You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disaese (I)1 Apr 2013704 MULTI-FOCALITY OF TESTICULAR GERM CELL TUMOURS − SINGLE INSTITUTION REVIEW OF 100 UK CASES James Douglas, Sam Dockree, Jeffery Theaker, and Matthew Hayes James DouglasJames Douglas Southampton, United Kingdom More articles by this author , Sam DockreeSam Dockree Southampton, United Kingdom More articles by this author , Jeffery TheakerJeffery Theaker Southampton, United Kingdom More articles by this author , and Matthew HayesMatthew Hayes Southampton, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.262AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is an increasing recognition of the importance of organ preserving surgery for numerous tumour types including testis tumours. Currently, guidelines suggest consideration of partial orchidectomy in testis tumours that are solitary and less than 2cm in maximum diameter. The objective of this study was to assess tumour focality in the last 100 cases of testicular germ cell tumours undergoing radical orchidectomy to determine what proportion of patients might have been potential candidates for partial orchidectomy using these criteria. METHODS The pathology departmentÆs database was interrogated to ascertain the last 100 cases of germ cell testicular tumours that met the study criteria. Patients, who were referred from external hospitals, had previous chemotherapy, radiotherapy, history of undescended testis or pure CIS were excluded from the study. The original pathology blocks were retrieved and reviewed by a single pathologist with a special interest in testis tumours. The size and number of tumours were re-assessed. The tumour type was recorded and the subtypes grouped into seminoma, pure or mixed non-seminomatous germ cell tumour (NSGCT) or NSGCT + seminoma. The tumour was described as uni-focal, multi-focal or total involvement. RESULTS 67% of case were seminomas, 25% pure or mixed NSGCT and 8% NSGCT + seminoma. Mean tumour size was 40.8mm (4-110 mm). Overall 46% of tumours were multi-focal and 85% were multi-focal or total involvement. 84% of cases had concurrent carcinoma in situ. 16.4 % of the seminomas were uni-focal, 16% of the pure or mixed NSGCT uni-focal and none of the NSGCT + seminoma group were uni-focal. All tumours that were greater than 70mm were either multi-focal or had total involvement. Of the tumours less than 20mm 78% of the seminomas were multi-focal or had total involvement. Of the cases that were originally considered uni-focal macroscopically 71% were subsequently shown to be multi-focal. CONCLUSIONS A relatively small number of cases were proven to be uni-focal and a high number of cases (71%) originally felt to be uni-focal were subsequently upgraded to multi-focal tumours. In this scenario partial orchidectomy would have afforded sub-optimal treatment. In light of these results great care must be taken when considering partial orchidectomy in treating these men. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e289-e290 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Douglas Southampton, United Kingdom More articles by this author Sam Dockree Southampton, United Kingdom More articles by this author Jeffery Theaker Southampton, United Kingdom More articles by this author Matthew Hayes Southampton, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...