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John P Donohue - One of the best experts on this subject based on the ideXlab platform.
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complications of post chemotherapy retroperitoneal lymph node dissection for Testis Cancer
The Journal of Urology, 2004Co-Authors: Ashraf Mosharafa, Richard S. Foster, Michael O Koch, Richard Bihrle, John P DonohueAbstract:ABSTRACTPurpose: Post-chemotherapy retroperitoneal lymph node dissection (PC RPLND) is a tool in the management of Testis Cancer. Our impression has been that the short-term morbidity of standard PC RPLND has diminished with time. Therefore, we attempted to verify this hypothesis by evaluating the morbidity of the procedure in 2 comparable groups of patients from 2 different periods.Materials and Methods: We compared 150 patients who underwent post-chemotherapy RPLND between July 2000 and July 2002 to 79 patients who underwent the same procedure between 1990 to 1992. All patients had clinical stage II–III Testis Cancer and had received 3 to 4 courses of standard platinum based chemotherapy before surgery. We compared surgical morbidity and postoperative complications in both groups. We also assessed a number of factors (patient characteristics, mass size, pathological features and surgical aspects) that could impact the rate of complications.Results: The 2 groups were comparable regarding preoperative cli...
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The role of retroperitoneal surgery in Testis Cancer.
Critical Reviews in Oncology Hematology, 2002Co-Authors: Hans-jürg Leisinger, John P DonohueAbstract:Abstract Testis Cancer is today a curable malignancy. But controversy remains about the appropriate management of patients presenting different stages. There is an increasing interest in surveillance rather than in primary retroperitoneal lymph node dissection (RPLND) for stage I non-seminomatous germ cell tumors (NSGCT). Adjuvant chemotherapy has become an efficient treatment option for high risk non-seminomatous germ cell Testis Cancer, however, biological and histologic risk factors of the primary tumor are not yet precisely defined. To determine the appropriate management of patients with testicular Cancer, postoperative morbidity after RPLND and risk of chemotherapy-induced morbidity must be balanced. Whoever reviews the literature must take into consideration that the excellent postoperative results after RPLND depend on high volume and large experience with Testis Cancer. As treatment morbidity and its intensity have a major impact on Testis Cancer patient quality of life, the choice of management must be based on the patient's social situation, his personal needs, and the doctor's experience and resources.
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Teratoma in the Orchiectomy Specimen and Volume of Metastasis are Predictors of Retroperitoneal Teratoma in Post-Chemotherapy Nonseminomatous Testis Cancer
The Journal of Urology, 1996Co-Authors: Stephen D.w. Beck, Lawrence H. Einhorn, Richard S. Foster, Michael O Koch, Richard Bihrle, Thomas M. Ulbright, Gregory R. Wahle, John P DonohueAbstract:ABSTRACTPurpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic Testis Cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection.Materials and Methods: A retrospective review of the Indiana University Testis Cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection.Results: Of the patients with teratoma in the orchiectomy specimen 85.6% had an element of teratoma in the ...
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The Clinical Implications of Procedural Deviations During Orchiectomy for Nonseminomatous Testis Cancer
The Journal of Urology, 1995Co-Authors: Ilan Leibovitch, Jack Baniel, Richard S. Foster, John P DonohueAbstract:AbstractPurpose: The clinical implications of procedural deviations during orchiectomy for nonseminomatous Testis Cancer were evaluated.Materials and Methods: A retrospective review was done of 78 of 1,708 patients (4.6 percent) with nonseminomatous Testis Cancer who presented to our university following scrotal violation.Results: A total of 56 patients (71.8 percent) underwent hemi-scrotectomy as part of treatment. A tumor was found in 6 of 56 hemi-scrotectomy specimens (10.7 percent) and 3 showed local recurrence. Of the 78 patients 5 (6.4 percent) had local recurrence, while 1 of 30 (3.3 percent) with scrotal specimens negative for tumor had recurrence in the groin. No patient treated by chemotherapy had local recurrence.Conclusions: Scrotal violation was associated with an increased risk for local recurrence mainly when a residual tumor in the scrotectomy specimen was found. The role of hemi-scrotectomy to avoid of local or systemic relapse is debatable.
