Epidemiologické charakteristiky nádorov testis v Slovenskej republike – retrospektívna štúdia

Východiská:

Nádory testis (NT) sú zriedkavou malignitou, ich medicínska závažnosť však spočíva v prudkom náraste hodnôt incidencie v posledných troch desaťročiach. Mortalita má v posledných 20-tich rokoch klesajúci trend.

Pacienti a metódy:
V celonárodnej restrospektívnej deskriptívnej štúdii sa hodnotilo 1 805 pacientov zo Slovenska, u ktorých sa diagnostikovalo 1 832 NT v rokoch 1993–2002. U chorých sa analyzovali údaje v zdravotnej dokumentácii a medicínske dotazníky, klinické príznaky a objektívne parametre pri klinickom vyšetrení.

Výsledky:
V rokoch 1993–2002 bola priemerná štandardizovaná incidencia (prepočítaná priamou metódou na svetovú štandardnú populáciu) 6,2/100 000; štandardizovaná mortalita dosiahla 0,5/100 000 mužov. Pri porovnávaní rizikových faktorov medzi skupinou pacientov s bilaterálnymi a unilaterálnymi NT bola najčastejšie sa vyskytujúcim rizikovým faktorom ingvinálna hernia (8,6%, p = 0,0026). V 3% prípadov chorých sa zistil bilaterálny NT. Z tohto počtu sa metachrónny výskyt zistil u 70,4% pacientov. Priemerný vek pacientov v čase diagnózy prvého NT u pacientov s bilaterálnym ochorením bol 27,5 rokov (p = 0,001); väčšina z nich (55%) mala NT diagnostikovaný vo veku 20–29 rokov. Priemerný vek pacientov s jednostranným NT bol 34 rokov. Osem pacientov malo synchrónny výskyt bilaterálneho nádoru, u 47 pacientov sa druhý NT diagnostikoval v rozpätí 2–302 mesiacov od prvej orchiektómie. V prípade seminómov bol časový interval medzi manifestáciou prvého a druhého NT v priemere 85 mesiacov, u neseminomatóznych nádorov bol tento interval 72 mesiacov (štatisticky nevýznamný rozdiel). Medián sledovania pacientov s NT bol 112,5 mesiacov (rozpätie 7–342 mesiacov), 5-ročné prežívanie bolo 96,2%.

Závery:
Ďalšie štúdium epidemiologických charakteristík NT je nevyhnutné pre definovanie rizikových faktorov ochorenia a možností včasnej liečebnej intervencie.

Kľúčové slová:
nádory testis – epidemiológia – rizikové faktory – prežívanie – onkologický register

Autoři: M. Ondrusova ^1,2; D. Ondrus ^3,4
Působiště autorů: Department of Cancer Epidemiology, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic 2Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic 3Department of Oncology, Comenius University Medical S ¹
Vyšlo v časopise: Klin Onkol 2009; 22(2): 52-57
Kategorie: Původní práce

Souhrn

Závery:
Ďalšie štúdium epidemiologických charakteristík NT je nevyhnutné pre definovanie rizikových faktorov ochorenia a možností včasnej liečebnej intervencie.

Kľúčové slová:
nádory testis – epidemiológia – rizikové faktory – prežívanie – onkologický register

Zdroje

1. Bray F, Richiardi L, Ekbom A et al. Trends in testicular cancer incidence and mortality in 22 European countries: continuing increases in incidence and declines in mortality. Int J Cancer 2006; 118(12): 3099–3111.

2. Ondrušová M, Ondruš D, Dušek L et al. National portal of cancer epidemiology in the Slovak Republic. Bratisl Med J 2008; 109(7): 329–330.

3. Buetow SA. Epidemiology of testicular cancer. Epidemiol Rev 1995; 17(2): 433–449.

4. Aareleid T, Sant M, Hédelin G & EUROCARE Working Group: Improved survival for patients with testicular cancer in Europe since 1978. Eur J Cancer 1998; 34(14): 2236–2240.

5. Plesko I, Obsitnikova A, Cuninkova M et al. Increasing occurrence of urological cancers in Slovakia. Neoplasma 2004; 51(4): 248–254.

