federal Armed Services Hospital Koblenz, Koblenz, Germany

    Tim Nestler & Hans Schmelz

Authors
  1. Tim Nestler
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  2. Hans Schmelz
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Corresponding authors

Correspondence to Tim Nestler or Hans Schmelz .

Editor information

Editors and Affiliations

  1. Urologie, Univ Lübeck, Lübeck, Schleswig-Holstein, Germany

    Axel Merseburger

  2. Dept. of Urology, University of Regensburg St. Josef Medical Centre, Regensburg, Germany

    Maximilian Burger

Section Editor information

  1. Universitätsklinikum Rostock , Urologische Klinik und Poliklinik, Rostock, Germany

    Chris Protzel

  2. Division of Oncological Urology, Department of Urology, University of Köln, Köln, Germany

    Axel Heidenreich

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Nestler, T., Schmelz, H. (2019). Epidemiology, Risk Factors, and Histopathology in Testicular Cancer. In: Merseburger, A., Burger, M. (eds) Urologic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42603-7_1-1

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  • DOI: https://doi.org/10.1007/978-3-319-42603-7_1-1

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