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Original Articles THE CLINICAL IMPLICATIONS OF PROCEDURAL DEVIATIONS DURING ORCHIECTOMY FOR NONSEMINOMATOUS Testis Cancer
1995Co-Authors: Ilan Leibovitch, Jack Baniel, Richard S. Foster, John P DonohueAbstract:Purpose: The clinical implications of procedural deviations during orchiectomy for nonseminomatous Testis Cancer were evaluated. Materials and Methods: A retrospective review was done of 78 of 1,708 patients (4.6%) with nonseminomatous Testis Cancer who presented to our university following scrotal violation. Results: A total of 56 patients (71.8%) underwent hemi-scrotectomy as part of treatment. A tumor was found in 6 of 56 hemi-scrotectomy specimens (10.7%) and 3 showed local recurrence. Of the 78 patients 5 (6.4%) had local recurrence, while 1 of 30 (3.3%) with scrotal specimens negative for tumor had recurrence in the pin. No patient treated by chemotherapy had local recurrence. Conclusions: Scrota1 violation was associated with an increased risk for local recurrence mainly when a residual tumor in the scrotectomy specimen was found. The role of hemi-scrotectomy to avoid of local or systemic relapse is debatable. Radical inguinal orchiectomy is the standard initial procedure for management of testicular Cancer. The principles of radical orchiectomy are exploration through an inguinal incision, early ligation of the spermatic cord, en bloc removal of the spermatic cord with a Testis enclosed within the intact tunics and prevention of tumor spillage. Making the incision in the inguinal area, distant from the Testis, decreases the chance of cutting into a tumor and the risk of tumor spillage with resultant contamination of the mtum and other lymphatic drainage areas (that is the inguinal nodes). Despite these theoretical advantages of radical orchiectomy, some patients with testicular neoplasms undergo transmtal procedures. We reviewed 78 patients with nonseminomatous Testis Cancer who presented to our university following scrotal violation.
Stephen M. Schwartz - One of the best experts on this subject based on the ideXlab platform.
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Differences in Testis Cancer Survival by Race and Ethnicity: A Population-Based Study, 1973–1999 (United States)
Cancer Causes & Control, 2004Co-Authors: Mary Lou Biggs, Stephen M. SchwartzAbstract:Objective : We examined the relationship between race/ethnicity and Testis Cancer survival in a population-based setting. Methods : We analyzed 16,086 cases of primary Testis Cancer diagnosed during 1973–1999 and reported to 12 Cancer registries participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. We compared Testis Cancer-specific survival between patients from different racial/ethnic groups by use of the hazard ratio (HR) and 95% confidence intervals (CI) calculated from Cox proportional hazards models, adjusting for stage, histology, and period of diagnosis. Conclusion : These findings are consistent with previous reports of race/ethnic disparities in stage at diagnosis and survival in Testis Cancer patients as well as other Cancer patients. Further research is needed to understand the reasons underlying these disparities.
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Differences in Testis Cancer survival by race and ethnicity: a population-based study, 1973-1999 (United States).
Cancer Causes & Control, 2004Co-Authors: Mary L. Biggs, Stephen M. SchwartzAbstract:Objective: We examined the relationship between race/ethnicity and Testis Cancer survival in a population-based setting. Methods: We analyzed 16,086 cases of primary Testis Cancer diagnosed during 1973–1999 and reported to 12 Cancer registries participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. We compared Testis Cancer-specific survival between patients from different racial/ethnic groups by use of the hazard ratio (HR) and 95% confidence intervals (CI) calculated from Cox proportional hazards models, adjusting for stage, histology, and period of diagnosis. Conclusion: These findings are consistent with previous reports of race/ethnic disparities in stage at diagnosis and survival in Testis Cancer patients as well as other Cancer patients. Further research is needed to understand the reasons underlying these disparities.
Richard S. Foster - One of the best experts on this subject based on the ideXlab platform.
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complications of post chemotherapy retroperitoneal lymph node dissection for Testis Cancer
The Journal of Urology, 2004Co-Authors: Ashraf Mosharafa, Richard S. Foster, Michael O Koch, Richard Bihrle, John P DonohueAbstract:ABSTRACTPurpose: Post-chemotherapy retroperitoneal lymph node dissection (PC RPLND) is a tool in the management of Testis Cancer. Our impression has been that the short-term morbidity of standard PC RPLND has diminished with time. Therefore, we attempted to verify this hypothesis by evaluating the morbidity of the procedure in 2 comparable groups of patients from 2 different periods.Materials and Methods: We compared 150 patients who underwent post-chemotherapy RPLND between July 2000 and July 2002 to 79 patients who underwent the same procedure between 1990 to 1992. All patients had clinical stage II–III Testis Cancer and had received 3 to 4 courses of standard platinum based chemotherapy before surgery. We compared surgical morbidity and postoperative complications in both groups. We also assessed a number of factors (patient characteristics, mass size, pathological features and surgical aspects) that could impact the rate of complications.Results: The 2 groups were comparable regarding preoperative cli...
