[Testicular tumors. Predictive factors].

Der Pathologe
G Mikuz

Abstract

Patients with germ cell tumors of the testis can be given adjuvant treatment immediately after orchidectomy or put under surveillance with definitive treatment deferred until relapse. Both therapies are equally successful (success rate 98-99%), with surveillance alone, however, only approximately 50% of cases need toxic chemotherapy. The surveillance strategy is especially successful in patients with tumors which do not have morphological predictors of metastases. In seminomas the strongest predictor of metastases is tumor invasion of the rete testis followed by the size (Ø > or =4 cm) of the tumor. Vascular invasion, the most important predictor in non-seminomatous germ cell tumors, is less important in seminomas. The second most important predictor in mixed tumors is the presence or absence and the amount of embryonal carcinoma. The presence of teratomas and yolk sac tumors are considered to be predictors of a favorable course of the disease. The statistical impact of these markers is, however, not very strong. The only reliable predictor of malignancy of the gonadal stromal tumors is the size and tumors with a diameter > or =5 cm are always malignant.

References

Apr 6, 2001·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·J AlexandreM J Terrier-Lacombe
Oct 12, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·C ParkerP Warde
Nov 15, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Padraig WardeHans von der Maase
Feb 15, 2005·International Journal of Radiation Oncology, Biology, Physics·Richard ChooSarat Chander
Nov 2, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jorge AparicioUNKNOWN Second Spanish Germ Cell Cancer Cooperative Group
Dec 13, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ronald de Wit, Karim Fizazi
Sep 7, 2007·Virchows Archiv : an International Journal of Pathology·F AlgabaA Lopez-Beltran

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