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Search Results (137)

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17 pages, 1815 KiB  
Review
Paternal Cocaine Exposure and Its Testicular Legacy: Epigenetic, Physiological, and Intergenerational Consequences
by Candela R. González and Betina González
Biology 2025, 14(8), 1072; https://doi.org/10.3390/biology14081072 - 18 Aug 2025
Viewed by 329
Abstract
Cocaine use remains a major public health concern, with rising global prevalence and a well-established profile of neurotoxicity and addictive potential. While the central nervous system has been the primary focus of cocaine research, emerging evidence indicates that cocaine also disrupts male reproductive [...] Read more.
Cocaine use remains a major public health concern, with rising global prevalence and a well-established profile of neurotoxicity and addictive potential. While the central nervous system has been the primary focus of cocaine research, emerging evidence indicates that cocaine also disrupts male reproductive physiology. In the testis, cocaine alters the endocrine microenvironment, induces cell-specific damage, and disrupts spermatogenesis. Cocaine also interferes with epigenetic programming in germ cells and mature sperm, potentially leading to heritable epimutations. Epidemiology data reveal that approximately two-thirds of regular cocaine users are males of reproductive age, and preclinical models have documented numerous behavioral and molecular alterations in their offspring, often linked to paternal cocaine exposure—such as increased drug resistance or vulnerability, altered anxiety-like behavior, impaired learning/memory, disrupted social behaviors, and shifts in neural circuitry and gene expression in reward-related brain regions. This review aims to integrate findings from studies that have independently examined testicular dysfunction, germline epigenetic reprogramming, and offspring outcomes, offering a unified perspective on their potential interconnections and highlighting future directions for research in the field of epigenetic inheritance. Full article
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13 pages, 601 KiB  
Article
Post-Nephrectomy Orchialgia: A Cross-Sectional Assessment of an Underreported Complication in Living Kidney Donors
by Aviad Gravetz, Fahim Kanani, Karin Lifshitz, Vladimir Tennak, Dana Bielopolski and Eviatar Nesher
J. Clin. Med. 2025, 14(16), 5807; https://doi.org/10.3390/jcm14165807 - 16 Aug 2025
Viewed by 304
Abstract
Background/Objectives: Orchialgia following kidney donation is an underrecognized complication with reported incidence varying dramatically between retrospective (2–3%) and prospective (44–55%) studies, suggesting significant underreporting. This study aimed to determine the incidence, characteristics, and clinical relevance of orchialgia in male kidney donors within [...] Read more.
Background/Objectives: Orchialgia following kidney donation is an underrecognized complication with reported incidence varying dramatically between retrospective (2–3%) and prospective (44–55%) studies, suggesting significant underreporting. This study aimed to determine the incidence, characteristics, and clinical relevance of orchialgia in male kidney donors within 2 years post-donation using direct patient assessment. Methods: This is a cross-sectional study of 100 male donors (64.5% response rate) from 155 eligible donors approached who underwent left laparoscopic donor nephrectomy between February 2021 and 2023. Donors completed a literature-based 15-item questionnaire at routine follow-up visits assessing testicular pain characteristics, timing, and impact. Results: Orchialgia occurred in 48% (48/100) of donors. Early onset (≤14 days) occurred in 47%, with median onset at day 2 (range 1–14). At 3-month follow-up, 37% reported persistent pain; by 1 year, only 0.8% experienced persistent pain based on our 10-year institutional database. No significant difference in incidence between altruistic (54%) and related donors (33%), though pain severity was lower in altruistic donors (mean 3.6 vs. 4.2, p = 0.04, independent t-test). Conservative management was effective in all cases; no invasive interventions were required. Conclusions: Orchialgia affects nearly half of male kidney donors when directly assessed, though it follows a benign, self-limiting course with minimal long-term clinical impact. These findings support enhanced preoperative counseling while reassuring donors about favorable outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Kidney Transplantation)
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28 pages, 3469 KiB  
Review
Prostate Cancer Treatments and Their Effects on Male Fertility: Mechanisms and Mitigation Strategies
by Aris Kaltsas, Nikolaos Razos, Zisis Kratiras, Dimitrios Deligiannis, Marios Stavropoulos, Konstantinos Adamos, Athanasios Zachariou, Fotios Dimitriadis, Nikolaos Sofikitis and Michael Chrisofos
J. Pers. Med. 2025, 15(8), 360; https://doi.org/10.3390/jpm15080360 - 7 Aug 2025
Viewed by 577
Abstract
Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating [...] Read more.
Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating a growing cohort of younger survivors for whom post-treatment quality of life—notably reproductive function—is paramount. Curative treatments such as radical prostatectomy, pelvic radiotherapy, androgen-deprivation therapy (ADT), and chemotherapy often cause irreversible infertility via multiple mechanisms, including surgical disruption of the ejaculatory tract, endocrine suppression of spermatogenesis, direct gonadotoxic injury to the testes, and oxidative sperm DNA damage. Despite these risks, fertility preservation is frequently overlooked in pre-treatment counseling, leaving many patients unaware of their options. This narrative review synthesizes current evidence on how PCa therapies impact male fertility, elucidates the molecular and physiological mechanisms of iatrogenic infertility, and evaluates both established and emerging strategies for fertility preservation and restoration. Key interventions covered include sperm cryopreservation, microsurgical testicular sperm extraction (TESE), and assisted reproductive technologies (ART). Psychosocial factors influencing decision-making, novel biomarkers predictive of post-treatment spermatogenic recovery, and long-term offspring outcomes are also examined. The review underscores the urgent need for timely, multidisciplinary fertility consultation as a routine component of PCa care. As PCa increasingly affects men in their reproductive years, proactively integrating preservation into standard oncologic practice should become a standard survivorship priority. Full article
(This article belongs to the Special Issue Clinical Advances in Male Genitourinary and Sexual Health)
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26 pages, 745 KiB  
Review
Parental Cigarette Smoke Exposure and Its Impact on Offspring Reproductive Health: A Systematic Review of Maternal, Paternal, and Dual-Smoking Effects
by Yasmin Azizbayli, Amanda Tatler, Victoria James, Adam Watkins and Lucy C. Fairclough
Int. J. Transl. Med. 2025, 5(3), 34; https://doi.org/10.3390/ijtm5030034 - 2 Aug 2025
Viewed by 882
Abstract
Objectives: Parental exposure to tobacco smoke is a significant public health concern, with over 1.1 billion smokers worldwide. The aim of this systematic review was to evaluate the impact of maternal, paternal, and dual-parental cigarette smoke exposure on offspring reproductive health. Methods: Original [...] Read more.
Objectives: Parental exposure to tobacco smoke is a significant public health concern, with over 1.1 billion smokers worldwide. The aim of this systematic review was to evaluate the impact of maternal, paternal, and dual-parental cigarette smoke exposure on offspring reproductive health. Methods: Original human clinical and animal research studies were included; titles and abstracts were manually scanned for relevance to the effect of parental smoking on offspring reproductive outcomes (Date of search:18/03/2025). Results: This systematic review incorporates 30 studies identified from three databases (PubMed, Web of Science, and Scopus). The results indicate that male offspring exhibit reduced spermatogenic capacity, characterized by decreased testicular size, lower sperm count, and impaired hormonal biosynthesis, with reductions of 30–40% in sperm production. Dual-parental smoking exacerbates these effects, with sperm counts averaging 85 million per ml in human male offspring from dual-smoking households, compared to 111 million per ml in single-smoking households. Animal studies provide mechanistic insights, revealing reduced testis weight in nicotine-exposed male rats and increased oxidative stress in offspring. Conclusions: This review highlights the dose-dependent and sex-specific effects of smoking on the fertility of offspring and underscores the need for standardized protocols to enhance the consistency and comparability of future research in both human and animal studies. Full article
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12 pages, 617 KiB  
Article
The Role of Neutrophil-to-Lymphocyte Ratio as a Predictor of Orchiectomy or Testicular Atrophy After Torsion in Children: A Multicentric Study
by Carlos Delgado-Miguel, Javier Arredondo-Montero, Julio César Moreno-Alfonso, Isabella Garavis Montagut, María San Basilio, Irene Hernández, Noela Carrera, Leopoldo Martínez, Estíbalitz Iraola, Inmaculada Ruiz Jiménez, Pablo Aguado Roncero, Ennio Fuentes, Ricardo Díez and Francisco Hernández-Oliveros
J. Pers. Med. 2025, 15(7), 310; https://doi.org/10.3390/jpm15070310 - 13 Jul 2025
Viewed by 906
Abstract
Introduction: Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker (hemogram-derived-ratio) related to ischemic-inflammatory diseases. Its usefulness in the diagnosis of pediatric testicular torsion (TT) has recently been reported, although its prognostic implication has not been evaluated. Our aim is to analyze the role [...] Read more.
