Testicular cancer: What's new in staging, prognosis, and therapy

Richard S. Foster, Craig R. Nichols

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Improvements in the clinical staging of testicular cancer may permit the identification of clinical stage I patients at low risk of harboring metastatic disease, who could be spared treatment and observed only. Both retrospective, single-institution studies and studies of unselected, consecutive patients have confirmed that vascular invasion, lymphatic invasion, and percentage of embryonal carcinoma are predictive of metastasis in patients with low-stage nonseminoma. Whether patients with these risk factors have a worse outcome if managed with surveillance, rather than with aggressive therapy, is unclear. Low MIB-1 staining (which identifies the Ki-67 antigen) in conjunction with a low percentage of embryonal carcinoma in the testicular specimen appears to be predictive of a low probability of metastasis. Computed tomography (CT) is a useful staging tool. A new prognostic classification system for seminomas and nonseminomas was recently developed by an international consensus conference. Laparoscopic retroperitoneal lymphadenectomy appears to be a feasible staging tool with acceptable short-term morbidity. Whether laparoscopic lymph node dissection is equivalent to the open procedure when used as a therapeutic modality is not yet known. At present, laparoscopy should be used only in selected patients in a study setting. Primary chemotherapy is not recommended currently because it has not yet been proven to be superior in patients with high-risk clinical stage I nonseminoma and can cause significant long-term sequelae.

Original languageEnglish (US)
Pages (from-to)1689-1694
Number of pages6
JournalONCOLOGY
Volume13
Issue number12
StatePublished - Dec 1 1999

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Testicular Neoplasms
Embryonal Carcinoma
Lymph Node Excision
Therapeutics
Ki-67 Antigen
Neoplasm Metastasis
Seminoma
Laparoscopy
Blood Vessels
Tomography
Staining and Labeling
Morbidity
Drug Therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Testicular cancer : What's new in staging, prognosis, and therapy. / Foster, Richard S.; Nichols, Craig R.

In: ONCOLOGY, Vol. 13, No. 12, 01.12.1999, p. 1689-1694.

Research output: Contribution to journalArticle

Foster, RS & Nichols, CR 1999, 'Testicular cancer: What's new in staging, prognosis, and therapy', ONCOLOGY, vol. 13, no. 12, pp. 1689-1694.
Foster, Richard S. ; Nichols, Craig R. / Testicular cancer : What's new in staging, prognosis, and therapy. In: ONCOLOGY. 1999 ; Vol. 13, No. 12. pp. 1689-1694.
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