Current problems in epidemiology, diagnosis and treatment of testicular cancer
- Authors: Korchagin M.P.1, Sokolov E.A.2,3, Pushkar D.Y.2,3,4
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Affiliations:
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
- S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center, Moscow Healthcare Department
- Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
- Russian University of Medicine, Ministry of Health of Russia
- Issue: Vol 21, No 4 (2025)
- Pages: 186-196
- Section: REVIEWS
- Published: 27.02.2026
- URL: https://oncourology.abvpress.ru/oncur/article/view/1917
- DOI: https://doi.org/10.17650/1726-9776-2025-21-4-186-196
- ID: 1917
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Full Text
Abstract
Testicular cancer is a rare malignant tumor of men of working age, with an incidence rate in Russia of less than 2 % per 100,000 people. The aim of our study was to analyze current epidemiological data, modern trends in diagnosis and treatment of germ cell and non-germ cell testicular neoplasms. A literature review was conducted using the PubMed, MEDLINE, Cochrane Library, eLibrary and Scopus databases. Given young age and the necessity to preserve high quality of life in this cohort of patients, timely and accurate diagnosis is important. Self-screening and cancer awareness programs, new biomarkers such as microRNA, circulating tumor DNA, circulating mitochondria DNA, and circulating tumor cells can improve detection of patients with this type of tumor. 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography with dual-time-point imaging has high sensitivity and specificity for restaging of residual masses in testicular cancer. Development of new drugs, including immunotherapeutic drugs, can solve the problem of resistance to platinum-based drugs among patients with metastatic cancer. The quality of life of patients with testicular cancer directly depends on the chosen treatment tactics. Therefore, time should always be devoted to psychological preparation and counselling of patients before starting therapy, talking through and discussing all possible short- and long-term complications from the chosen type of treatment.
About the authors
Mikhail P. Korchagin
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Author for correspondence.
Email: mihailsun@mail.ru
ORCID iD: 0000-0001-8060-6691
Russian Federation, 24 Kashirskoe Shosse, Moscow 115522
E. A. Sokolov
S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center, Moscow Healthcare Department; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Email: mihailsun@mail.ru
ORCID iD: 0000-0002-8887-5789
Department of Urology and Surgical Andrology, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation, 5 2nd Botkinskiy Proezd, Moscow 125284; 2/1 Barrikadnaya St., Moscow 125993D. Yu. Pushkar
S.P. Botkin Moscow Multidisciplinary Scientific and Clinical Center, Moscow Healthcare Department; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; Russian University of Medicine, Ministry of Health of Russia
Email: mihailsun@mail.ru
ORCID iD: 0000-0002-6096-5723
Department of Urology and Surgical Andrology, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation, 5 2nd Botkinskiy Proezd, Moscow 125284; 2/1 Barrikadnaya St., Moscow 125993; 4 Dolgorukovskaya St., Moscow 127006References
- Del Risco Kollerud R., Ruud E., Haugnes H.S. et al. Family history of cancer and risk of pediatric and young adult’s testicular cancer: a Norwegian cohort study. Br J Cancer 2019;120(10):1007–14. doi: 10.1038/s41416-019-0445-2
- Bray F., Laversanne M., Sung H. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74(3):229–63. doi: 10.3322/caac.21834
- Malignant tumors in Russia in 2023 (morbidity and mortality). Eds.: A.D. Kaprin, V.V. Starinskiy, A.O. Shakhzadova. Moscow: Moskovskiy nauchno-issledovatelskiy onkologicheskiy institut im. P.A. Gertsena – filial FGBU “Natsionalnyy medicinskiy issledovatelskiy tsentr radiologii” Minzdrava Rossii, 2024. 276 p. (In Russ.).