Introduction: Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker (hemogram-derived-ratio) related to ischemic-inflammatory diseases. Its usefulness in the diagnosis of pediatric testicular torsion (TT) has recently been reported, although its prognostic implication has not been evaluated. Our aim is to analyze the role of NLR in the evolution of TT in children, determining its potential for predicting the risk of adverse outcomes such as orchiectomy or testicular atrophy. Methods: We performed a retrospective multicentric case-control study in patients with clinical and ultrasound suspicion of TT, in whom surgical testicular examination was performed between 2016–2022 in seven pediatric hospitals. Patients’ outcomes were analyzed according to the intraoperative and postoperative evolution (orchiectomy/testicular atrophy or not). Demographics and clinical, ultrasound and laboratory features at admission were analyzed. Sensitivity and specificity were determined by the area under the curve (AUC) represented on the receiver operating characteristic (ROC) curves. Results: A total of 455 patients (median age 13.2 years; interquartile range 10.6–14.4 years) were included, in whom 87 orchiectomies (19.1%) were performed and 34 cases of testicular atrophy (7.5%) were observed during follow-up (median follow-up: 10 months). When comparing clinical, ultrasound and laboratory predictors of both events on ROC curves, NLR was the most sensitive and specific parameter for predicting orchiectomy (AUC = 0.834; p < 0.001), as well as testicular atrophy (AUC = 0.849; p < 0.001). Compared with other parameters, the designed cut-off point of NLR = 5.2 had maximum sensitivity and specificity (82.2% and 77.0%, respectively) for predicting orchiectomy or atrophy after testicular torsion. Conclusions: NLR may be considered the best predictor for the risk of orchiectomy or testicular atrophy following torsion in pediatric patients, helping the identification of high-risk cases. It can be useful both for obtaining more accurate preoperative information on patient prognosis and for closer follow-up of high-risk testicular atrophy patients. Full article
(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Urological Diseases)
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21 pages, 1412 KiB  
Review
Multi-Omics Perspectives on Testicular Aging: Unraveling Germline Dysregulation, Niche Dysfunction, and Epigenetic Remodeling
by Aris Kaltsas
Cells 2025, 14(12), 899; https://doi.org/10.3390/cells14120899 - 13 Jun 2025
Cited by 1 | Viewed by 1118
Abstract
Male reproductive aging proceeds gradually and involves complex alterations across germ cells, somatic cells, and the testicular niche. Multi-omics analyses highlight shifts in spermatogonial stem cell dynamics, diminished sperm quantity and quality, and reconfigured support from Sertoli and Leydig cells. These somatic cells [...] Read more.
Male reproductive aging proceeds gradually and involves complex alterations across germ cells, somatic cells, and the testicular niche. Multi-omics analyses highlight shifts in spermatogonial stem cell dynamics, diminished sperm quantity and quality, and reconfigured support from Sertoli and Leydig cells. These somatic cells show numerical declines and exhibit senescence-associated changes that amplify inflammatory signals and compromise blood–testis barrier integrity. Concurrently, fibrosis and heightened immune cell infiltration disrupt intercellular communication, contributing to further deterioration of spermatogenesis. Epigenetic remodeling—including DNA methylation drift, histone modification imbalances, and altered small non-coding RNA profiles—adds another dimension, reducing sperm integrity and potentially exerting transgenerational effects on offspring health. Observed hormonal changes, such as reduced testosterone and INSL3 production by aging Leydig cells, reflect the additional weakening of testicular function. These multifactorial processes collectively underlie the drop in male fertility and the increased incidence of adverse outcomes, such as miscarriages and developmental anomalies in the offspring of older fathers. Research into mitigation strategies, including interventions targeting senescent cells, oxidative stress, and inflammatory pathways, may slow or reverse key mechanisms of testicular aging. These findings underscore the importance of understanding the molecular hallmarks of male reproductive aging for preserving fertility and safeguarding offspring well-being. Full article
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26 pages, 760 KiB  
Review
Male Infertility and Reduced Life Expectancy: Epidemiology, Mechanisms, and Clinical Implications
by Aris Kaltsas, Andreas Koumenis, Marios Stavropoulos, Zisis Kratiras, Dimitrios Deligiannis, Konstantinos Adamos and Michael Chrisofos
J. Clin. Med. 2025, 14(11), 3930; https://doi.org/10.3390/jcm14113930 - 3 Jun 2025
Cited by 4 | Viewed by 2060
Abstract
Male infertility is a prevalent condition affecting approximately 15% of couples worldwide. Recent evidence indicates that, beyond its immediate reproductive implications, male infertility may reflect broader health concerns. Large-scale cohort studies consistently show that men with poorer semen parameters have elevated all-cause mortality [...] Read more.
