TY - JOUR
T1 - Cryptorchidism and testicular germ cell tumors
T2 - Comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics
AU - Banks, Kimberly
AU - Tuazon, Ellenie
AU - Berhane, Kiros
AU - Koh, Chester J.
AU - De Filippo, Roger E.
AU - Chang, Andy
AU - Kim, Steve S.
AU - Daneshmand, Siamak
AU - Davis-Dao, Carol
AU - Lewinger, Juan P.
AU - Bernstein, Leslie
AU - Cortessis, Victoria K.
PY - 2013/2
Y1 - 2013/2
N2 - Introduction: Risk of testicular germ cell tumors (TGCT) is consistently associated with a history of cryptorchidism (CO) in epidemiologic studies. Factors modifying the association may provide insights regarding etiology of TGCT and suggest a basis for individualized care of CO. To identify modifiers of the CO-TGCT association, we conducted a comprehensive, quantitative evaluation of epidemiologic data. Materials and Methods: Human studies cited in PubMed or ISI Web of Science indices through December 2011 and selected unpublished epidemiologic data were reviewed to identify 35 articles and one unpublished dataset with high-quality data on the COTGCT association. Association data were extracted as point and 95% confidence interval estimates of odds ratio (OR) or standardized incidence ratio (SIR), or as tabulated data. Values were recorded for each study population, for subgroups defined by features of study design, CO and TGCT. Extracted data were used to estimate summary risk ratios (sRR) and evaluate heterogeneity of the CO-TGCT association between subgroups. Results: The overall meta-analysis showed that history of CO is associated with fourfold increased TGCT risk [RR = 4.1(95% CI = 3.6-4.7)]. Subgroup analyses identified five determinants of stronger association: bilateral CO, unilateral CO ipsilateral to TGCT, delayed CO treatment, TGCT diagnosed before 1970, seminoma histology. Conclusions: Modifying factors may provide insight into TGCT etiology and suggest improved approaches to managing CO. Based on available data, CO patients and their parents or caregivers should be made aware of elevated TGCT risk following orchidopexy, regardless of age at repair, unilateral vs. bilateral non-descent, or position of undescended testes.
AB - Introduction: Risk of testicular germ cell tumors (TGCT) is consistently associated with a history of cryptorchidism (CO) in epidemiologic studies. Factors modifying the association may provide insights regarding etiology of TGCT and suggest a basis for individualized care of CO. To identify modifiers of the CO-TGCT association, we conducted a comprehensive, quantitative evaluation of epidemiologic data. Materials and Methods: Human studies cited in PubMed or ISI Web of Science indices through December 2011 and selected unpublished epidemiologic data were reviewed to identify 35 articles and one unpublished dataset with high-quality data on the COTGCT association. Association data were extracted as point and 95% confidence interval estimates of odds ratio (OR) or standardized incidence ratio (SIR), or as tabulated data. Values were recorded for each study population, for subgroups defined by features of study design, CO and TGCT. Extracted data were used to estimate summary risk ratios (sRR) and evaluate heterogeneity of the CO-TGCT association between subgroups. Results: The overall meta-analysis showed that history of CO is associated with fourfold increased TGCT risk [RR = 4.1(95% CI = 3.6-4.7)]. Subgroup analyses identified five determinants of stronger association: bilateral CO, unilateral CO ipsilateral to TGCT, delayed CO treatment, TGCT diagnosed before 1970, seminoma histology. Conclusions: Modifying factors may provide insight into TGCT etiology and suggest improved approaches to managing CO. Based on available data, CO patients and their parents or caregivers should be made aware of elevated TGCT risk following orchidopexy, regardless of age at repair, unilateral vs. bilateral non-descent, or position of undescended testes.
KW - Cryptorchidism
KW - Meta-analysis
KW - Non-seminoma
KW - Seminoma
KW - Testicular neoplasms
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U2 - 10.3389/fendo.2012.00182
DO - 10.3389/fendo.2012.00182
M3 - Article
AN - SCOPUS:85014106195
SN - 1664-2392
VL - 3
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
M1 - 182
ER -