- Cayuela L., Cabrera Fernández S., Pereyra-Rodríguez J.J. et al. Rising testicular cancer incidence in Spain despite declining mortality: an age-period-cohort analysis. Actas Urol Esp (Engl Ed) 2024;48(8):596–602. doi: 10.1016/j.acuroe.2024.05.003
- Spiller C.M., Bowles J. Germ cell neoplasia in situ: the precursor cell for invasive germ cell tumors of the testis. Int J Biochem Cell Biol 2017;86:22–5. doi: 10.1016/j.biocel.2017.03.004
- Demirci A., Başar H. Effects of epidemiological risk factors on prognosis in testicular cancer. Int Urol Nephrol 2023;55(1):51–9. doi: 10.1007/s11255-022-03359-2
- Kharazmi E., Hemminki K., Pukkala E. et al. Cancer risk in relatives of testicular cancer patients by histology type and age at diagnosis: a joint study from five nordic countries. Eur Urol 2015;68(2):283–9. doi: 10.1016/j.eururo.2014.12.031
- Kreiberg M., Bandak M., Lauritsen J. et al. Adverse health behaviors in long-term testicular cancer survivors: a Danish nationwide study. Acta Oncol 2021;60(3):361–9. doi: 10.1080/0284186X.2020.1851765
- Maiolino G., Fernández-Pascual E., Ochoa Arvizo M.A. et al. Male infertility and the risk of developing testicular cancer: a critical contemporary literature review. Medicina (Kaunas) 2023;59(7):1305. doi: 10.3390/medicina59071305
- Skakkebaek N.E., Rajpert-De Meyts E., Main K.M. Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod 2001;16(5):972–8. doi: 10.1093/humrep/16.5.972
- Sharpe R.M., Skakkebaek N.E. Are estrogens involved in falling sperm counts and disorders of the male reproductive tract? Lancet 1993;341(8857):1392–5. doi: 10.1016/0140-6736(93)90953-e
- Chong R.I.H., Leow J.J., Choo Z.W. et al. Testicular self-examination for early detection of testicular cancer. World J Urol 2023;41(4):941–51. doi: 10.1007/s00345-023-04381-4
- Casey R.G., Grainger R., Butler M.R. et al. Public awareness of testis cancer and the prevalence of testicular self-examination-changing patterns over 20 years. Urology 2010;76(4):915–8. doi: 10.1016/j.urology.2010.03.022
- Heijnsdijk E.A.M., Supit S.J., Looijenga L.H.J., de Koning H.J. Screening for cancers with a good prognosis: the case of testicular germ cell cancer. Cancer Med 2021;10(8):2897–903. doi: 10.1002/cam4.3837
- Aksoy C., Ihrig A., Reimold P. et al. Better knowledge about testicular cancer might improve the rate of testicular (self-)examination: a survey among 1,025 medical students in Germany. Urol Int 2022;106(10):1056–60. doi: 10.1159/000525854
- Duran M.B., Kizilkan Y. Quality analysis of testicular cancer videos on YouTube. Andrologia 2021;53(8):e14118. doi: 10.1111/and.14118
- Dieckmann K.P., Radtke A., Spiekermann M. et al. Serum levels of microRNA miR-371a-3p: a sensitive and specific new biomarker for germ cell tumors. Eur Urol 2017;71(2):213–20. doi: 10.1016/j.eururo.2016.07.029
- Statello L., Guo C.J., Chen L.L., Huarte M. Gene regulation by long non-coding RNAs and its biological functions. Nat Rev Mol Cell Biol 2021;22(2):96–118. doi: 10.1038/s41580-020-00315-9
- Das M.K., Furu K., Evensen H.F. et al. Knockdown of SPRY4 and SPRY4-IT1 inhibits cell growth and phosphorylation of Akt in human testicular germ cell tumors. Sci Rep 2018;8(1):2462. doi: 10.1038/s41598-018-20846-8
- Wienholds E., Kloosterman W.P., Miska E. et al. MicroRNA expression in zebrafish embryonic development. Science 2005;309(5732):310–1. doi: 10.1126/science.1114519
- Lin K., Farahani M., Yang Y. et al. Loss of MIR15A and MIR16-1 at 13q14 is associated with increased TP53 mRNA, de-repression of BCL2 and adverse outcome in chronic lymphocytic leukaemia. Br J Haematol 2014;167(3):346–55. doi: 10.1111/bjh.13043
- Tokumaru Y., Oshi M., Huyser M.R. et al. Low expression of miR-29a is associated with aggressive biology and worse survival in gastric cancer. Sci Rep 2021;11(1):14134. doi: 10.1038/s41598-021-93681-z
- Murray M.J., Halsall D.J., Hook C.E. et al. Identification of microRNAs from the miR-371~373 and miR-302 clusters as potential serum biomarkers of malignant germ cell tumors. Am J Clin Pathol 2011;135(1):119–25. doi: 10.1309/AJCPOE11KEYZCJHT
- Lobo J., Leão R., Jerónimo C., Henrique R. Liquid biopsies in the clinical management of germ cell tumor patients: state-of-the-art and future directions. Int J Mol Sci 2021;22(5):2654. doi: 10.3390/ijms22052654
- Ellinger J., Wittkamp V., Albers P. et al. Cell-free circulating DNA: diagnostic value in patients with testicular germ cell cancer. J Urol 2009;181(1):363–71. doi: 10.1016/j.juro.2008.08.118
- Boublikova L., Kramarzova K.S., Zwyrtkova M. et al. The clinical value of circulating free tumor DNA in testicular germ cell tumor patients. Urol Oncol 2022;40(9):412.e15–412.e24. doi: 10.1016/j.urolonc.2022.04.021
- Krasic J., Skara L., Bojanac A.K. et al. The utility of cfDNA in TGCT patient management: a systematic review. Ther Adv Med Oncol 2022;14:17588359221090365. doi: 10.1177/17588359221090365
- Ellinger J., Albers P., Müller S.C. et al. Circulating mitochondrial DNA in the serum of patients with testicular germ cell cancer as a novel noninvasive diagnostic biomarker. BJU Int 2009;104(1):48–52. doi: 10.1111/j.1464-410X.2008.08289.x
- Ashworth T.R. A case of cancer in which cells similar to those in the tumours were seen in the blood after death. Med J Aust 1869;14:146–7.