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Early-stage Testis Cancer.
Current Treatment Options in Oncology, 2001Co-Authors: Richard S. FosterAbstract:The treatment of low-stage Testis Cancer (defined as clinical stage I or low-volume clinical stage II disease) varies, depending on whether or not the orchiectomy specimen reveals seminoma or nonseminoma. Treatments for clinical stage I seminoma include radiotherapy to the retroperitoneum, surveillance, or two courses of carboplatin chemotherapy. Until the results of an ongoing randomized study comparing radiotherapy with two courses of carboplatin are known, standard accepted treatments currently include radiotherapy or surveillance. In nonbulky clinical stage II seminoma, therapeutic options include radiotherapy or cisplatin-based chemotherapy. For clinical stage I nonseminoma, equivalent short-term survival rates are obtained with either nerve-sparing retroperitoneal lymph node dissection (RPLND), surveillance, or two courses of BEP (bleomycin, etoposide, and platinum) chemotherapy. However, minimization of toxicity of treatment would argue that the two preferred treatments in clinical stage I nonseminoma are nerve-sparing RPLND or surveillance. For lowvolume clinical stage II nonseminoma, options include three courses of BEP or primary RPLND. The overall chance for cure is essentially the same for either of these options. Therefore, in each clinical stage of early-stage Testis Cancer, therapeutic options exist that, based upon current data, are therapeutically equivalent in the short term. Therefore, the ultimate choice of therapy is also dependent upon the short- and long-term toxicity of therapy and the likelihood of late recurrence of disease.
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Teratoma in the Orchiectomy Specimen and Volume of Metastasis are Predictors of Retroperitoneal Teratoma in Post-Chemotherapy Nonseminomatous Testis Cancer
The Journal of Urology, 1996Co-Authors: Stephen D.w. Beck, Lawrence H. Einhorn, Richard S. Foster, Michael O Koch, Richard Bihrle, Thomas M. Ulbright, Gregory R. Wahle, John P DonohueAbstract:ABSTRACTPurpose: Patients who require post-chemotherapy retroperitoneal lymph node dissection after induction chemotherapy for metastatic Testis Cancer derive therapeutic benefit from resection of teratoma but resection of necrosis is not beneficial. We determine if the absence of teratoma in the orchiectomy specimen is a reliable predictor of the absence of teratoma in the retroperitoneum at post-chemotherapy retroperitoneal lymph node dissection.Materials and Methods: A retrospective review of the Indiana University Testis Cancer data base was performed. A total of 644 patients who underwent retroperitoneal lymph node dissection after induction chemotherapy only were selected for study. The presence or absence of teratoma in the orchiectomy specimen and volume of retroperitoneal tumor were analyzed as predictors of retroperitoneal teratoma at post-chemotherapy retroperitoneal lymph node dissection.Results: Of the patients with teratoma in the orchiectomy specimen 85.6% had an element of teratoma in the ...
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The Clinical Implications of Procedural Deviations During Orchiectomy for Nonseminomatous Testis Cancer
The Journal of Urology, 1995Co-Authors: Ilan Leibovitch, Jack Baniel, Richard S. Foster, John P DonohueAbstract:AbstractPurpose: The clinical implications of procedural deviations during orchiectomy for nonseminomatous Testis Cancer were evaluated.Materials and Methods: A retrospective review was done of 78 of 1,708 patients (4.6 percent) with nonseminomatous Testis Cancer who presented to our university following scrotal violation.Results: A total of 56 patients (71.8 percent) underwent hemi-scrotectomy as part of treatment. A tumor was found in 6 of 56 hemi-scrotectomy specimens (10.7 percent) and 3 showed local recurrence. Of the 78 patients 5 (6.4 percent) had local recurrence, while 1 of 30 (3.3 percent) with scrotal specimens negative for tumor had recurrence in the groin. No patient treated by chemotherapy had local recurrence.Conclusions: Scrotal violation was associated with an increased risk for local recurrence mainly when a residual tumor in the scrotectomy specimen was found. The role of hemi-scrotectomy to avoid of local or systemic relapse is debatable.
