Urology>>>>>Testicular Cancer
Question 5#

Regarding germ cell neoplasia in situ (GCNIS), which of the following is TRUE?

A. Overall incidence in the contralateral testis is approximately 10%
B. Incidence of a contralateral metachronous tumour is approximately 10%
C. Biopsy of the contralateral testis is mandatory in most cases
D. Chemotherapy is more effective than radiotherapy in its treatment
E. Five-year risk of developing testicular cancer is 90% with a normal contralateral testis

Correct Answer is A

Comment:

Answer A

Overall incidence of GCNIS in the contralateral testis is approximately 10% with a 50% fiveyear risk of developing testicular cancer. Incidence of a contralateral metachronous tumour is approximately with current EAU guidelines identified risk factors for detecting GCNIS which is the reason to biopsy the contralateral testis and found that patients presenting younger than 31 years of age, and those with a small testis (<12 mL), history of undescended testes, or poor spermatogenesis (Johnsen score of 1–3) had higher rates of GCNIS that could be as high as 34%. Radiotherapy is the treatment of choice for confirmed GCNIS and is given at a dose of 16–20 Gy in fractions of 2 Gy. If patient is undergoing post-orchidectomy chemo, then there is a 66% chance of treating ITGCN, and a rebiopsy after 2 years would be sensible.