Skip to main content

Advertisement

Impact du délai diagnostique sur la survie du cancer du testicule

Impact of time to diagnosis on survival of testicular cancer

Article metrics

  • 186 Accesses

  • 1 Citations

Résumé

Objectifs

Le cancer du testicule est le premier cancer de l’adulte jeune et son incidence augmente dans la quasi-totalité des pays industrialisés. Le taux de survie après cancer du testicule est de 95%, tous stades confondus, cependant un groupe de patients à mauvais pronostic continue à échapper aux thérapeutiques. Le délai diagnostique est défini comme le temps en mois entre la perception du premier symptôme de cancer du testicule par le patient et le diagnostic par le médecin de la maladie. L’objectif de cette étude est de déterminer si le délai diagnostique a une valuer pronostique, en particulier s’il est corrélé avec le stade de la maladie et la survie.

Matériel et méthodes

Le délai diagnostique a été étudié chez 542 patients ayant eu un diagnostic de cancer du testicule entre 1983 et 2002 dans la région Midi-Pyrénées. L’information concernant la maladie et les traitements contenus dans les dossiers médicaux a été colligée sur un document synthétique. Le délai diagnostique a été corrélé avec les paramètres pronostiques, dont le stade et la survie.

Résultats

Le délai diagnostique était de 3,7±5,1 mois et était plus long pour les séminomes (4,9±6,1 mois) que pour les tumeurs germinales non séminomateuses (TGNS) (2,8±4,0 mois). La durée du délai diagnostique était corrélée avec le stade de la maladie et la survie à 5 ans, sur l’ensemble de la population et dans le groupe des TGNS, mais non dans le groupe des séminomes.

Conclusions

La précocité du diagnostic conserve une valeur pronostique (corrélation avec le stade de la maladie et le taux de survie à 5 ans). Les mesures de sensibilisation et d’information du cancer du testicule sont donc à considérer.

Abstract

Objectives

Testicular cancer is the leading cancer of young adults and its incidence is increasing in almost all industrialized countries. The survival rate after testicular cancer is 95%, all stages combined, but a group of patients with poor prognosis still fails to respond to treatment. The time to diagnosis is defined as the time in months between perception of the first symptoms of testicular cancer by the patient and the diagnosis of the disease by the doctor. The objective of this study is to determine whether the time to diagnosis has a prognostic value, particularly whether it is correlated with the stage of the disease and survival.

Material and Methods

The time to diagnosis was studied in 542 patients with a diagnosis of testicular cancer between 1983 and 2002 in the Midi-Pyrenées region. Information concerning the disease and treatments contained in medical files was collected on a summary document. The time to diagnosis was correlated with prognostic parameters, including stage and survival.

Results

The mean time to diagnosis was 3.7±5.1 months and was longer for seminomas (4.9±6.1 months) than for non-seminomatous germ cell tumours (NSGCT) (2.8 ±4.0 months). The time to diagnosis was correlated with the stage of the disease and the 5-year survival on the overall population and in the NSGCT group, but not in the seminoma group.

Conclusions

Early diagnosis has a prognostic value (correlation with stage of the disease and 5-year survival rate). Testicular cancer information campaigns should therefore be envisaged.

References

  1. 1.

    HUYGHE E., MATSUDA T., THONNEAU P.: Increasing incidence of testicular cancer worldwide: a review. J. Urol., 2003, 170: 5–11.

  2. 2.

    BOSL G.J., VOGELZANG N.J., GOLDMAN A. et al.: Impact of delay in diagnosis on clinical stage of testicular cancer. Lancet, 1981, 2: 970–973.

  3. 3.

    MOUL J.W., PAULSON D.F., DODGE R.K., WALTHER P.J.: Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years. J. Urol., 1990, 143: 520–523.

  4. 4.

    BOSL G.J., MOTZER R.J.: Testicular germ-cell cancer. N. Engl. J. Med., 1997, 337: 242–253.

  5. 5.

    HUYGHE E., MATSUDA T., DAUDIN M. et al.: Fertility after testicular cancer treatments: results of a large multicenter study. Cancer, 2004, 100: 732–737.

