Testes Cancer

Dr. Kenneth Lim

Urology – MSU-COM

POH McLaren Medical Center

Testes Cancer

Most common solid tumor in 20s High cure rate Delay in diagnosis due to fear,

ignorance, failure for self examination Presentation – painless testicular

mass

Testes Cancer -Treatment

Cure milestones – 2 and 5 years Surveillance protocols – reliabilty Serum markers – use to justify treatment Surgery(RPLND) – diagnostic and

therapeutic Chemotherapy – must weigh therapeutic

advantage vs. salvage cure rate

Testes Ca

1% -Benign Non-Germ Cell (5-10%)

Leydig cellSertoli cell

Germ Cell (90-95%)SeminomaNon-seminoma

Testes Ca - Epidemiology

1. Age 0-10 20-30 25-35 30-40 >50

Histology Yolk sac tumor Choriocarcinoma Mixed – E,T, TC Seminoma Lymphoma

Risk factors for Testes Ca

Cryptorchidism HIV infections Intratubular Germ Cell Neoplasia Gonadal dysgenesis with Y

chromosome

Staging

Tumor markersAFP, HCG, LDH

Chest, Abdominal, Pelvic CT Scan Brain Scan

Testes Ca 5 Year Survival

Stage Risk Status

I - IIA / IIB - Good IIC / III

Intemed Poor

Seminoma Nonsem >98 >98 >95 >95 86 92 72 80 48

Surgery for Testes Ca

Radical Orchiectomy Retroperitoneal Lymph Node

Dissection (RPLND)

Radiation Therapy

Retroperitoneal Templates

Testes Ca – Chemotherapy for NSGCT

Bleomycin Etoposide Cisplatin