T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 Collecting Cancer - PDF document

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 Collecting Cancer Data: Testis 2014-2015 NAACCR We b ina r Se rie s Ja nua ry 8, 2015 Q&A • Ple a se sub mit a ll q ue stio ns c o nc e rning we b ina r c o nte nt thro ug h the Q&A pa ne l. Re minde r: • I f yo u ha ve pa rtic ipa nts wa tc hing this we b ina r a t yo ur site , ple a se c o lle c t the ir na me s a nd e ma ils. • We will b e distrib uting a Q&A do c ume nt in a b o ut o ne we e k. T his do c ume nt will fully a nswe r q ue stio ns a ske d during the we b ina r a nd will c o nta in a ny c o rre c tio ns tha t we ma y disc o ve r a fte r the we b ina r. 2 F ABUL OUS PRIZE S 3 NAAC CR 2014-2015 We b ina r Se rie s 1

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 OVERVIEW T e stis COUNT S • E stima te d ne w c a se s a nd de a ths fro m te stic ula r c a nc e r in the Unite d Sta te s in 2014: • Ne w c a se s: 8,820 • De a ths: 380 • Mo st c o mmo n so lid tumo r ma lig na nc y a mo ng me n b e twe e n 15 a nd 34 ye a rs o f a g e . • Wo rld wide inc ide nc e ha s do ub le d in la st 40 ye a rs. F IVE - YE AR RE L AT IVE * SURVIVAL RAT E S (% ) BY ST AGE AT DIAGNOSIS, 2003- 2009 L oc a l Re g iona l Dista nt All Sta g e s T e stis 99 96 74 95 *Ra te s a re a djuste d fo r no rma l life e xpe c ta nc y a nd a re b a se d o n c a se s dia g no se d in the SE E R 18 a re a s fro m 2003-2009, a ll fo llo we d thro ug h 2010. So urc e : Ho wla de r N, No o ne AM, K ra pc ho M, e t a l. (e ds). SE E R Ca nc e r Sta tistic s Re vie w, 1975-2010, Na tio na l Ca nc e r I nstitute , Be the sda , MD http:/ / se e r.c a nc e r.g o v/ c sr/ 1975_2010/ , b a se d o n No ve mb e r 2012 SE E R da ta sub missio n, po ste d to the SE E R We b site , April 2013 6 NAAC CR 2014-2015 We b ina r Se rie s 2

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 ANATOMY http:/ / www.c a nc e r.ne t (Vas) Re te T e stis T unic a Vaginalis T unic a Albugine a RE GIONAL L YMPH NODE S • Inte ra o rto c a va l • Pre c a va l • Pa ra a o rtic • Re tro a o rtic • Pa ra c a va l • Re tro c a va l • Pre a o rtic Re trope ritone al lymph Node s NAAC CR 2014-2015 We b ina r Se rie s 3

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 RE GIONAL L YMPH NODE S • L e ft te stic le dra ins prima rily to the pa ra a o rtic lymph no de s • Rig ht te stic le dra ins prima rily to the inte r a o rto c a va l lymph no de s http:/ / www.c a nc e r.ne t/ site s/ c a nc e r.ne L ung Re trope ritone al node s ICD O 3 SIT E S ICD O 3 T e rm C62.0 Unde sc e nde d te stis C62.1 De sc e nde d te stis C62.9 T e stis, NOS NAAC CR 2014-2015 We b ina r Se rie s 4

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 PAT HOL OGY • Ove r 95% o f te stic ula r c a nc e rs a re g e rm-c e ll tumo rs • Se mino ma s 40% • No n Se mino ma 60% 13 GE RM CE L L T UMORS (GCT ) • Se mino ma , NOS (9061) • Cla ssic (9061) • Ana pla stic (9062) • Spe rma to c ytic (9063) GCT • No n-se mino ma • E mb ryo na l c a rc ino ma (9070/ 3) • Ma lig na nt te ra to ma (9080/ 3) • T e ra to c a rc ino ma (9081/ 3) • Mixe d e mb ryo na l c a rc ino ma a nd te ra to ma • Ma lig na nt te ra to ma , undiffe re ntia te d (9082/ 3) • Ma lig na nt te ra to ma , inte rme dia te (9083/ 3) • E xtra -e mb ryo nic e le me nts • Cho rio c a rc ino ma • Yo lk sa c tumo r • No n-se mino ma is the mo re c linic ally aggre ssive tumo r NAAC CR 2014-2015 We b ina r Se rie s 5

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 MAT URE T E RAT OMA • I CD O 3 histo lo g y fo r Ma ture T e ra to ma is 9080/ 0 • A ma ture te ra to ma o c c urring in a dults (po st pub e rty) is re po rta b le . • Co de to 9080/ 3 • A ma ture te ra to ma (no s) o c c urring in c hild is no t re po rta b le . • Co de to 9080/ 0 • If physic ia n indic a te s the ma ture te ra to ma is ma lig na nt the c a se is re po rta b le a nd sho uld b e c o de d to 9080/ 3 MIXE D CE L L • Se mino ma mixe d with no n-se mino ma sho uld b e c o nside re d no n-se mino ma fo r tre a tme nt de c isio ns NON- GE RM CE L L T UMORS • L e ydig c e ll tumo r (8650/ 3) • Se rto li c e ll tumo r (8640/ 3) • L ympho ma • Rha b do mysa rc o ma • Me la no ma NAAC CR 2014-2015 We b ina r Se rie s 6

