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Inicio Actas Urológicas Españolas (English Edition) The effect of diagnosis delay in testis cancer on tumor size, tumor stage and tu...
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Vol. 48. Issue 5.
Pages 356-363 (June 2024)
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Vol. 48. Issue 5.
Pages 356-363 (June 2024)
Original article
The effect of diagnosis delay in testis cancer on tumor size, tumor stage and tumor markers
Efecto del retraso en el diagnóstico del cáncer testicular en el tamaño tumoral, estadio y marcadores tumorales
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O. Gerceka,
Corresponding author
osmangercek1989@hotmail.com

Corresponding author.
, K. Topalb, A.K. Yildizc, K. Ulusoya, V.M. Yazara
a Afyonkarahisar Health Sciences University, Department of Urology, Afyonkarahisar, Turkey
b Afyonkarahisar State Hospital, Department of Urology, Afyonkarahisar, Turkey
c Ankara Bilkent City Hospital, Department of Urology, Ankara, Turkey
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Tables (3)
Table 1. Demographic and clinical data of the groups.
Table 2. Correlation analysis of demographic and clinical data.
Table 3. Linear regression analysis regarding the diagnostic delay time and pathological tumor size.
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Abstract
Introduction

In testicular cancer, the positive effect of early diagnosis on survival has been known for many years. In this study, we aimed to determine the diagnostic features of testicular cancer patients, to examine the effect of duration of diagnosis delay (DD) on tumor size, tumor stage, and serum tumor markers, and to reveal the possible benefits of early diagnosis.

Methods

A total of 71 patients who underwent inguinal orchiectomy due to suspicion of testicular cancer and whose pathology was found to be the germ cell tumor were included in the study. The relationship between the duration of diagnosis delay and tumor size, level of tumor markers, TNM stage, presence of LAP, and presence of metastasis were examined.

Results

Seminoma was detected in 39 (54.9%) patients and non-seminoma tumor was detected in 32 (45.1%) patients. In the correlation analysis between the markers, a significant and positive correlation was found between DD and radiological tumor size, pathological tumor size, retroperitoneal LAP detection rate, LDH and AFP levels, and N stage (respectively; r=0.345 p=0.003, r=0.324 p=0.006, r=0.244 p=0.041, r=0.286 p=0.015, r=0.244 p=0.040, r=0.238 p=0.046). It was determined that a 1-day increase in DD caused an increase of 0.431mm in the pathological size of the tumor.

Conclusion

Duration of diagnosis delay is an issue that still keeps its importance for testicular tumors. Delay in diagnosis not only leads to an increase in tumor size but also negatively affects tumor stage and prognostic factors.

Keywords:
Testis cancer
Diagnosis
Malignancy
TNM staging
Resumen
Introducción

El impacto positivo del diagnóstico precoz sobre la supervivencia del cáncer testicular es bien conocido desde hace muchos años. El objetivo de este estudio fue determinar las características diagnósticas de los pacientes con cáncer testicular, examinar el impacto del retraso en el diagnóstico (RD) sobre el tamaño del tumor, el estadio tumoral y los marcadores tumorales séricos, e identificar los posibles beneficios del diagnóstico precoz.

Métodos

Se incluyeron en el estudio 71 pacientes sometidos a orquiectomía inguinal por sospecha de cáncer testicular, cuya patología se confirmó como tumor de células germinales. Se examinó la relación entre el tiempo de retraso en el diagnóstico y el tamaño del tumor, los niveles de los marcadores tumorales, el estadio TNM, la presencia de adenopatía (ADP) y de metástasis.

Resultados

Se detectó seminoma en 39 (54,9%) pacientes y tumor no seminomatoso en 32 (45,1%) pacientes. En el análisis de correlación entre marcadores, se encontró una correlación significativa y positiva entre el RD y el tamaño tumoral determinado por pruebas radiológicas (tamaño radiológico), el tamaño tumoral determinado por el estudio patológico (tamaño radiológico), la tasa de detección de ADP retroperitoneal, los niveles de LDH y AFP, y estadio N (respectivamente; r=0,345 p=0,003, r=0,324 p=0,006, r=0,244 p=0,041, r=0,286 p=0,015, r=0,244 p=0,040, r=0,238 p=0,046). Se determinó que un aumento de 1 día en el RD provocaba un aumento de 0,431mm en el tamaño patológico del tumor.

Conclusión

El tiempo de retraso en el diagnóstico es un aspecto relevante en el contexto de los tumores testiculares. El retraso en el diagnóstico no sólo produce un aumento del tamaño tumoral, sino que también afecta negativamente el estadio tumoral y los factores pronósticos.

Palabras clave:
Cáncer de testículo
Diagnóstico
Malignidad
Estadificación TNM

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