Abstract: Pulmonary metastases are frequently met in testicular cancers. Determining the pulmonary relapse model, studying prognosis factors for defining risk groups and applying different therapeutic strategies with the evaluation of survival represent the study's main objectives.
We've taken into our study patients diagnosed with testicular cancer all presenting pulmonary, pleural or mediastinal metastases. We evaluated the risk factors correlated with survival: the average age is 29.63 (p=0.613), place of origin (p=0.895), histology (p=0.078 >0, 05); tumor markers for our batch: Beta HCG, AFP (alpha-fetoprotein); LDH does not influence survival (p=0.786), (p= 0.345) respectively (p= 0.153); types of pulmonary metastases: (p=0.08 >0, 05); the presence of other metastases: does not influence survival (p= 0.439);the number of metastatic locations (p= 0.465 > >0, 05). Knowing the prognosis factors and how they are used to identify patients into different risk groups is of vital importance of the management of testicular cancer therapy. Identification into good risk and poor risk groups has a statistical significance as a prognosis factor (p=0.0254). The data and results of the studies on clinical-imagistic bases are limited
due to the small number of patients included into the study (low incidence). The evaluation of other prognosis factors at an immune-histological, genetic or molecular level allows the redefinition of the prognosis and improvement of the germinal tumors' management. Because the risk factors usually available are not sufficient to identify the subgroups of patients with an unfavorable prognosis, we tried to evaluate new genetic markers which could prove their prognosis value. We emphasized the presence of the hTERT more expressed from a quantitative point of view at the level of testicular tumors with pulmonary metastases compared with tumors without pulmonary metastases. Until the identification of new prognosis factors (for example hTERT), validated by future studies, treatment and conduct will be based on the predictive value of other classical prognosis factors. Long term survival (over 5 years) and the curability rate of patients with testicular
cancer, although in literature is above 90%, our study revealed only a 35.29% survival rate.This justifies the increase of investigations regarding patients with unfavorable risk factors.The diagnosis of metastasis using molecular biological techniques has been attempted with various tissues including blood, pancreatic juice, ascites, lymph nodes, but the methods is still controversial. Micrometastasis, which is not detectable by routine histological examinations, can now be identified by genetic methods Understanding the biology and tumor cell genetic can become research therapeutic targets.