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Multifocality in testicular germ cell tumor (TGCT): what is the significance of this finding?

  • Urology - Original Paper
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Abstract

Purpose

The aim of the study is to determine the association between multifocality and the pathological features of testicular germ cell tumors and its clinical implication.

Methods

Orchiectomy specimens from 254 consecutive patients with testis cancer between 2003 and 2013 were included. Multifocality was defined as a distinct tumor focus of cluster of malignant cells > 0.5 mm and separable from the main tumor mass. Univariate logistic regression analysis was performed to evaluate the association between multifocality and other pathological features. Multivariate logistic regression analyses were carried out to identify potential predictive factors of multifocality for clinical stages II–III and the pathological stage ≥ pT2.

Results

Median patient age was 33 years (range 19–70). Multifocality was identified in 58 (22.83 %) orchiectomy specimens. Subjects with multifocality had larger primary tumor lesions (3.7 vs. 3.0 cm; p < 0.05). No association was found between histology and multifocality (p = 0.95). On univariate logistic regression analysis, multifocality was not significantly associated with all pathological features. On multivariate logistic regression analysis, multifocality was not demonstrated to be an adverse pathological feature of clinical stages II–III (p = 0.23) or pathological stage ≥ pT2 (p = 0.30) when included in a model with tumor size ≥ 4 cm and rete testis invasion in seminoma tumor and neither of clinical stages II–III (p = 0.36) or pathological stage ≥ pT2 (p = 0.20) when included in a model with lymphovascular invasion and percentage of embrional cancer ≥ 50 % in non-seminoma ones.

Conclusion

Multifocality should not be considered an adverse pathological feature in patients with testis cancer, independently to histological subtypes.

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Conflict interest

Each author discloses that no competing financial interests exist.

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Authors and Affiliations

  1. Department of Urology, School of Medicine Policlinico Hospital, University of Catania, Catania, Italy

    Vincenzo Favilla, Giorgio Ivan Russo, Fabio Spitaleri, Daniele Urzì, Alberto Saita, Sebastiano Cimino & Giuseppe Morgia

  2. Department of Urology, University of Sassari, Sassari, Italy

    Marco Garau, Massimo Madonia & Furio Pirozzi Farina

  3. Section of Endocrinology, Andrology, and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy

    Sandro La Vignera, Rosita Condorelli & Aldo E. Calogero

Authors
  1. Vincenzo Favilla
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  2. Giorgio Ivan Russo
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  3. Fabio Spitaleri
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  4. Daniele Urzì
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  5. Marco Garau
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  6. Massimo Madonia
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  7. Alberto Saita
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  8. Furio Pirozzi Farina
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  9. Sandro La Vignera
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  10. Rosita Condorelli
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  11. Aldo E. Calogero
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  12. Sebastiano Cimino
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  13. Giuseppe Morgia
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Corresponding author

Correspondence to Giorgio Ivan Russo.

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Favilla, V., Russo, G.I., Spitaleri, F. et al. Multifocality in testicular germ cell tumor (TGCT): what is the significance of this finding?. Int Urol Nephrol 46, 1131–1135 (2014). https://doi.org/10.1007/s11255-013-0617-6

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  • DOI: https://doi.org/10.1007/s11255-013-0617-6

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