title: Bilateral germ-cell tumours: 22-year experience at the Institut Gustave Roussy.
abstract: 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.
authors.affiliation: Department of Medicine, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94800 Villejuif, France. theodore@igr.fr
authors.forename: Ch
authors.initials: Ch
authors.lastname: Theodore
authors.forename: M J
authors.initials: MJ
authors.lastname: Terrier-Lacombe
authors.forename: A
authors.initials: A
authors.lastname: Laplanche
authors.forename: G
authors.initials: G
authors.lastname: Benoit
authors.forename: K
authors.initials: K
authors.lastname: Fizazi
authors.forename: O
authors.initials: O
authors.lastname: Stamerra
authors.forename: P
authors.initials: P
authors.lastname: Wibault
mesh_terms: 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