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Original Articles THE CLINICAL IMPLICATIONS OF PROCEDURAL DEVIATIONS DURING ORCHIECTOMY FOR NONSEMINOMATOUS Testis Cancer
1995Co-Authors: Ilan Leibovitch, Jack Baniel, Richard S. Foster, John P DonohueAbstract:Purpose: The clinical implications of procedural deviations during orchiectomy for nonseminomatous Testis Cancer were evaluated. Materials and Methods: A retrospective review was done of 78 of 1,708 patients (4.6%) with nonseminomatous Testis Cancer who presented to our university following scrotal violation. Results: A total of 56 patients (71.8%) underwent hemi-scrotectomy as part of treatment. A tumor was found in 6 of 56 hemi-scrotectomy specimens (10.7%) and 3 showed local recurrence. Of the 78 patients 5 (6.4%) had local recurrence, while 1 of 30 (3.3%) with scrotal specimens negative for tumor had recurrence in the pin. No patient treated by chemotherapy had local recurrence. Conclusions: Scrota1 violation was associated with an increased risk for local recurrence mainly when a residual tumor in the scrotectomy specimen was found. The role of hemi-scrotectomy to avoid of local or systemic relapse is debatable. Radical inguinal orchiectomy is the standard initial procedure for management of testicular Cancer. The principles of radical orchiectomy are exploration through an inguinal incision, early ligation of the spermatic cord, en bloc removal of the spermatic cord with a Testis enclosed within the intact tunics and prevention of tumor spillage. Making the incision in the inguinal area, distant from the Testis, decreases the chance of cutting into a tumor and the risk of tumor spillage with resultant contamination of the mtum and other lymphatic drainage areas (that is the inguinal nodes). Despite these theoretical advantages of radical orchiectomy, some patients with testicular neoplasms undergo transmtal procedures. We reviewed 78 patients with nonseminomatous Testis Cancer who presented to our university following scrotal violation.
Axel Heidenreich - One of the best experts on this subject based on the ideXlab platform.
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Contralateral testicular biopsy in Testis Cancer: current concepts and controversies.
BJU international, 2020Co-Authors: Axel HeidenreichAbstract:Of all patients with unilateral Testis Cancer, approximately 5% harbour testicular intraepithelial neoplasia (TIN) in their contralateral testicle that will progress into an invasive germ cell tumour over time. The accurate diagnosis of TIN by a random two-site surgical Testis biopsy and effective therapy by local radiation has led to the concept of a contralateral screening biopsy in all patients with Testis Cancer. However, screening and preventive treatment are only indicated if the therapeutic outcome of the screened population is improved, and the physiological function of the affected organ is not impaired. Based on a critical review of previous reports, some drawbacks of this policy have to be considered and question the routine indication for contralateral Testis biopsy: (i) all TIN-negative patients still have to undergo meticulous follow-up for metachronous Testis Cancer due to a false negative biopsy rate of 0.5-1.0%; (ii) local radiation of TIN results in irreversible infertility due to eradication of spermatogenesis; (iii) local radiation of TIN results in an impairment of endocrine Leydig cell function in 25% of the patients; (iv) therapeutic outcome and prognosis will not be improved in irradiated patients as compared to patients on surveillance; (v) local tumour resection for the management of metachronous testicular Cancer represents an effective and viable option. Current reports do not support the strategy of contralateral Testis biopsy in all patients with unilateral testicular germ cell tumours. According to the recommendations of the European Germ Cell Cancer Consensus Group, a Testis biopsy might be offered to high-risk patients for contralateral TIN (testicular volume
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European Association of Urology Guidelines on Testis Cancer: Important Take Home Messages
European urology focus, 2019Co-Authors: Axel Heidenreich, Pia Paffenholz, Tim Nestler, David G. PfisterAbstract:Abstract Testicular germ-cell tumors represent the most common solid neoplasms among young men aged 20–40 yr. Owing to interdisciplinary management and high chemosensitivity, cure rates are high even among patients with poor risk. Although the diagnostic and therapeutic approaches for organ-confined disease and low-volume and high-volume metastatic disease are well standardized and reported in numerous national and international guidelines, guidelines, high frequency of guideline noncompliance has recently been observed, resulting in poorer long-term outcomes. This article underlines the clinically most important messages that should be adhered to in the management of Testis Cancer patients to avoid patient harm and achieve the best therapeutic outcomes. These recommendations include: (1) a detailed pathology report by an experienced uropathologist; (2) organ-sparing surgery or frozen section analysis for patients with bilateral Testis Cancer or testicular masses of uncertain identity; (3) risk-adapted therapy for clinical stage I seminomas and nonseminomas; and (4) interdisciplinary management of patients with advanced Testis Cancer in high-volume centers. Patient summary Management of Testis Cancer has been standardized but lack of compliance with guidelines is increasing, resulting in inferior oncological outcomes. Close adherence to guidelines and early referral of complex cases are of utmost importance for high cure rates.
