title: Testicular cancer.
abstract: In testicular cancer epidemiology, the increasing recognition that germinal epithelial atrophy is the final common pathway in the development of this tumor has developed along with reports that elevated follicule-stimulating hormone levels at the time of diagnosis of first tumor correlate with risk of developing a second tumor. There is also evidence from experimental studies that atrophy is a complication of vasectomy, a recently reported risk factor. In the area of new diagnostic approaches, correlation of the rate of rise of tumor markers after orchiectomy in patients with metastases has defined a new risk factor for predicting drug-resistant disease. In the treatment of nonseminoma, it has been reported that use of adjuvant chemotherapy for stage I tumors with two courses of combination chemotherapy produces a relapse rate lower than that seen after surgical staging. For seminoma, chemotherapy results have improved, with nearly 100% of patients cured by combination regimens and 80% cured by single-agent carboplatin. This success is finally leading to questioning of the role of radiotherapy as adjuvant therapy for stage I tumors. A study using two courses of adjuvant carboplatin produced equivalent results and possibly less toxicity.
authors.affiliation: London Hospital Medical College, UK.
authors.forename: R T
authors.initials: RT
authors.lastname: Oliver
mesh_terms: D004407:Dysgerminoma / Q000628:therapy; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*