6. Garner MJ, Turner MC, Ghadirian P et al. Epidemiology of testicular cancer: an overview. Int J Cancer 2005; 116(3): 331–339.

7. Huyghe E, Matsuda T, Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol 2003; 170(1): 5–11.

8. Moger TA, Aalen OO, Heimdal K et al. Analysis of testicular cancer data a frailty model with familial dependence. Statist Med 2004; 23(4): 617–632.

9. Purdue MP, Devesa SS, Sigurdson AJ et al. International patterns and trends in testis cancer incidence. Int J Cancer 2005; 11(5): 822–827.

10. Ferlay J, Bray F, Pisani P et al. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide IARC CancerBase No. 5. version 2.0, Lyon, IARC Press; 2004.

11. Curado MP, Edwards B, Shin HR et al (eds). Cancer Incidence in Five Continents, Vol. IX IARC Scient. Publ. No. 160. Lyon: IARC 2007.

12. Levi F, Lucchini F, Boyle P et al. Cancer incidence and mortality in Europe, 1988–1992. J Epidemiol Biostat 1998; 3: 295–373.

13. Parkin DM, Whelan SL, Ferlay J et al (eds). Cancer Incidence in Five Continents. Vol. 8, IARC Scient. Publ. Lyon: IARC 2002.

14. Safaei Diba Ch, Pleško I (eds). Cancer incidence in the Slovak Republic 2004. National Cancer Registry of the Slovak Republic, National Health Information Center, Bratislava 2008: 168.

15. Adami HO, Bergström R, Möhner M, et al. Testicular cancer in nine northern European countries. Int J Cancer 1994; 59: 33–38.

16. Nakata S, Ohtake N, Kubota Y et al. Incidence of urogenital cancers in Gunma Prefecture, Japan: a 10 year summary. Int J Urol 1998; 5(4): 364–369.

17. Liu S, Wen SW, Mao Y et al. Birth cohort effects underlying the increasing testicular cancer incidence in Canada. Can J Publ Health 1999; 90: 176–180.

18. Weir HK, Marrett LD, Kreiger N et al. Pre‑natal and peri-natal exposures and risk of testicular germ cell cancer. Int J Cancer 2000; 87(3): 438–443.

19. Power DA, Brown RSD, Brock CS et al. Trends in testicular carcinoma in England and Wales, 1971–1999. BJU Int 2001; 87(4): 361–365.

20. Levi F, Te VC, Randimbison L, La Vecchia C. Trends in testicular cancer incidence in Vaud, Switzerland. Eur J Cancer Prev 2003; 12(4): 347–349.

21. Levi F, La Vecchia C, Boyle P et al. Western and eastern European trends in testicular cancer mortality. Lancet 2001; 357: 1853–1854.

22. Cortessis V. Epidemiologic insights into the occurrence and causes of testicular cancer, 16–29. In: Raghavan D (ed). Atlas of Clinical Oncology, Germ Cell Tumors. Hamilton: B.C.Decker, Inc., 2003.

23. Oliver T, Mead G. Testicular cancer. Curr Opin Oncol 1993; 5: 559–567.

24. Bosl GJ, Sheinfeld J, Bajorin DF et al. Cancer of the testis, 1397–1425. In: DeVita VT, Hellman S, Rosenberg SA (eds). Cancer: Princliples and Practice of Oncology. 5th ed. Philadelphia: Lippincott-Raven Publ 1997.

25. Boyle P: Testicular cancer: the challenge for cancer control. Lancet Oncol 2004; 5: 56–61.

26. Møller H, Jorgensen N, Forman D. Trends in incidence of testicular cancer in boys and adolescent men. Int J Cancer 1995; 61: 761–764.

27. Liu S, Semenciw R, Waters C et al. Clues to aetiological heterogeneity of testicular seminomas and non‑seminomas. Time trends and age-period-cohort effects. Int J Epidemiol 2000; 29: 826–831.

28. Møller H. Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology. Eur Urol 1993; 23: 8–15.

29. Tamini R, Adami HO. Testicular cancer, Chapt. 19, 429–445. In: Adami HO, Hunter D, Trichopoulos D (eds). Textbook of cancer epidemiology. New York: Oxford University Press 2002.