Male infertility is a prevalent condition affecting approximately 15% of couples worldwide. Recent evidence indicates that, beyond its immediate reproductive implications, male infertility may reflect broader health concerns. Large-scale cohort studies consistently show that men with poorer semen parameters have elevated all-cause mortality compared to fertile counterparts, with a dose-dependent pattern whereby more severe abnormalities correlate with a higher risk of early death. Proposed mechanisms linking infertility to reduced life expectancy encompass genetic, hormonal, and lifestyle factors. For instance, Klinefelter syndrome exemplifies a genetic cause of azoospermia that also predisposes to metabolic syndrome, diabetes, and certain malignancies. Low testosterone, a frequent finding in testicular dysfunction, is implicated in obesity, insulin resistance, and cardiovascular disease, all of which can shorten lifespan. Additionally, psychosocial stress and depression—commonly reported among infertile men—may contribute to health-compromising behaviors. Environmental exposures and socioeconomic factors further compound these risks. Collectively, these data underscore the importance of recognizing male infertility as an early indicator of potentially modifiable health vulnerabilities. A comprehensive evaluation of infertile men should therefore extend beyond fertility assessments to include screening for chronic diseases, hormonal imbalances, and mental health issues. Targeted surveillance for specific cancers (e.g., testicular and prostate) and early interventions—such as lifestyle modifications, appropriate hormonal therapies, and psychosocial support—can improve both reproductive outcomes and long-term well-being. Given these insights, male fertility assessment may serve as a valuable gateway to broader men’s healthcare, prompting proactive strategies that mitigate associated risks and potentially enhance longevity. Full article
(This article belongs to the Special Issue Male Fertility in the Modern Age: Challenges and Opportunities)
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5 pages, 1858 KiB  
Case Report
Aberrant Left Testicular Artery Originating from the Inferior Mesenteric Artery Identified on Angiography in a Patient with Gastrointestinal Bleeding: Case Report
by Sarah M. Taheri, Connor S. Centner, Rahim H. Shalash, Touqeer Sulehria and Nana Ohene Baah
Reports 2025, 8(2), 86; https://doi.org/10.3390/reports8020086 - 3 Jun 2025
Viewed by 379
Abstract
Background and Clinical Significance: This case presents a rare variation in mesenteric and pelvic vasculature that holds relevance for endovascular procedures. Limited published cases of the testicular artery arising off the inferior mesenteric artery exist in the literature and play an important role [...] Read more.
Background and Clinical Significance: This case presents a rare variation in mesenteric and pelvic vasculature that holds relevance for endovascular procedures. Limited published cases of the testicular artery arising off the inferior mesenteric artery exist in the literature and play an important role in clinical outcomes. Case Presentation: An 89-year-old male presented with gastrointestinal bleeding from diverticulosis. During an arteriogram to locate and assess sigmoid arteries for embolization, an unusual anatomical variant of the left testicular artery was discovered. Typically, the left testicular artery originates from the abdominal aorta below the renal arteries. However, in this patient, the left testicular artery was found to directly branch off the inferior mesenteric artery, while the superior rectal artery was absent from the inferior mesenteric artery. Conclusions: Awareness of such vascular variations is essential for interventionalists to optimize procedural success and minimize complications. Recognizing potential vascular anomalies, such as those presented in this case, is essential for effective pre-procedural planning and intraoperative management to improve patient outcomes. Full article
(This article belongs to the Section Surgery)
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15 pages, 596 KiB  
Article
Quality of Life of Adolescents and Young Adults After Testicular Prosthesis Surgery During Childhood: A Qualitative Study and Literature Review
by Zoi Chantzi, Sotirios Fouzas, Alexandros Drivalos, Athanasia Stamati, Agapios Gkentzis, Maria Athanasopoulou, Katerina Kambouri, Despoina Gkentzi, Eirini Kostopoulou, Anastasia Vareli, Evangelos Blevrakis, Konstantinos Zachos, Vasileios Alexopoulos, Antonios Panagidis, Panagiotis Plotas, Aspasia Louta, Ageliki A. Karatza, Theodore Dassios, Gabriel Dimitriou, Eleni Jelastopulu and Xenophon Sinopidisadd Show full author list remove Hide full author list
Children 2025, 12(6), 720; https://doi.org/10.3390/children12060720 - 31 May 2025
Viewed by 920
Abstract
Background/Objectives: To evaluate the quality of life (QoL) of adolescent and young adult males who had testicular prosthesis surgery during their childhood, as well as their own and their parents’ inner perceptions and feelings. To our knowledge, this is the first qualitative study [...] Read more.
