Introduction and Objectives
Testicular cancer is one of the few solid cancers that can be cured in the majority of cases even when it is metastasized with overall survival rate 89.3%.
Aim
To establish the age adjusted incidence of testicular cancer.
To critically assess the management of testicular tumour (diagnostic, Medical and surgical Aspects) in a tertiary referral centre covering an area with a population catchments of more than 300000 and in-line with the applied clinical guidelines.
Material and Methods
It is a retrospective study, 109 cases are included, representing all those who underwent orchidectomy for the period from 2002–2005, no age group is specified. Complete review of pathology types, cancer staging, management plans and follow up plans.
Results
This study has concluded that there is no substantial difference between the crude and the age standardised incidence, moreover no difference from the reported crude incidence by the Scottish intercollegiate guidelines. All patients were seen with 1–2weeks from referral. In terms of tumour types we found (55.1%) seminoma, (14.28%) Non-seminoma and (30.61%) combined (seminoma and non seminoma).
Stage I disease in 61.22% of cases, stage II in 36.73% of cases stage IV in 2.04%cases. Most of the cancers were in the age group (20–50) with the majority (48.97%) in the age group (31–40). 42.85% of cases were identified with high tumour markers; out of these: Alpha feto protein was high in 14.28% of cases; Beta HCG was high in 16.32% of cases and both reported as high in (12.24%) of cases and one case was not reported. In terms of pre orchidectomy ultrasound, (2.12%) of cases reported as inflammatory area, (4.25%) of cases reported as cystic area with (8.16%) of cases did not have ultrasound scan before their orchidectomy with the rest reported suspiciously. C.T. Scan was performed 2–3 weeks post orchidectomy in 100% of cases.
Higher percentage of seminoma at stage II (40.74%) compared to the internationally published percentages. Only 2% of cases had scrotal orchidectomy with the rest all had radical inguinal orchidectomy. All stage management were compliant with the guidelines understudy except for stage I mixed cell tumour were surveillance was utilised as initial management option for cases which require more aggressive action and that did lead to cancer relapse.
Conclusions
All stages management were compliant with the current available guidelines except for mixed tumour stage I. Highly curative rates can be attained by all three modalities. Standard treatment with radiotherapy is challenged by surveillance and chemotherapy. Higher percentage of cases with mixed cell tumour as well as Stage II seminoma.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
