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Tenuta M, Mazzotta P, Sesti F, Angelini F, Gelibter AJ, Speranza I, Paoli D, Lombardo F, Anzuini A, Magliocca FM, Franco G, Cortesi E, Santini D, Lenzi A, Gianfrilli D, Isidori AM, Pozza C. Testicular ultrasonographic features predict future risk for bilateral testicular germ cell tumour: A long-term single centre follow-up study. Andrology 2024. [PMID: 39078248 DOI: 10.1111/andr.13704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Bilateral testicular germ cell tumours (B-GCT) are rare, with an incidence of 2-5%, and can be classified as synchronous (sB-GCT) or metachronous (mB-GCT). Our study aimed to identify clinical, biochemical, and radiological risk factors for mB-GCT in a cohort of patients with GCT at a single tertiary referral centre. METHODS This retrospective case-control study included patients with GCT referred to Policlinico Umberto I-Sapienza University of Rome, from 2005 to 2023. We evaluated clinical history, testicular ultrasound features, hormone levels, semen analysis, histological characteristics, staging, and treatments. mB-GCTs were compared with unilateral GCT patients with a follow-up longer than the median time-to-onset of the second tumour. RESULTS Of 319 patients, 52 experienced B-GCT, with a median time-to-onset of the second tumour of 62 months (range: 8-229). The mB-GCT group showed higher gonadotropin levels (FSH 13.6mUI/mL vs. 7.4mUI/mL, p < 0.001; LH 6.6mUI/mL vs. 3.9mUI/mL, p = 0.004), lower sperm concentration (27 × 106/ejaculate vs. 78 × 106/ejaculate, p = 0.009), smaller residual testis volume (10.4 mL vs. 16.3 mL, p < 0.001), more inhomogeneous echotexture [57.5% vs. 14%, p < 0.001], and presence of microlithiasis (75% vs. 19.5%, p < 0.001). Kaplan-Meier curves confirmed that ultrasound features of the residual testis increased the cumulative risk of developing a second tumour. Microlithiasis was a strong independent predictor (OR 30.712, 95% CI 3.357-280.942, p = 0.002). CONCLUSIONS Histological features of the first tumour or its treatment do not influence the onset of a second tumour. However, low residual testis volume, inhomogeneous echotexture, and microlithiasis significantly increase this risk. A comprehensive evaluation of the residual testis at baseline is essential for developing a personalised surveillance programme in GCT survivors, with regular ultrasound follow-up recommended beyond the conventional 5-year limit.
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Affiliation(s)
- Marta Tenuta
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Paola Mazzotta
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Franz Sesti
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Francesco Angelini
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Alain J Gelibter
- Division of Oncology B, Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University, Rome, Italy
| | - Iolanda Speranza
- Division of Oncology A, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Donatella Paoli
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Francesco Lombardo
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Antonella Anzuini
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Fabio Massimo Magliocca
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | - Giorgio Franco
- Department of Maternal and Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Enrico Cortesi
- Division of Oncology B, Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University, Rome, Italy
| | - Daniele Santini
- Division of Oncology A, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Andrea Lenzi
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Daniele Gianfrilli
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Andrea M Isidori
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Carlotta Pozza
- Division of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy
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Rajpert-De Meyts E, Krausz C. European Academy of Andrology (EAA): Annual Report 2021. Andrology 2022; 10:619-624. [PMID: 35443085 DOI: 10.1111/andr.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 01/01/2022] [Accepted: 02/20/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ewa Rajpert-De Meyts
- Secretary of the Executive Council of the European Academy of Andrology, Department of Growth and Reproduction, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Csilla Krausz
- President of the European Academy of Andrology, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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