Background/Objectives: To evaluate the quality of life (QoL) of adolescent and young adult males who had testicular prosthesis surgery during their childhood, as well as their own and their parents’ inner perceptions and feelings. To our knowledge, this is the first qualitative study and one of few with an integrated approach on the QoL of pediatric testicular prosthesis recipients. Methods: Recipients and their parents were interviewed regarding their life with the testicular prosthesis. Major QoL domains (i.e., physical and mental health, interpersonal relationships, sexuality) were assessed. Results: Although there were participants who viewed the outcomes with negativity, most expressed satisfaction. Daily routine returned to normal after a postoperative period with precautions, such as fear of damaging either the implant or the healthy testis. Prosthesis feeling was acceptable and normalized with time, while self-image and self-confidence were boosted by the presence of the prosthesis. All participants outlined the importance of privacy as being kept in the inner family circle. Some exhibited introverted behavior. Regarding sentimental and sexual intimacy, the prosthesis produced anxiety and concern both in experienced recipients and minors, which was moderated by a normal scrotal appearance. Conclusions: Testicular prosthesis surgery performed from childhood to adulthood may create profound and variable concerns, which may affect the recipients and their companions in the long term. Therefore, it should not be considered in a simplistic manner as a routine procedure and should be preceded by thorough conversation with experts. Full article
(This article belongs to the Section Pediatric Surgery)
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12 pages, 1030 KiB  
Article
Retrospective Analysis of Laparoscopic Varicocelectomy in Pediatric Patients: Impact of Lymphatic-Sparing Techniques and Methylene Blue on Outcomes—A Series of Cases
by Arzu Canmemis, Meltem Caglar and Cigdem Ulukaya Durakbasa
J. Clin. Med. 2025, 14(11), 3814; https://doi.org/10.3390/jcm14113814 - 29 May 2025
Viewed by 988
Abstract
Objective: This study aimed to evaluate the outcomes and complications of laparoscopic varicocelectomy (LV) in pediatric and adolescent patients, comparing lymphatic-sparing (LS) and non-lymphatic-sparing (NLS) techniques, with a particular focus on the postoperative effects of methylene blue dye. Methods: A retrospective [...] Read more.
