Testicular cancer patterns in Tunisian men : Diagnosis problems, pathological types and prognosis. About 41 patients

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Published Sep 12, 2012
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Vol. 90 No. 8 (2012): Issue Aug 2012

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Sataa Sallami
Nfoussi Haifa
Abaza Hajer
Chelif Mohamed
Boussen Hammouda
Horchani Ali

Abstract

Aim: To analyze the testicular cancer (TCa) incidence, diagnosis aspects, pathologic grade, stage, and survival in Tunisian men.
Methods: We studied all patients who had histopathologically confirmed TCa treated in La Rabta University-Hospital between 1991 and 2010. Baseline demographic data included age at diagnosis, year of diagnosis, clinical symptoms, stage at diagnosis, histologic type, management strategies and survival were analyzed.
Results: The incidence of TCa among Tunisians is very low; we collected only 41 cases over a period of 20 years with an average incidence of 2 new cases per year. Peak age incidence was 30-49 years. Testicular swelling was the principal complaint in 25 patients. 58.5% of tumours were rightsided and 39% were left-sided. There was bilateral involvement in only one case. The mean interval between onset of symptoms and presentation was 16.5 months (1-120). Most patients presented at stages T2 and T3 (63.4% and 26.8% respectively). Treatment consisted of radical orchidectomy in all patients and cisplatin-based chemotherapy and radiotherapy in respectively 11 and 12 patients (association in 5 patients). One patient with a tumour in an intra-abdominal testis underwent laparotomy. The most common histological types were seminomas (n=20) and mixed germ cell (n=8). Three patients died within 48 months, while half were lost to follow-up.
Conclusions: The incidence of TCas in Tunisia remains low. Late presentation and treatment are major challenges to management. Better health funding and education regarding testicular selfexamination is essential.

Keywords:

Testicular, Cancer, Incidence, Epidemiology, Cryptorchidism, Orchiectomy, Mortality, Tunisia.

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