30. Møller H, Prener A, Skakkebæk NE. Testicular cancer, cryptorchidism, inguinal hernia, testicular atrophy, and genital malformation: case-control study in Denmark. Cancer Causes Control 1996; 7: 264–274.

31. Dieckmann K-P, Pichlmeier U. Clinical epidemiology of testicular germ cell tumors. World J Urol 2004; 22: 2–14.

32. Matoska J. Pathology, 60–160. In: Ondrus D et al (eds). Testicular tumors, diagnostics and treatment (in Slovak). Martin: Osveta 2004.

33. Prener A, Engholm G, Jensen OM. Genital anomalies and risk for testicular cancer in Danish men. Epidemiology 1996; 7: 14–19.

34. Stang A, Ahrens W, Bromen K et al. Undescended testis and the risk of testicular cancer: importance of sourse and classification of exposure information. Int J Epidemiol 2001; 30(5): 1050–1056.

35. Benson RC, Beard CM, Kelalis PP et al. Malignant potential of the cryptrorchid testis. Mayo Clin Proc 1991; 66: 372–378.

36. Brock D, Fox S, Gosling G et al. Testicular cancer. Semin Oncol Nurs 1993; 3(4): 224–236.

37. Plesko I, Cuninkova M. Etiology and risk factors, 28–37. In: Ondrus D et al (eds). Testicular tumors, diagnostics and treatment (in Slovak). Martin: Osveta 2004.

38. Matoska J. Risk factors and etiology of testicular tumors. In: Hornak M, Matoska J (eds). Testicular tumors, diagnostics and treatment (in Slovak). Bratislava: Veda 1990: 17–27.

39. Stone JM, Cruickshank DG, Sandeman TF et al. Laterality, maldescent, trauma and other clinical factors in the epidemiology of testis cancer in Victoria, Australia. Br J Cancer 1991; 64: 132–138.

40. Park DS, Prow DM, Amato RJ et al. Clinical characteristics of metachronous bilateral testicular tumors in the chemotherapeutic era. Yonsei Med J 1999; 40: 137–143.

41. Tabernero J, Paz-Ares L, Salazar R et al. Incidence of contralateral germ cell testicular tumors in South Europe: report of the experience at 2 Spanish university hospitals and review of the literature. J Urol 2004; 171(1): 164–167.

42. Ondrus D, Hornak M, Matoska J. Bilateral testicular germ-cell tumors: a single centre long‑term experience. Int Urol Nephrol 2001; 33(3): 521–524.

43. Ondrus D, Matoska J (eds). Testicular tumors, diagnostics and treatment (in Slovak). Martin: Osveta 2004.

44. Oliver RTD. Testicular cancer. Curr Opin Oncol 1996; 8: 252–258.

45. Hemminki K, Li X. Familial risk in testicular cancer as a clue to a heritable and environmental aetiology. Br J Cancer 2004; 90(9): 1765–1770.

46. Westergaard T, Olsen JH, Frisch M et al. Cancer risk in fathers and brothers of testicular cancer patients in Denmark. A population‑based study. Int J Cancer 1996; 66: 627–631.

47. Coupland CA, Forman D, Chilvers CE et al. Maternal risk factors for testicular cancer: a population‑based case-control study (UK). Cancer Causes Control 2004; 15(3): 277–283.

48. Swerdlow AJ, Huttly SR, Smith PG. Prenatal and familial associations of testicular cancer. Br J Cancer 1987; 55: 571–577.

49. Dieckmann KP, Endsin G, Pichlmeier U. How valid is the prenatal estrogen excess hypothesis of testicular germ cell cancer? Eur Urol 2001; 40: 677–684.

50. Dusek L, Abrahamova J, Lakomy R et al. Multivariate analysis of risk factors for testicular cancer: a hospital‑based case-control study in the Czech Republic. Neoplasma 2008; 55(4): 356–368.

51. Krizan P. Molecular biology and genetics. In: Ondrus D, Matoska J (eds). Testicular tumors, diagnostics and treatment (in Slovak). Martin: Osveta 2004: 39–58 .