Asunto(s)
Diagnóstico por Imagen/métodos , Neoplasias de los Genitales Masculinos/diagnóstico , Neoplasias de los Genitales Masculinos/patología , Oncología Médica/métodos , Neoplasias de Células Germinales y Embrionarias/diagnóstico , Neoplasias de Células Germinales y Embrionarias/patología , Neoplasias de la Próstata/diagnóstico , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patología , Adulto , Anciano , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones/métodos , Neoplasias de la Próstata/patología , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodosRESUMEN
Laparoscopic retroperitoneal lymph node dissection (RPLND) is a feasible, minimally invasive procedure for the treatment of testicular cancer patients who require surgery to address the retroperitoneal lymph nodes. We report a case of retroperitoneal recurrent disease including a port-site metastasis secondary to laparoscopic RPLND.
Asunto(s)
Laparoscopía/efectos adversos , Escisión del Ganglio Linfático , Siembra Neoplásica , Neoplasias de Células Germinales y Embrionarias/tratamiento farmacológico , Neoplasias Testiculares/tratamiento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Metástasis Linfática , Masculino , Neoplasias de Células Germinales y Embrionarias/patología , Espacio Retroperitoneal , Neoplasias Testiculares/patología , alfa-Fetoproteínas/análisisRESUMEN
OBJECTIVE: To assess the prevalence of fertility or infertility in men before and after treatment for unilateral testicular cancer. The results were compared with the lifetime prevalence of infertility in the general population (20%-28%). DESIGN: Survey. SETTINGS: University referral center for testicular cancer. PATIENT(S): Two hundred twenty-six patients treated for testicular cancer. INTERVENTION(S): Questionnaire on fertility and fertility-related factors before and after treatment of disease. MAIN OUTCOME MEASURE(S): Prevalence of fertility before and after treatment for testicular cancer. RESULT(S): Before the cancer was diagnosed, 79 (66%) of 120 couples who attempted to conceive succeeded within 1 year. After treatment, 38 (43%) of 88 couples conceived within 1 year. Seven couples used cryopreserved sperm to conceive a child after treatment. The different treatment modalities did not significantly influence the outcome of patients' wish for children. Congenital malformations were recorded in approximately 4% of the children born before or after treatment. CONCLUSION(S): Although the majority of the patients with testicular cancer have a fulfilled wish with regard to children, it seems to be more difficult to father a child after treatment compared with the case in the general population. Because it is not possible to predict which patient will have fertility problems after treatment, cryopreservation should be offered to every testicular cancer patient. An increased risk for congenital malformations was not observed.
Asunto(s)
Fertilidad , Germinoma/fisiopatología , Neoplasias Testiculares/fisiopatología , Adulto , Anciano , Anomalías Congénitas/etiología , Eyaculación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas Reproductivas Asistidas , Conducta SexualRESUMEN
PURPOSE OF REVIEW: In the present review we outline the use of different staging methods and highlight future possibilities in the management of testicular germ cell cancer. RECENT FINDINGS: The 5-year survival for testicular cancer has improved dramatically over the past 30 years, with cure rates approaching 95%. This success is attributed to the appropriate integration of effective treatments and staging modalities. Staging currently represents the cornerstone on which treatment is based. Because most patients will be cured, attention has shifted toward reducing morbidity of treatment while maintaining high cure rates. This implies that staging must be accurate before any change to the treatment regimen can be instituted. SUMMARY: Effective management of testicular germ cell cancer continues to pose a major challenge. Early and accurate diagnosis is very important because it will influence the choice of treatment and thus may impact on prognosis.