  6. 6.

    DOUCHEZ J., DROZ J.P., DESCLAUX B., et al.: Quality of life in long-term survivors of nonseminomatous germ cell testicular tumors. J. Urol., 1993, 149: 498–501.

  7. 7.

    SCHER H., BOSL G., GELLER N. et al.: Impact of symptomatic interval on prognosis of patients with stage III testicular cancer. Urology, 1983, 21: 559–561.

  8. 8.

    BODEN G., GIBB R.: Radiotherapy and testicular neoplasms. Lancet, 1951, 2: 1195–1197.

  9. 9.

    CHILVERS C.E., SAUNDERS M., BLISS J.M. et al.: Influence of delay in diagnosis on prognosis in testicular teratoma. Br. J. Cancer, 1989, 59: 126–128.

  10. 10.

    THORNHILL J.A., FENNELLY J.J., KELLY D.G. et al.: Patients’ delay in the presentation of testis cancer in Ireland. Br. J. Urol., 1987, 59: 447–451.

  11. 11.

    MEFFAN P.J., DELAHUNT B., NACEY J.N.: The value of early diagnosis in the treatment of patients with testicular cancer. N. Z. Med. J., 1991, 104: 393–394.

  12. 12.

    TOKLU C., OZEN H., SAHIN A. et al.: Factors involved in diagnostic delay of testicular cancer. Int. Urol. Nephrol., 1999, 31: 383–388.

  13. 13.

    HERNES E.H., HARSTAD K., FOSSA: Changing incidence and delay of testicular cancer in southern Norway (1981–1992). Eur. Urol., 1996, 30: 349–357.

  14. 14.

    DIECKMANN K.P., BECKER T., BAUER H.W.: Testicular tumors: presentation and role of diagnostic delay. Urol. Int., 1987, 42: 241–247.

  15. 15.

    STEELE G.S., RICHIE J.P., STEWART A.K., MENCK H.R.: The National Cancer Data Base report on patterns of care for testicular carcinoma, 1985–1996. Cancer, 1999, 86: 2171–2183.

  16. 16.

    BRENNER J.S., HERGENROEDER A.C., KOZINETZ C.A., KELDER S.H.: Teaching testicular self-examination: education and practices in pediatric residents. Pediatrics, 2003, 111: 239–244.

  17. 17.

    SHELEY J.P., KINCHEN E.W., MORGAN D.H., GORDON D.F.: Limited impact of testicular self-examination promotion. J. Community Health, 1991, 16: 117–124.

  18. 18.

    WARDLE J., STEPTOE A., BURCKHARDT R. et al.: Testicular self-examination: attitudes and practices among young men in Europe. Prev. Med., 1994, 23: 206–210.

  19. 19.

    THORNHILL J.A., CONROY R.M., KELLY D.G. et al.: Public awareness of testicular cancer and the value of self examination. Br. Med. J. (Clin. Res. Ed.) 1986, 293: 480–481.

  20. 20.

    JONES W., APPLEYARD I.: Early diagnosis of testicular cancer. Practitioner, 1989, 233: 509.

  21. 21.

    VASUDEV N.S., JOFFE J.K., COOKE C. et al.: Delay in the diagnosis of testicular tumours — changes over the past 18 years. Br. J. Gen. Pract., 2004, 54: 595–597.

  22. 22.

    CHAPPLE A., ZIEBLAND S., McPHERSON A.: Qualitative study of men’s perceptions of why treatment delays occur in the UK for those with testicular cancer. Br. J. Gen. Pract., 2004, 54: 25–32.

Download references

Author information

Correspondence to Eric Huyghe.

Additional information

Bourse SALF 2005

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Huyghe, E., Khedis, M., Doumerc, N. et al. Impact du délai diagnostique sur la survie du cancer du testicule. Androl. 16, 235–239 (2006) doi:10.1007/BF03034861

Download citation

Mots Clés

  • cancer du testicule
  • diagnostic
  • survie
  • stade

Key words

  • testicular neoplasms
  • diagnosis
  • survival
  • stage