Concomitant Microscopic Tumor Deposits Accompanying Overt Testicular Cancer

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 12 Jun 2008 - 6:00 PDT

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ORLANDO, FL (UroToday.com) - Are we leaving cancer behind?

Testis-sparing surgery is gaining momentum for treatment of small/localized testicular tumors.

Ehrlich and colleagues identified 145 patients who underwent orchiectomy for germ cell tumor. The investigators re-reviewed the pathologic specimens from these patients and evaluated whether any satellite tumor sites were present in addition to the primary mass. These investigators found that 33% of patient had concomitant microscopic tumors in the orchiectomy specimen! These tumors fell into one of four categories: (1) discrete tumor foci spatially unrelated (median distance 4 mm) to the primary mass - 12% (2) single or a small group of malignant germ cells within normal testicular parenchymal tissues - 14% (3) tumor deposits in the lymphovascular channels within otherwise normal parenchyma- 12% (4) pagetoid tumor spread to rete testis - 1.4%.

Presence of satellite tumor sites was more likely if the patient's tumor was small (p<0.001). For instance, patients with tumor size of 3 cm or less had a nearly 50% chance of harboring another malignant focus elsewhere in the testis. Presence of a seminomatous component also placed patients at a higher risk for having concomitant microscopic tumor sites (p=0.007).

These findings are certainly intriguing. If the data is validated at other centers, "testis-sparing surgery" could be coined as "tumor-sparing surgery." Caution with this approach is advised. Read a Related Review.

Presented by Yaron Ehrlich, MD, Miriam Konichezky, MD, Ofer Yossepowitch, MD, Jack Baniel, MD, and Petah Tiqwa, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD

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