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Metastatic surgery in Testis Cancer.
Current Opinion in Urology, 2016Co-Authors: David Pfister, Pia Paffenholz, Friederike Haidl, Axel HeidenreichAbstract:PURPOSE OF REVIEW: In Testis Cancer, prognosis is excellent even in metastatic disease. Treatment and timing of patients with multiple metastatic deposits can be challenging. This review was performed to underline the current guideline recommendations. RECENT FINDINGS: Depending on the primary histology, the indication of further surgical resections differ. In seminoma, residual tumor resections are performed according to the results of a flouoro-deoxy-D-glucose-PET. Positive results must be considered critically, and to recent results it is advisable to first repeat flouoro-deoxy-D-glucose-PET to avoid overtreatment. In nonseminomatous germ cell Cancer, complete remissions in good prognosis patients are followed and can be spared from surgery. All other patients still need to undergo postchemotherapy retroperitoneal lymph node dissection. In bone metastases, significant histology is found in 80% so that one should go for complete resection. In liver metastases, resections can be performed according to the histology in the retroperitoneum. Both resections, including vessel replacement, are usually performed in one session underlining the complex multidisciplinary approach. Pulmonal metastases, at least in one lobe, need to be resected. Brain metastases are rare with no standard treatment recommendation. SUMMARY: Every patient should be presented in a multidisciplinary tumor board. Surgical interventions should be done in tertiary referral centers to achieve the best oncologic outcome and reduced morbidity.
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contemporary management of postchemotherapy Testis Cancer
European Urology, 2012Co-Authors: Siamak Daneshmand, Peter Albers, Sophie D Fossa, Axel Heidenreich, Christian Kollmannsberger, Susan Krege, Craig R Nichols, Jan Oldenburg, Lori WoodAbstract:Abstract Context Some controversy still exists regarding the management of Testis Cancer following chemotherapy for disseminated disease. Objective To review the available literature concerning the management of postchemotherapy Testis Cancer. Evidence acquisition A Medline search was conducted to identify original and review articles, as well as guidelines addressing the management of Testis Cancer following first-line chemotherapy. Keywords included germ cell tumor, Testis Cancer, retroperitoneal lymph node dissection , and chemotherapy. The most relevant articles were critically reviewed with the consensus of all the collaborative authors, who have expertise in the management of germ cell tumors (GCTs). Evidence synthesis Approximately one-third of patients who undergo chemotherapy for metastatic GCTs have residual retroperitoneal disease. All patients with residual masses ≥1cm after chemotherapy for nonseminomatous GCTs should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) because of the risk of mature teratoma in 40–45% of cases and of viable GCT in 10–15% of cases. Patients who obtain a complete serologic remission and radiographic residual 90% chance of cure, while patients with viable GCTs should be considered for additional therapy, depending on the percentage of viable tumor. In patients with disseminated seminoma, postchemotherapy masses 3cm should be evaluated with positron emission tomography (PET)/computed tomography 2 mo after completion of chemotherapy, with very selective administration of PC-RPLND. Late relapse occurring >2 yr after chemotherapy is rare, and surgery remains the mainstay of therapy in cases of resectable masses independent of tumor markers. There is still controversy on whether high-dose chemotherapy confers a survival benefit compared with conventional-dose chemotherapy in the salvage setting. Surgery should always be considered for resectable masses following salvage therapies or in chemoresistant disease to maximize chance of cure. Conclusions Patients with advanced GCTs can achieve long-term disease-free survival when chemotherapy is combined with expert and judicious resection of residual disease. PC-RPLND is recommended for residual masses >1cm identified on postchemotherapy imaging in nonseminomatous GCT and possibly for PET-positive residual disease ≥3cm in treated seminomas.
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Contralateral testicular biopsy in Testis Cancer: current concepts and controversies.
