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Testicular germ cell tumours in Iceland: A nationwide clinicopathological study

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Agnarsson BA, Gudbjartsson T, Einarsson GV, Magnusson K, Thoroddsen A, Bergthorsson JT, Amundadottir L, Barkardottir RB, Björnsson J. Testicular germ cell tumours in Iceland. A nationwide clinicopathological study. APMIS 2006;114:779–83.

The purpose of this study was to examine the pathology of all germ cell tumours of the testis diagnosed in Iceland 1955–2002. A total of 214 patients were included in the study. The current age-standardized incidence was found to be 6.1 per 100,000 and had increased almost fourfold during the study period. Seminoma was diagnosed in 55% of cases. Non-seminomas were diagnosed in 45%, and these were further classified as mixed germ cell tumours (33%), embryonal carcinoma (8%), teratoma (3%), and yolk sac tumour (n=1). The mean age at diagnosis was significantly higher for the seminomas than the non-seminomas (38 years versus 29 years) (p<0.001) and the non-seminomas were diagnosed at a significantly higher stage than the seminomas (p<0.001). Thus, in seminoma patients the tumour was localized to the testis (stage I) in 81% of cases, in 17% of patients the tumour had spread to the lymph nodes (stage II or III), and only 2% had extranodal metastasis at diagnosis (stage IV). In contrast, in the non-seminoma patients, the tumours were found to be stage I in 56%, stage II or III in 24%, and stage IV in 20% of cases. No significant difference in staging was found between non-seminoma subtypes. Identification of necrosis or vascular invasion was significantly associated with metastatic disease at diagnosis (p=0.002). During the study period a significant increase in stage I tumours was found as well as a decrease in the size of the tumours.

Keywords: Testicular tumours; epidemiology; germ cell tumours; pathology; staging

Document Type: Research Article


Affiliations: 1: Urology and 2: Oncology, Landspitali-University Hospital, 3: Decode Genetics, Reykjavik, and 4: Pathology,

Publication date: November 1, 2006


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