| Abstract | dc.description.abstract | To compare several risk factors in the testicular biopsy of patients with pure seminoma with and
without clinical metastasis at diagnosis.
METHODS We performed a retrospective study of patients with pure seminoma. The retroperitoneum was
staged with computed tomography and the thorax with simple radiography and/or computed
tomography, taking into account the original reports and clinical stage. The previous reports and
original pathology plates were reviewed by pathologists who were unaware of the clinical stage
of the patients. Patients with beta-human chorionic gonadotropin greater than 800 mUI/mL
were excluded.
RESULTS A total of 86 patients had sufficient data and comprised the study cohort. Of the 86 patients, 62
had clinical Stage I (72%), 20 had Stage II (23%), and 4 had Stage III (5%). On univariate
analysis, tumor size greater than 4 cm (P 0.0135), testicular vascular invasion (P 0.0042),
rete testis invasion (P 0.0002), tunica albuginea penetration (P 0.00001), base of the
spermatic cord invasion (P 0.0002), epididymis invasion (P 0.001), and vascular invasion
of the cord (P 0.024) were predictive of metastasis. On multivariate analysis, tumor size greater
than 6 cm (odds ratio 6.9, 95% confidence interval 1.3 to 35, P 0.02) and rete testis invasion
(odds ratio 6.1, confidence interval 1.2 to 30, P 0.025) remained as important predictors of
metastasis (tumor size less than 6 cm was not significant on multivariate analysis).
CONCLUSIONS The results of this study have demonstrated that rete testis invasion and tumor size correlate
independently with the presence of clinical metastasis at diagnosis of testicular
seminoma. | en_US |