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 SE RUM T UMOR MARKE RS • Use d to he lp dia g no se dise a se • Sta g e dise a se • De te rmine pro g no sis • Mo nito r fo r re la pse • L e ve ls sho uld b e de te rmine d • Be fo re o rc hie c to my • Afte r o rc hie c to my • T hro ug ho ut fo llo w-up 19 AL PHA- F E T OPROT E IN (AF P) • E le va te d AF P va lue s a re fo und in no n- se mino ma to us ma lig na nc ie s a nd mixe d tumo rs o f the te stis. • Ra re ly o c c ur in pure se mino ma s • Ca n b e use d to he lp ide ntify spe c ific c e ll type s a nd to mo nito r re spo nse to tre a tme nt. • Ha lf life is 5-7 da ys BE T A- HUMAN CHORIONIC GONADOT ROPIN (BE T A- HCG) • I nc re a se d le ve ls o f Be ta -HCG a re typic a lly pre se nt in b o th se mino ma s a nd no n- se mino ma s. • E le va te d le ve ls a fte r re missio n indic a te s a po te ntia l re la pse . • Ha lf life is 1-3 da ys 21 NAAC CR 2014-2015 We b ina r Se rie s 7

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 L ACT AT E DE HYDROGE NASE (L DH) • An e le va te d L DH ha s a pro g no stic va lue in me n with a dva nc e d te stic ula r c a nc e r. • T he L DH ma y re fle c t the g ro wth ra te a nd tumo r b urde n in me n with a dva nc e d dise a se . • Inc re a se d L DH ha s b e e n re po rte d in a ppro xima te ly 80% o f a dva nc e d se mino ma s a nd 60% o f no n- se mino ma s. • Ha lf life o f L DH is 1-3 da ys Pro g no stic fe a ture s a nd ma rke rs fo r te stic ula r c a nc e r ma na g e me nt http:/ / www.nc b i.nlm.nih.g o v/ p mc / a rtic le s/ PMC2878444/ 22 L YMPH VASCUL AR INVASION (L VI) • I ndic a te s the pre se nc e o r a b se nc e o f tumo r c e lls in lympha tic c ha nne ls (no t lymph no de s) o r b lo o d ve sse ls within the prima ry tumo r a s no te d mic ro sc o pic a lly b y the pa tho lo g ist. • Use d to de te rmine the T va lue • Ma y b e the diffe re nc e b e twe e n a T 1 a nd T 2 • L ymphva sc ula r inva sio n is a stro ng risk fa c to r fo r re c urre nc e . MULTIPLE PRIMARY AND HISTOLOGY RULES Othe r Rule s NAAC CR 2014-2015 We b ina r Se rie s 8

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 HIST OL OGY RUL E S • Rule H11 • Co de the histo lo g y whe n o nly o ne histo lo g ic type is ide ntifie d • Rule H13 • Co de the mo st spe c ific histo lo g ic te rm HIST OL OGY RUL E S • Rule H16 • Co de the a ppro pria te c o mb ina tio n/ mixe d c o de (T a b le 2) whe n the re a re multiple spe c ific histo lo g ie s o r whe n the re is a no n-spe c ific histo lo g y with multiple spe c ific histo lo g ie s • Rule H17 • Co de the histo lo g y with the nume ric a lly hig he r ICD- O-3 c o de . MUL T IPL E PRIMARY AND HIST OL OGY RUL E S Re quire d Histology Combine d Combine d T e r m Code With T e ra to ma E mb ryo na l T e ra to c a rc ino ma 9081 Ca rc ino ma T e ra to ma a nd o ne Se mino ma Mixe d g e rm c e ll 9085 o r mo re histo lo g ie s Yo lk sa c tumo r tumo r in c o lumn 2 Cho rio c a rc ino ma T e ra to ma Cho rio c a rc ino ma 9101 Se mino ma with o the r g e rm E mb ryo na l c e ll e le me nts NAAC CR 2014-2015 We b ina r Se rie s 9

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 POP QUIZ • Wha t histo lo g y wo uld b e a ssig ne d to a sing le tumo r c o nsisting o f… • Se mino ma a nd e mb ryo na l c a rc ino ma • Ma lig na nt te ra to ma a nd e mb ryo na l c a rc ino ma • Se mino ma , yo lk sa c tumo r, a nd te ra to ma QUESTIONS? ST AGING: T E ST IS 30 NAAC CR 2014-2015 We b ina r Se rie s 10

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 AJCC Ca nc e r Sta g e T E ST IS: CHAPT E R 42 31 32 33 NAAC CR 2014-2015 We b ina r Se rie s 11

T e stic ula r Ma lig na nc ie s 2015 1/ 8/ 15 34 AJCC CANCE R ST AGE : T E ST IS • I CD-O-3 T o po g ra phy Co de s • C62.0, C62.1, C62.9 • I CD-O-3 Histo lo g y Co de Ra ng e s • 8000-8576 • 8590-8670 • 8940-8950 • 8980-8981 • 9060-9090 • 9100-9105 35 AJCC CANCE R ST AGE : T E ST IS CL ASSIF ICAT ION • Clinic a l sta g ing • Clinic a l e xa m a nd histo lo g ic a sse ssme nt • Ra dio g ra phic a sse ssme nt o f c he st, a b do me n, & pe lvis to de te rmine N & M sta tus 36 NAAC CR 2014-2015 We b ina r Se rie s 12