RECENT ADVANCES IN MANAGEMENT OF TESTICULAR TUMOUR

Abstract

. Recent interest in the etiology of GCT has highlighted a number of common and wide spreads environmental features that may prove to Increase the risk ofGCT in men. However, further investigations will be required in this area. By contrast, the treatment of GCT overall has not changed a great deal in the last five years, although there is a trend toward more frequent use of chemotherapy in the earlier stages. The long term risks and toxicities of such treatment will require careful pestoperative evaluation given our limited knowledge of the effect of many of the chemotherapeutic agents used.

As outlined above a few major surgical controversies still exist. First the benefits and risk s of contralateral testicular biopsy and second the correct identification of residual masses containing undifferentiated or mature teratoma which require surgical removal.

More accurate prognostic model and the use of PET imaging might help guide decisions about resecting residual masses in the future. A fUither surgical conundrum is the benefiis of orchidopexy to prevent the development of GCT, this situation might be explained by the fact that adverse histological changes start to appear in the maldescended tests at age 2 years. So it might be that only orchidopexy done at a very young age can reduce risk.