- Nastały P., Honecker F., Pantel K., Riethdorf S. Detection of circulating tumor cells (CTCs) in patients with testicular germ cell tumors. Methods Mol Biol 2021;2195:245–61. doi: 10.1007/978-1-0716-0860-9_16
- Rasheed R., Al-Kandari F., Ghanem M. et al. Significance of 18F-FDG PET/CT in characterization of equivocal lesions in high-risk testicular carcinoma in restaging setting. Asian Pac J Cancer Prev 2020;21(2):511–5. doi: 10.31557/APJCP.2020.21.2.511
- Nasr I.M., Talaat O.M., Rezk M.A. et al. 18F-FDG PET–CT dual-time imaging in detection and characterization of recurrent lesions in patients with testicular cancer. Egypt J Radiol Nucl Med 2022;53:228. doi: 10.1186/s43055-022-00915-9
- Hellesnes R., Myklebust T.Å., Fosså S.D. et al. Testicular cancer in the cisplatin era: causes of death and mortality rates in a population-based cohort. J Clin Oncol 2021;39(32):3561–73. doi: 10.1200/JCO.21.00637
- Padayachee J., Clark R., Warde P., Hamilton R.J. Management of stage I testicular cancer. Curr Opin Urol 2022;32(1):17–23. doi: 10.1097/MOU.0000000000000942
- Petrelli F., Coinu A., Cabiddu M. et al. Surveillance or adjuvant treatment with chemotherapy or radiotherapy in stage I seminoma: a systematic review and meta-analysis of 13 studies. Clin Genitourin Cancer 2015;13(5):428–34. doi: 10.1016/j.clgc.2015.04.005
- Milano M.T., Dinh P.C., Yang H. et al. Solid and hematologic neoplasms after testicular cancer: a US population-based study of 24 900 survivors. JNCI Cancer Spectr 2020;4(3):pkaa017. doi: 10.1093/jncics/pkaa017
- Pierorazio P.M., Cheaib J.G., Patel H.D. et al. Comparative effectiveness of surveillance, primary chemotherapy, radiotherapy and retroperitoneal lymph node dissection for the management of early stage testicular germ cell tumors: a systematic review. J Urol 2021;205(2):370–82. doi: 10.1097/JU.0000000000001364
- Klein B., Haggeney T., Fietz D. et al. Specific immune cell and cytokine characteristics of human testicular germ cell neoplasia. Hum Reprod 2016;31(10):2192–202. doi: 10.1093/humrep/dew211
- Fankhauser C.D., Curioni-Fontecedro A., Allmann V. et al. Frequent PD-L1 expression in testicular germ cell tumors. Br J Cancer 2015;113(3):411–3. doi: 10.1038/bjc.2015.244
- Cierna Z., Mego M., Miskovska V. et al. Prognostic value of programmed-death-1 receptor (PD-1) and its ligand 1 (PD-L1) in testicular germ cell tumors. Ann Oncol 2016;27(2):300–5. doi: 10.1093/annonc/mdv574
- Jennewein L., Bartsch G., Gust K. et al. Increased tumor vascularization is associated with the amount of immune competent PD-1 positive cells in testicular germ cell tumors. Oncol Lett 2018;15(6):9852–60. doi: 10.3892/ol.2018.8597
- Chovanec M., Cierna Z., Miskovska V. et al. Prognostic role of programmed-death ligand 1 (PD-L1) expressing tumor infiltrating lymphocytes in testicular germ cell tumors. Oncotarget 2017;8(13):21794–805. doi: 10.18632/oncotarget.15585
- Siska P.J., Johnpulle R.A.N., Zhou A. et al. Deep exploration of the immune infiltrate and outcome prediction in testicular cancer by quantitative multiplexed immunohistochemistry and gene expression profiling. Oncoimmunology 2017;6(4):e1305535. doi: 10.1080/2162402X.2017.1305535
- Zschäbitz S., Lasitschka F., Hadaschik B. et al. Response to anti-programmed cell death protein-1 antibodies in men treated for platinum refractory germ cell cancer relapsed after high-dose chemotherapy and stem cell transplantation. Eur J Cancer 2017;76:1–7. doi: 10.1016/j.ejca.2017.01.033
