BILATERAL TESTICULAR GERM-CELL TUMORS IN PATIENTS WITH INITIAL-STAGE I DISEASE - PREVALENCE AND PROGNOSIS - A SINGLE CENTERS 30 YEARS EXPERIENCE

Development of second testicular tumours, i.e. bilateral testicular ca ncer, is influenced by systemic chemotherapy for the first tumour. The prevalence of bilateral testicular cancer was studied in patients wit h initial stage I disease, in which no systemic treatment was given af ter orchidectomy. All stage I testicular cancer patients entered a sur veillance study with an intensive follow-up since 1982. We hypothesise d that after 1982, bilateral testicular cancer was diagnosed at an ear lier stage of disease. The prevalence of bilateral testicular cancer w as 4.7% (8/170) in stage I patients treated between 1967 and 1981, and 2.9% (8/275) in stage I patients treated between 1982 and 1997 (P> 0. 5, chi(2)-test). In the period 1967-1981, 6 patients had stage I secon d tumours and 2 patients had stage III second tumours. The former 6 pa tients are alive with no evidence of disease and the 2 patients with m etastatic tumours died of disease or treatment. In the period 1982-197 7, all 8 patients had stage I second tumours and all are alive with no evidence of disease. The overall prevalence of bilateral testicular c ancer in stage I patients was 3.6% and has slightly decreased over the past three decades. Intensive follow-up, improvement of radiodiagnost ic computed tomography techniques, availability of serum tumour marker s, and patient education have resulted in earlier diagnosis and lower stage of contralateral testicular tumours, contributing to improved pr ognosis. (C) 1998 Elsevier Science Ltd. All rights reserved.