The CancerWeb Report, What's New In Cancer: June, 1996
Testicular Cancer

• European countries report major rise in incidence - A survey of six European countries - Denmark, East Germany, Finland, Norway, Poland, and Sweden - reported in the June 1, 1996 issue of the Journal of the National Cancer Institute, showed that the incidence of testicular cancer is increasing annually at rates of 2.3% (Sweden) to 5.2% (East Germany). Data from cancer registries covering 30,908 cases diagnosed from 1945 to 1989 were analyzed by age groups. It was found there was little or no change for men born between 1880 and 1920, after which the rate began to rise, leveling off for the World War II period from about 1930 to 1945. After 1945, rates rose uninterruptedly in all countries. Compared with men born about 1905, the relative risks for those born in 1965 ranged from 3.9 in Sweden to 11.4 in East Germany. (Bergstrom, J National Cancer Institute 88:727, 1996)

  Editor's Comment: - The pattern of increasing incidence appears to be worldwide, having been reported in the Baltic countries, Colombia, the UK, and the US. This study represents a refinement in that it looked at age cohorts, which may help in identifying factors that might be responsible for the increase. There also could be a relationship to the widely reported, but still controversial accounts of reduction in sperm count, if some common factor toxic to the testis were involved.

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• Surgery for residual tumor after chemotherapy - Testicular cancers include tumors for which chemotherapy, with or without prior surgery, is curative, an unfortunately all too infrequent situation. When residual masses remain, it is often difficult to distinguish live tumor from dead or benign (teratoma) tumor, or from fibrotic tissue, by radiologic means, and each mass may be different, so exploration is necessary. There may be a number of these masses, and a group of surgeons from the Memorial Sloan- Kettering Cancer Center in New York, recommend one operation to remove all residual masses at once. This is feasible, especially since the patients are generally young. In their series of 24 patients, the operation lasted an average of just under six hours, required 500 mL of blood, a 9-day median hospital stay, had no mortality, and gave overall 5-year survival of 79%. The pathologic diagnoses were similar at all sites for 18 patients, but in six the findings were different in the chest and abdomen. (Brenner, J Clin Oncol 14:1765, 1996)