Urology Medical News about testicular germ cell cancer;control of contralateral testicular intraepithelial neoplasia

Become a Member Today!
Register

Most Viewed Abstracts

1. Report Shows Shift in Starting Salaries for Physicians

2. 2008 Exclusive Survey—Earnings: Good news for primary care income

3. Medicare pay-for-reporting effort draws fire from frustrated doctors

4. Debunking Myths in the US Healthcare System

5. Doctors and the DEA Free full text

Your Article Summary

See Latest Articles

(Click the title below to leave the MDLinx Network and go to the Journal's Website)

Chemotherapy is of limited efficacy in the control of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell cancer
Oncology (Karger), 05/15/09

Kleinschmidt K et al. - In a trial to assess the use of chemotherapy in the control of contralateral testicular intraepithelial neoplasia in pts with testicular germ cell cancer, chemotherapy was shown to be of little effect in eradicating testicular intraepithelial neoplasia (TIN). Failure rate of 64% is much higher than reported previously. As the majority of failing cases had received carboplatin single-agent therapy or adjuvant platin, etoposide, bleomycin (PEB) therapy with 2 cycles, it may be speculated that the efficacy of chemotherapy regarding TIN clearance is dose dependent. Multidrug regimens appear to be more efficacious than single-agent therapy. As spermatogenesis is only incompletely eliminated by chemotherapy, it is postulated that chemotherapy does no more than temporarily suppress TIN, while only selected cases are cleared of the lesion. Practically, rebiopsy to look for retained TIN about 2 years after completion of chemotherapy is valuable.

Methods

11 pts with unilateral testicular cancer (5 pure seminoma, 6 nonseminoma) and biopsy-proven contralateral TIN underwent chemotherapy.
4 pts received 2 courses of carboplatin single agent, 4 had 2 courses of platin, etoposide, bleomycin (PEB) treatment and 3 had a full 3-cycle treatment with PEB.
Rebiopsy to look for persistent TIN was performed after a mean interval of 8.8 mos.
Pts were then followed clinically.

Results

5 pts had persistent TIN upon rebiopsy.
Each of the pts failing to chemotherapy had undergone 2 or 3 cycles of the PEB regimen, while 3 had received carboplatin treatment.
2 of the pts with no TIN upon rebiopsy developed invasive testis cancer subsequently.
7 of 11 pts failed to chemotherapy (64%).
3 pts had complete absence of spermatogenesis upon rebiopsy histologically, while the remaining cases showed various forms of spermatogenetic arrest.
3 of the failing pts were rescued by local radiotherapy, 4 pts underwent partial orchidectomy followed by local radiotherapy.

<< Previous
C-reactive protein haplotype is associated with high PSA as a...

Next >>
Prostate Specific Antigen Half-Time and Prostate Specific Antigen...