BJUI, 2009Co-Authors: Axel HeidenreichAbstract:Of all patients with unilateral Testis Cancer, ≈5% harbour testicular intraepithelial neoplasia (TIN) in their contralateral testicle that will progress into an invasive germ cell tumour over time. The accurate diagnosis of TIN by a random two-site surgical Testis biopsy and effective therapy by local radiation has led to the concept of a contralateral screening biopsy in all patients with Testis Cancer. However, screening and preventive treatment are only indicated if the therapeutic outcome of the screened population is improved, and the physiological function of the affected organ is not impaired. Based on a critical review of previous reports, some drawbacks of this policy have to be considered and question the routine indication for contralateral Testis biopsy: (i) all TIN-negative patients still have to undergo meticulous follow-up for metachronous Testis Cancer due to a false negative biopsy rate of 0.5–1.0%; (ii) local radiation of TIN results in irreversible infertility due to eradication of spermatogenesis; (iii) local radiation of TIN results in an impairment of endocrine Leydig cell function in 25% of the patients; (iv) therapeutic outcome and prognosis will not be improved in irradiated patients as compared to patients on surveillance; (v) local tumour resection for the management of metachronous testicular Cancer represents an effective and viable option. Current reports do not support the strategy of contralateral Testis biopsy in all patients with unilateral testicular germ cell tumours. According to the recommendations of the European Germ Cell Cancer Consensus Group, a Testis biopsy might be offered to high-risk patients for contralateral TIN (testicular volume
Jorma Toppari - One of the best experts on this subject based on the ideXlab platform.
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recent adverse trends in semen quality and Testis Cancer incidence among finnish men
International Journal of Andrology, 2011Co-Authors: Niels Jørgensen, N E Skakkebaek, Matti Vierula, Rune Jacobsen, Eero Pukkala, Antti Perheentupa, Helena E. Virtanen, Jorma ToppariAbstract:Impaired semen quality and testicular Cancer may be linked through a testicular dysgenesis syndrome of foetal origin. The incidence of Testis Cancer has been shown to increase among Finnish men, whereas there is no recent publication describing temporal trends in semen quality. Therefore, we carried out a prospective semen quality study and a registry study of Testis Cancer incidence among Finnish men to explore recent trends. A total of 858 men were investigated in the semen quality study during 1998–2006. Median sperm concentrations were 67 (95% CI 57–80) million/mL, 60 (51–71) and 48 (39–60) for birth cohorts 1979–81, 1982–83 and 1987; total sperm counts 227 (189–272) million, 202 (170–240) and 165 (132–207); total number of morphologically normal spermatozoa 18 (14–23) million, 15 (12–19) and 11 (8–15). Men aged 10–59 years at the time of diagnosis with testicular Cancer during 1954–2008 were included in the registry study, which confirmed the increasing incidence of testicular Cancer in recent cohorts. These simultaneous and rapidly occurring adverse trends suggest that the underlying causes are environmental and, as such, preventable. Our findings necessitate not only further surveillance of male reproductive health but also research to detect and remove the underlying factors.
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Recent adverse trends in semen quality and Testis Cancer incidence among Finnish men: Adverse trends in semen quality and Testis Cancer among Finnish men
International Journal of Andrology, 2011Co-Authors: Niels Jørgensen, N E Skakkebaek, Matti Vierula, Rune Jacobsen, Eero Pukkala, Antti Perheentupa, Helena E. Virtanen, Jorma ToppariAbstract:Impaired semen quality and testicular Cancer may be linked through a testicular dysgenesis syndrome of foetal origin. The incidence of Testis Cancer has been shown to increase among Finnish men, whereas there is no recent publication describing temporal trends in semen quality. Therefore, we carried out a prospective semen quality study and a registry study of Testis Cancer incidence among Finnish men to explore recent trends. A total of 858 men were investigated in the semen quality study during 1998–2006. Median sperm concentrations were 67 (95% CI 57–80) million/mL, 60 (51–71) and 48 (39–60) for birth cohorts 1979–81, 1982–83 and 1987; total sperm counts 227 (189–272) million, 202 (170–240) and 165 (132–207); total number of morphologically normal spermatozoa 18 (14–23) million, 15 (12–19) and 11 (8–15). Men aged 10–59 years at the time of diagnosis with testicular Cancer during 1954–2008 were included in the registry study, which confirmed the increasing incidence of testicular Cancer in recent cohorts. These simultaneous and rapidly occurring adverse trends suggest that the underlying causes are environmental and, as such, preventable. Our findings necessitate not only further surveillance of male reproductive health but also research to detect and remove the underlying factors.