Testicular cancer natural history, complications and prognosis
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Prognosis of testicular cancer is generally good, and the 5-year survival rate is approximately 96.6% (2004-2010). Common complications of testicular cancer include metastasis, bleeding, infection, and infertility.
Germ cell testicular tumor
- Seminoma tends to occur in middle aged people.
- Rarely metastasize.
- Affects people in their 15 and 35 years old
- Median age is 30 years old
- Has most of the component of mixed non seminoma germ tumor
- Tend to metastasize early to lungs, retroperitoneum, and liver
- Patient presents with early symptoms if there are metastatic lesions.
- Early metastasis through hematogenous route
- Tends to metastasize to lungs, brain, liver, peritoneum, and others.
- Affects most male patients in the second and third decade of their life.
Yolk Sac tumor
- Mostly seen in children less than 2 years old
- Patients are usually asymptomatic at onset
- Tends to have elevated alpha fetoproteins (AFP)
Sex cord stromal testicular tumor
Leydig cell tumor
- Seen mostly in any age
- Benign in boys aged 5 to 10 years old and malignant in adults aged 30 to 60 years old
- It metastasizes in the regional lymph nodes such as iliac, inguinal and retroperitonial nodes
Sertoli cell tumor
- It affects both infants and older adults
- Malignancy is seen in infants in presence of metastasis
- Sertoli cell tumor is associated with Peutz-Jeghers syndrome and Carney complex.
- large cell calcifying sertoli cell tumor is associated with Carney's complex (syndrome of myxoma, spotty pigmentation and endocrine overactivity).
Granulosa cell tumor
- It is rare type of testicular cancer.
- Seen mostly in the ovary
- It is seen mostly in infants.
- It is mostly benign
- It has an underlined association with sex chromosome abnormalities, ambiguous genitalia, and ipsilateral cryptorchidism.
Common complications of testicular cancer include:
- Post-surgery complications
- Between 2004 and 2010, the 5-year relative survival of patients with testicular cancer was 96.6%.
- When stratified by age, the 5-year relative survival of patients with testicular cancer was 95.4% and 86.4% for patients <65 and ≥ 65 years of age respectively.
- The survival of patients with testicular cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of testicular cancer:
|Stage||5-year relative survival (%), (2004-2010)|
- Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of testicular cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.
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