Bilateral germ-cell tumours: 22-year experience at the Institut Gustave Roussy.
The aim of this study was to describe the incidence, clinical and histological characteristics, treatment and long-term follow-up of bilateral germ-cell tumours (BGCT) of the testis in order to determine in what respects they differ significantly from unilateral germ-cell tumours. In all, 31 patients with BGCT had metachronous tumours and 14 had synchronous tumours. Among the metachronous tumours, 61% occurred more than 5 years after the first tumour. The overall incidence of BGCT in patients with testicular germ-cell tumours (TGCT) was 1.9%. The incidence was 3.2% in patients presenting with a seminoma and 1.4 % in patients presenting with a nonseminomatous germ-cell tumour (NSGCT). Patients under 30 years of age at the time of the initial diagnosis had a higher incidence of bilateral tumours compared with older men. The outcome of BGCT was excellent. A high association was found between BGCT, sterility and suspected genetic risk factors for TGCT. These results argue against a systematic contralateral biopsy at diagnosis of first TGCT in all patients, but emphasise the importance of patient education and of the need to better identify patients at risk for a second TGCT. Therapeutic indications for synchronous BGCT, including conservative treatment, need to be better defined.
Theodore
Ch
Ch
Department of Medicine, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94800 Villejuif, France. theodore@igr.fr
Terrier-Lacombe
M J
MJ
Laplanche
A
A
Benoit
G
G
Fizazi
K
K
Stamerra
O
O
Wibault
P
P
D000293:Adolescent; D000328:Adult; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D010353:Patient Education as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D018239:Seminoma / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D013997:Time Factors