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Testicular Cancer Research

The Department of Urology at Indiana University School of Medicine is one of the world’s largest centers for the management of patients with testicular cancer. The surgical approach to the disease was pioneered at IU School of Medicine several decades ago and modifications have continued over time to improve patient care and outcomes. Through continued collaboration with the medical oncology, thoracic and general surgery divisions, faculty physicians are able to provide a comprehensive approach to patient care. Their research in testicular cancer is focused on lowering morbidity and improving patient outcomes.

Active Research

Researchers are currently collecting biospecimens to validate a new potential marker for germ cell tumors, micro RNA 371. This is a promising new biomarker in this population that may hold predictive characteristics. This is currently being evaluated in patients with clinical stage I and advanced disease.

Researchers are studying ways to improve postoperative pain and length of stay following retroperitoneal lymph node dissection (RPLND) by using newer pain regimens and medications to maintain normal bowel function to lower postoperative pain and shorten hospital stays. This is the largest study ever conducted in this patient population and demonstrated decreased pain scores and shorter hospital stays by using this new medication regimen.

The main goal of this project is to ensure IU School of Medicine faculty physicians continue to build upon the work they have done over the past 40 years with this surgery as well as to quantify how often physicians cure patients with surgery alone when found to have metastatic disease. This offers the benefit to patients of avoiding chemotherapy when possible.

The department is researching certain subpopulations of testis cancer, such as studying patients who present with extremely high beta hCG tumor marker blood levels, understanding surgical outcomes in patients with non-germ cell testicular cancers such as Leydig cell or Sertoli cell tumors, and predicting teratoma in the retroperitoneum after chemotherapy based on the percentage of teratoma in the testicle at the time of initial diagnosis.

Department of Urology researchers are participating in the multi-institutional surgery in early metastatic seminoma (SEMS) trial. IU School of Medicine is the highest enrolling center for this trial in the United States. This trial seeks to help researchers understand if surgery is an option in patients with low volume metastatic seminoma in hopes to avoid either chemotherapy or radiation.

Faculty researchers are working to understand pulmonary and operative morbidity following postchemotherapy retroperitoneal lymph node dissection with and without the use of bleomycin chemotherapy. Researchers have demonstrated there is no increased surgical risk when patients receive bleomycin prior to surgery, despite other centers speculating about this concern. This work was published in the Journal of Clinical Oncology.

Past Publications

Cho JS, Kaimakliotis HZ, Cary C, et al: Modified retroperitoneal lymph node dissection for post-chemotherapy residual tumour: a long-term update. BJU Int 2017; 128: 315–5.