Objective: This study aimed to evaluate the outcomes and complications of laparoscopic varicocelectomy (LV) in pediatric and adolescent patients, comparing lymphatic-sparing (LS) and non-lymphatic-sparing (NLS) techniques, with a particular focus on the postoperative effects of methylene blue dye. Methods: A retrospective review was conducted for patients with Grade 3 left-sided varicocele who underwent LV between 2010 and 2023. Patients were grouped according to whether lymphatic-sparing techniques were used. Testicular volumes were measured pre- and postoperatively by ultrasonography. Surgical complications including hydrocele, recurrence, and intratesticular calcification were recorded. Statistical comparisons were made between the two groups. Results: A total of 21 patients with a median age of 15 years were included. LS suvrgery was performed in seven patients (33.3%), and arterial sparing in four (19%). Methylene blue was used to identify lymphatic vessels in the LS group. Postoperative hydrocele was observed in three patients (14.3%) and occurred equally in both groups. However, testicular calcification was detected only in the LS group and was significantly more common compared to the NLS group (p = 0.002). Recurrence rates were not significantly different between groups (p = 0.694). No cases of testicular atrophy were observed. The median follow-up duration was 6 years in the NLS group and 3 years in the LS group (p = 0.026). Conclusions: Lymphatic-sparing laparoscopic varicocelectomy appears effective in preserving testicular volume, but the use of intratesticular methylene blue is associated with a higher incidence of calcification. These findings highlight the need for caution and further long-term evaluation of vital dyes in pediatric varicocelectomy. Full article
(This article belongs to the Section Clinical Pediatrics)
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13 pages, 828 KiB  
Article
Survival Outcomes in Metastatic Germ Cell Tumors: A Multicenter Study from Turkey
by Gul Sema Yildiran Keskin, Ozge Yetginoglu, Sertac Vurgun, Evrican Zin Guzel, Fariz Emrah Ozkan, Mesut Yilmaz, Cem Murat Soylemez, Yesim Agyol, Sinem Akbas, Muhammed Fatih Sagiroglu, Gizem Yildirim, Huseyin Salih Semiz, Ali Murat Tatli, Ferhat Ekinci, Ramazan Cosar, Ramazan Acar, Musa Baris Aykan, Ismail Erturk and Nuri Karadurmus
Medicina 2025, 61(6), 951; https://doi.org/10.3390/medicina61060951 - 22 May 2025
Viewed by 984
Abstract
Background/Objectives: Metastatic testicular germ cell tumor (mGCT) is a highly curable disease with first-line cisplatin-based combination chemotherapy. This study aims to evaluate the clinicopathological characteristics and survival outcomes of patients with metastatic testicular cancer in a nationwide multicenter cohort. Methods: This [...] Read more.
Background/Objectives: Metastatic testicular germ cell tumor (mGCT) is a highly curable disease with first-line cisplatin-based combination chemotherapy. This study aims to evaluate the clinicopathological characteristics and survival outcomes of patients with metastatic testicular cancer in a nationwide multicenter cohort. Methods: This multicenter retrospective cohort study included 316 male patients diagnosed with mGCT who were treated with first-line cisplatin-based chemotherapy across 10 institutions in Turkey between 2011 and 2024. Clinical and pathological data, including International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification, treatment details, and survival outcomes, were analyzed. Results: The median age of the cohort was 28 years, and 76.3% of patients were diagnosed with non-seminoma. According to IGCCCG risk stratification, 53.2% had good-risk, 25.3% intermediate-risk, and 21.5% poor-risk disease. Median follow-up was 38.4 months. Among patients with seminoma, the 5-year overall survival (OS) rate was 100% in the good-risk group and 87.5% in the intermediate-risk group. In patients with non-seminoma, 5-year OS rates were 96.6%, 86.9%, and 65.1% in the good-, intermediate-, and poor-risk groups, respectively. Among 125 patients who received salvage treatment, high-dose chemotherapy (HDCT) significantly improved survival in the International Prognostic Factors Study Group (IPFSG) very high-risk group (3-year OS: 55.0% vs. 16.3% with conventional-dose chemotherapy (CDCT), p = 0.007). Conclusions: This study provides the first large-scale nationwide dataset on mGCT outcomes in Turkey, demonstrating overall survival rates comparable to international cohorts. The findings emphasize the importance of a multidisciplinary approach, adherence to treatment guidelines, and optimal surgical interventions in improving patient outcomes. Full article
(This article belongs to the Section Oncology)
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20 pages, 3785 KiB  
Article
Overall Survival of Hungarian Cancer Patients Diagnosed Between 2011 and 2019, Based on the Health Insurance Fund Database
by Zoltán Kiss, Tamás László Berki, Anikó Maráz, Zsolt Horváth, Péter Nagy, Ibolya Fábián, Valéria Kovács, György Rokszin, György Surján, Zsófia Barcza, István Kenessey, András Wéber, István Wittmann, Gergő Attila Molnár, Tamás G. Szabó, Viktória Buga, Eugenia Karamousouli, Miklós Darida, Zsolt Abonyi-Tóth, Renáta Bertókné Tamás, Viktória Diána Fürtős, Krisztina Bogos, Judit Moldvay, Gabriella Gálffy, Lilla Tamási, Veronika Müller, Zoárd Tibor Krasznai, Gyula Ostoros, Zsolt Pápai-Székely, Gabriella Branyiczkiné Géczy, Lászlóné Hilbert, Csaba Polgár and Zoltán Vokóadd Show full author list remove Hide full author list
Cancers 2025, 17(10), 1670; https://doi.org/10.3390/cancers17101670 - 15 May 2025
Viewed by 1020
Abstract
Background: Assessing cancer survival trends is crucial for monitoring progress in cancer management and prevention. As part of the broader HUN-CANCER EPI study, this analysis examined overall survival (OS) in the Hungarian cancer population between 2011 and 2019. Methods: Using data extracted from [...] Read more.