- Chi E.A., Schweizer M.T. Durable response to immune checkpoint blockade in a platinum-refractory patient with nonseminomatous germ cell tumor. Clin Genitourin Cancer 2017;15(5):e855–e857. doi: 10.1016/j.clgc.2017.04.005
- Adra N., Einhorn L.H., Althouse S.K. et al. Phase II trial of pembrolizumab in patients with platinum refractory germ-cell tumors: a Hoosier Cancer Research Network Study GU14-206. Ann Oncol 2018;29(1):209–14. doi: 10.1093/annonc/mdx680
- Mego M., Svetlovska D., Chovanec M. et al. Phase II study of avelumab in multiple relapsed/refractory germ cell cancer. Invest New Drugs 2019;37(4):748–54. doi: 10.1007/s10637-019-00805-4
- Albany C., Einhorn L.H., Garbo L. et al. Treatment of CD30-expressing germ cell tumors and sex cord stromal tumors with brentuximab vedotin: identification and report of seven cases. Oncologist 2018;23(3):316–23. doi: 10.1634/theoncologist.2017-0544
- Schover L.R., von Eschenbach A.C., Smith D.B., Gonzalez J. Sexual rehabilitation of urologic cancer patients: a practical approach. CA Cancer J Clin 1984;34(2):66–74. doi: 10.3322/canjclin.34.2.66
- Incrocci L., Hop W.C., Wijnmaalen A., Slob A.K. Treatment outcome, body image, and sexual functioning after orchiectomy and radiotherapy for stage I–II testicular seminoma. Int J Radiat Oncol Biol Phys 2002;53(5):1165–73. doi: 10.1016/s0360-3016(02)02849-3
- Nezu K., Yamashita S., Kakimoto K. et al. Association of financial toxicity with quality of life in testicular cancer survivors. Int J Urol 2022;29(12):1526–34. doi: 10.1111/iju.15039
- Ramos S.A., Pinheiro A.M., Barcelos A.P. et al. Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors. Rev Int Androl 2022;20(2):110–5. doi: 10.1016/j.androl.2020.10.006
- Petersen P.M., Skakkebaek N.E., Rørth M., Giwercman A. Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer. J Urol 1999;161(3):822–6. PMID: 10022693
- Pallotti F., Petrozzi A., Cargnelutti F. et al. Long-term follow up of the erectile function of testicular cancer survivors. Front Endocrinol (Lausanne) 2019;10:196. doi: 10.3389/fendo.2019.00196
- Averette H.E., Boike G.M., Jarrell M.A. Effects of cancer chemotherapy on gonadal function and reproductive capacity. CA Cancer J Clin 1990;40(4):199–209. doi: 10.3322/canjclin.40.4.199
- Bandak M., Lauritsen J., Johansen C. et al. Sexual function in a nationwide cohort of 2,260 survivors of testicular cancer after 17 years of followup. J Urol 2018;200(4):794–800. doi: 10.1016/j.juro.2018.04.077
- Schover L.R., Gonzales M., von Eschenbach A.C. Sexual and marital relationships after radiotherapy for seminoma. Urology 1986;27(2):117–23. doi: 10.1016/0090-4295(86)90367-5
- La Vignera S., Cannarella R., Duca Y. et al. Hypogonadism and sexual dysfunction in testicular tumor survivors: a systematic review. Front Endocrinol (Lausanne) 2019;10:264. doi: 10.3389/fendo.2019.00264
- Barkatz J., Kleinclauss F., Rigaud J. et al. Sexual dysfunctions of patients treated with orchidectomy, chemotherapy and retroperitoneal lymphadenectomy, need for systematic andrological care? Bull Cancer 2019;106(10):915–22. (French). doi: 10.1016/j.bulcan.2019.03.020
- Matos E., Skrbinc B., Zakotnik B. Fertility in patients treated for testicular cancer. J Cancer Surviv 2010;4(3):274–8. doi: 10.1007/s11764-010-0135-9
- Mittakanti H.R., Porter J.R. Robot-assisted laparoscopic retroperitoneal lymph node dissection: a minimally invasive surgical approach for testicular cancer. Transl Androl Urol 2020;9(Suppl 1): S66–73. doi: 10.21037/tau.2019.12.36
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