Knowledge on the male reproductive tract and testicular cancer among adolescents in Austria.

PURPOSE: Testicular cancer is the most frequent malignant tumour among young adults. Therefore, regular self-examination for early detection is recommended by all guidelines. The fact that the knowledge of young adults living in Austria on this important topic is unknown, prompted the current investigation. MATERIALS AND METHODS: To evaluate the knowledge on anatomy and function of the male reproductive tract and of testicular cancer in particular a German questionnaire recently developed by Anheuser et al. (Urologe 2019;58:1331-1337) was applied. This 4-page questionnaire contains mainly multiple-choice questions. This questionnaire was distributed in three different schools to male and female students in the 11th and 12th school level. RESULTS: A total of 337 students (mean age: 17.3 years; male: n = 183; female: n = 154) completed the questionnaire. In a simple pictogramm, 63% were able to correctly identify the prostate, 87% the testis and 64% the epididymis. Half of the students (49.3%) could describe the function of the testis. The question regarding the age peak of testicular cancer was correctly answered by 81%, yet 18% believed that testicular cancer is caused by the sexual contact. The purpose of the testicular self-examination was correctly answered by only 54.9% with a higher rate for women (67.5% vs. 44.3%, p = 0.001). With a theoretical maximal score of 15, the students reached a mean overall of 10.4 with no sex difference (p > 0.05). Differences were noted for the school type: the highest score was present in the Gymnasium (11.2), followed by the Realgymnasium (10.8) and the HTL (9.8; p = 0.001). CONCLUSIONS: This survey demonstrates relevant knowledge deficits of young adults regarding the male reproductive tract, testicular cancer and self-examination.

Resource use in the last year of life of prostate cancer patients-A register-based analysis.

BACKGROUND: Given the paucity of data on the end of life (EOL) of prostate-cancer (PC) patients, we investigated medication prescription patterns and hospitalizations during their final year of life. METHODS: The data base of the Österreichische Gesundheitskasse Vienna (ÖGK-W) was used to identify all men who died with the diagnosis PC between 1.1.2015 and 31.12.2021 and who were under androgen deprivation and/or new hormonal therapies. Patient age, prescription patterns and hospitalizations during the last year of life were recorded, odds ratios for age groups were analyzed. RESULTS: A total of 1.109 patients were included. ADT was given in 86.7% (n = 962) and NHT in 62.8% (n = 696). Overall, prescription of analgesics increased from 41% (n = 455) during the first to 65.1% (n = 722) in the last quarter of the final year of life. Prescription of NSAIDs was almost consistent (18-20%) whereas the number of patients receiving other non-opioids (paracetamol, metamizole) more than doubled (18 to 39%). Older men had lower prescription rates for NSAID (OR: 0.47, 95% CI: 0.35-0.64), non-opioids (OR: 0.43, 95% CI: 0.32-0.57), opioids (OR: 0.45, 95% CI: 0.34-0.6) and adjuvant analgesics (OR: 0.42, 95% CI: 0.28-0.65). Approximately 2/3 of patients (n = 733) died in the hospital with a median of four hospitalizations in the final year of life. The overall cumulative length of admission was less than 50d in 61.9%, 51-100d in 30.6% and >100d in 7.6%. Younger patients (<70 yrs) were more likely to die in the hospital (OR: 1.66, 95% CI: 1.15-2.39), had a higher median rate of hospitalizations (n = 6) and longer cumulative duration of admissions. CONCLUSIONS: Resource use increased during the last year life of PC patients with highest rates in younger men. Hospitalization rates were high and 2/3 died in the hospital, both showed clear age dependency with higher rates, duration and death in the hospital for younger men.

Testicular Tumor Markers in the Spermatic Vein - Correlation to Pathology, Stage and Outcome.

OBJECTIVE: To report our findings in patients with determination of testicular tumor markers from the vena spermatica during inguinal orchiectomy. METHODS: In a retrospective setting, data of patients who underwent inguinal orchiectomy between January 2004 and December 2014 were analyzed. Cubital and testicular vein tumor markers were assessed and correlated to histology, clinical stage and outcome. RESULTS: A total of 90 patients (seminomatous: n = 53, non-seminomatous: n = 37) with a median age of 37 years were included. The mean follow-up was 109 months. Overall, 60% (n = 54) of patients had one or more positive tumor marker level in the cubital vein vs 88.9% (n = 80) in the testicular vein. Median tumor marker levels of hCGß in cubital and testicular vein were 1.9 U/l and 30.8U/l; the respective values for AFP were 2.9ng/ml and 2.4ng/ml and for hPLAP 49.9 mU/l and 418.9 mU/l. Differences in cubital vs testicular vein positivity were stage dependant and highest for pT1. Patients with seminomatous tumors had peripheral positivity of 59.3% vs 88.9% in the testicular vein (P = 0.003); in non-seminomatous patients the respective values were 61.1% and 88.9% (P = 0.02). All recurrent cancer patients under active surveillance (n = 5) were positive in the testicular vein. CONCLUSION: Virtually all testicular cancers shed tumor markers in the circulation. Differences in marker positivity (testicular vs testicular vein) were stage dependent (greatest in pT1), largely independent of histology and highest for hCGß. The prognostic value of testicular vein sampling remains speculative.