Background: Assessing cancer survival trends is crucial for monitoring progress in cancer management and prevention. As part of the broader HUN-CANCER EPI study, this analysis examined overall survival (OS) in the Hungarian cancer population between 2011 and 2019. Methods: Using data extracted from the Hungarian National Health Insurance Fund (NHIF) database, short- and long-term OS were estimated for various cancer types according to age, sex, and diagnostic period using Kaplan–Meier analysis. The study also identified cancer types with significant early mortality following diagnosis. Results: From 2011 to 2019, a total of 528,808 patients were diagnosed with cancer. During the 2015–2019 diagnostic period, the lowest 5-year OS rates were observed for esophageal (7.0%), pancreatic (10.7%), liver (12.5%), gallbladder (13.9%), and lung cancer (18.4%). Conversely, tumor types with better OS included testicular cancer (91.6%), thyroid cancer (89.0%), Hodgkin’s lymphoma (84.0%), melanoma (78.6%), and breast cancer (74.1%). A notable proportion of deaths occurred within 2 months of diagnosis for liver (33.2%), pancreatic (27.9%), and gallbladder cancer (29.0%). Significant early mortality within 6 months post-diagnosis was also noted for esophageal (51.3%), stomach (42.9%), and lung cancer (41.7%). Conclusions: The HUN-CANCER EPI study conducted between 2011 and 2019 provides valuable insights into cancer survival patterns in Hungary, emphasizing the importance of early detection and targeted interventions to improve patient outcomes. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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21 pages, 14030 KiB  
Article
Impact of Type 1 Diabetes on Testicular Microtubule Dynamics, Sperm Physiology, and Male Reproductive Health in Rat
by Alessandra Biasi, Maria Rosaria Ambruosi, Maria Zelinda Romano, Serena Boccella, Sara Falvo, Francesca Guida, Francesco Aniello, Sabatino Maione, Massimo Venditti and Sergio Minucci
Int. J. Mol. Sci. 2025, 26(10), 4579; https://doi.org/10.3390/ijms26104579 - 10 May 2025
Cited by 1 | Viewed by 829
Abstract
Type 1 diabetes (T1D) is a chronic metabolic disease defined by sustained hyperglycemia, leading to oxidative stress (OS) and systemic complications, including male subfertility. This study investigates the potential impact of T1D-induced OS on microtubule (MTs) dynamics and microtubule-associated proteins (MAPs) in the [...] Read more.
Type 1 diabetes (T1D) is a chronic metabolic disease defined by sustained hyperglycemia, leading to oxidative stress (OS) and systemic complications, including male subfertility. This study investigates the potential impact of T1D-induced OS on microtubule (MTs) dynamics and microtubule-associated proteins (MAPs) in the testis and spermatozoa (SPZ). Using a streptozotocin-induced T1D rat model, we examined the expression and localization of key MAPs, including Microtubule Affinity-Regulating Kinase 4 (MARK4), Microtubule-Associated Protein 1A (MAP1A), Dynein Light Chain LC8-Type 1 (DYNLL1), Prolyl Endopeptidase (PREP), and Radial Spoke Head 6 Homolog A (RSPH6A), alongside sperm functional parameters. Our findings showed that T1D significantly impaired the expression and distribution of these proteins, which may affect MTs organization and be associated with cytoskeletal disorganization, and impaired germ cell differentiation. Moreover, T1D rats exhibited reduced sperm count, viability, and motility, accompanied by increased DNA fragmentation and chromatin defects. Elevated levels of 4-hydroxy-2-nonenal (4-HNE), a marker of OS, were detected in SPZ, particularly in the acrosome and flagellum, correlating with mitochondrial dysfunction and ATP depletion. Additionally, decreased intracellular Ca2+ levels, downregulation of Cation Channel of Sperm (CATSPER) and Voltage-Dependent Anion Channel 3 (VDAC3), and altered tubulin acetylation, possibly due to imbalanced Alpha-Tubulin N-Acetyltransferase 1 (ATAT1) and Histone Deacetylase 6 (HDAC6) expression, were also associated with impaired sperm motility. The combined data suggest that T1D-induced OS is linked to disrupted MTs dynamics, which may contribute to testicular dysfunction and reduced sperm quality, potentially affecting male fertility. A better understanding of these associations may support the development of therapeutic strategies to mitigate the reproductive consequences of T1D and improve male fertility outcomes. Full article
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10 pages, 1608 KiB  
Case Report
Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
by Iuliana Pantelimon, Andra-Maria Stancu, Claudiu Socoliuc, Fikirie Abzait, Irina Balescu, Nicolae Bacalbasa, Cristian Balalau, Laurenţia Nicoleta Galeș and Iulian Brezean
J. Mind Med. Sci. 2025, 12(1), 30; https://doi.org/10.3390/jmms12010030 - 6 May 2025
Viewed by 666
Abstract
Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical [...] Read more.
Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical manifestations, prompting emergent extensive surgical intervention. Upon admission to the Oncology Department, the adolescent presented with jaundice and dyspnea, being diagnosed with pure non-seminomatous embryonal carcinoma, a poor-risk prognosis group. Based on his prognostic group, the patient should have undergone chemotherapy with a well standardized regimen, but the imminent “liver visceral crisis” did not allow for the standard dose chemotherapy administration, so an adapted regimen of chemotherapy was considered and the full number of cycles was applied after this induction cycle. The treatment journey was protracted, emphasizing the need for early recognition and intervention in such cases. A comprehensive ongoing evaluation, including imagistic examinations and laboratory tests, revealed the presence of extensive refractory disease, which led to urgent treatment. Conclusions: This case provides valuable insights into the management of advanced testicular germ cell tumor in young patients facing imminent organ failure and underlines the importance of interdisciplinary collaboration. Understanding the complexities of this condition can aid in improving patient outcomes and enhancing the quality of care provided. Full article
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13 pages, 2506 KiB  
Article
Robotic Retroperitoneal Lymph Node Dissection for Testicular Cancer—First Experience and Learning Curve of a Single Surgeon
by Markus Angerer, Christian Wülfing and Klaus-Peter Dieckmann
Cancers 2025, 17(9), 1476; https://doi.org/10.3390/cancers17091476 - 27 Apr 2025
Cited by 1 | Viewed by 871
Abstract
Background/Objectives: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the staging and treatment of testicular cancer and is often mandatory. RPLND is associated with a high risk of morbidity. The use of minimally invasive techniques has significantly increased the number of [...] Read more.
Background/Objectives: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the staging and treatment of testicular cancer and is often mandatory. RPLND is associated with a high risk of morbidity. The use of minimally invasive techniques has significantly increased the number of robotic procedures performed over the last few years. This study aimed to analyze the perioperative and postoperative outcomes and trends of an increasing number of surgeries performed. Materials and Methods: We retrospectively analyzed 30 robotic RPLNDs (R-RPLNDs) performed at our testicular cancer center between 2020 and 2024. Logistic regression analyses were used to analyze the independent variables of operative time (OT), hospital stay (HS), estimated blood loss, lymph node yield, and complications according to the Clavien–Dindo classification system. The independent predictors included case number, clinical stage, post-chemotherapy status, preoperative retroperitoneal tumor mass, and body mass index. Furthermore, the patients were categorized into three groups: group A (cases 1–10), group B (cases 11–20), and group C (cases 21–30). A Kruskal–Wallis test was performed to assess differences among the groups concerning OT, HS, and lymph node yield. Results: OT significantly decreased with an increasing number of cases (p < 0.001), and HS was significantly affected by overall complications (p = 0.0006). There were two major perioperative complications (6.6%). No factors predicted overall complications or Clavien–Dindo grades I-II or III–V. The Kruskal–Wallis test showed a significant difference (p < 0.05) in OT and HS for group C. Conclusions: R-RPLND for GCTs demonstrates a clear learning curve, with significant improvements in OT, HS, and complication rates as surgeons gain experience. Overall, the low complication rates for R-RPLND did not indicate predictive factors for perioperative or postoperative complications. RPLND presents promising potential as a safe and effective treatment for GCTs, especially when performed by experienced surgeons in specialized centers. Full article
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