Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients
STUDY QUESTION What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)? SUMMARY ANSWER Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with test...
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| Veröffentlicht in: | Human reproduction (Oxford) 2015-12, Vol.30 (12), p.2853-2858 |
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| creator | Suzuki, K. Shin, T. Shimomura, Y. Iwahata, T. Okada, H. |
| description | STUDY QUESTION
What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)?
SUMMARY ANSWER
Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with testicular germ cell tumors (TGCTs).
WHAT IS KNOWN ALREADY
Onco-TESE is a key modality for fertility preservation in cases of inadequate pretreatment sperm collection and azoospermic men with testicular cancer. TGCTs are known to reduce sperm quality such that ∼10% of these patients are azoospermic, making surgical TESE at the same time as orchiectomy their only means of fertility preservation.
STUDY DESIGN, SIZE, DURATION
This study is a retrospective analysis performed in a single university hospital from 2002 to 2014.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Participants were 102 male patients (104 testes) who underwent inguinal orchiectomy and were diagnosed with a germinoma. In each specimen, the Johnsen Score Count (JSC) in seminiferous tubules at each established distance from the tumor margin (1, 2.5, 5, 7.5, 10 and 12.5 mm) was determined. We analyzed the relations between age, tumor histopathologic type, tumor size (maximum diameter), distance from the tumor, non-tumor tissue width and JSC.
MAIN RESULTS AND THE ROLE OF CHANCE
The 104 specimens consisted of 78 seminomas and 26 non-seminomatous TGCTs. The mean ± SD JSC was 4.7 ± 2.4 in seminomas and 3.9 ± 2.5 in non-seminomatous germ cell tumors, with no significant difference between the two subtypes. Single regression analysis showed that tumor diameter was significantly negatively correlated with spermatogenesis (RC = −0.422, P < 0.001). Multiple linear regression analysis also showed that tumor diameter had a negative influence on spermatogenesis (RC = −0.437, P < 0.001). The greater the distance the seminiferous tubules from the tumor, the better the preservation of spermatogenesis. Mature spermatozoa were identified in 93.0% of patients with a NCTW ≥7.5 mm and in 41.3% of those with NCTW |
| doi_str_mv | 10.1093/humrep/dev250 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1733193883</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/humrep/dev250</oup_id><sourcerecordid>1733193883</sourcerecordid><originalsourceid>FETCH-LOGICAL-c435t-282dd1977c53cf813b9e8fb8b78fd6f00406d03c15e47802c83e347cb459a2503</originalsourceid><addsrcrecordid>eNqFkM1LxDAQxYMo7rp69Co9eombjzZNj7K4KizsQT2HNJ2ukX6ZNIL_vVm76lEYmGH48ebNQ-iSkhtKCr58Da2DYVnBB8vIEZrTVBDMeEaO0ZwwITGlgs7QmfdvhMRRilM0YyJlklE2R9unAVyrx34HHXjrE9slY2h7h0vQzna7ZAQfa7_fRTIx0DTfO2tCo11idGfAJYMeLXSjP0cntW48XBz6Ar2s755XD3izvX9c3W6wSXk24ni9qmiR5ybjppaUlwXIupRlLutK1ISkRFSEG5pBmkvCjOTA09yUaVbo-ChfoOtJd3D9e4h2VGv93pvuoA9e0ZxzWnApeUTxhBrXe--gVoOzrXafihK1z1BNGaopw8hfHaRD2UL1S_-E9ne7D8M_Wl_JRX00</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1733193883</pqid></control><display><type>article</type><title>Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Suzuki, K. ; Shin, T. ; Shimomura, Y. ; Iwahata, T. ; Okada, H.</creator><creatorcontrib>Suzuki, K. ; Shin, T. ; Shimomura, Y. ; Iwahata, T. ; Okada, H.</creatorcontrib><description>STUDY QUESTION
What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)?
SUMMARY ANSWER
Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with testicular germ cell tumors (TGCTs).
WHAT IS KNOWN ALREADY
Onco-TESE is a key modality for fertility preservation in cases of inadequate pretreatment sperm collection and azoospermic men with testicular cancer. TGCTs are known to reduce sperm quality such that ∼10% of these patients are azoospermic, making surgical TESE at the same time as orchiectomy their only means of fertility preservation.
STUDY DESIGN, SIZE, DURATION
This study is a retrospective analysis performed in a single university hospital from 2002 to 2014.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Participants were 102 male patients (104 testes) who underwent inguinal orchiectomy and were diagnosed with a germinoma. In each specimen, the Johnsen Score Count (JSC) in seminiferous tubules at each established distance from the tumor margin (1, 2.5, 5, 7.5, 10 and 12.5 mm) was determined. We analyzed the relations between age, tumor histopathologic type, tumor size (maximum diameter), distance from the tumor, non-tumor tissue width and JSC.
MAIN RESULTS AND THE ROLE OF CHANCE
The 104 specimens consisted of 78 seminomas and 26 non-seminomatous TGCTs. The mean ± SD JSC was 4.7 ± 2.4 in seminomas and 3.9 ± 2.5 in non-seminomatous germ cell tumors, with no significant difference between the two subtypes. Single regression analysis showed that tumor diameter was significantly negatively correlated with spermatogenesis (RC = −0.422, P < 0.001). Multiple linear regression analysis also showed that tumor diameter had a negative influence on spermatogenesis (RC = −0.437, P < 0.001). The greater the distance the seminiferous tubules from the tumor, the better the preservation of spermatogenesis. Mature spermatozoa were identified in 93.0% of patients with a NCTW ≥7.5 mm and in 41.3% of those with NCTW <7.5 mm (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
Study data were obtained retrospectively, which might have affected the quality of data. We were unable to compare spermatogenesis determined using preoperative seminograms with that determined histopathologically. It was not possible to evaluate spermatogenesis in the total volume of noncancerous testicular tissue.
WIDER IMPLICATIONS OF THE FINDINGS
When Onco-TESE is conducted at sites distant from tumors, the rate of sperm extraction is high and contamination by tumor cells can be prevented. By measuring non-testicular cancerous margin before the operation, the possibility of sperm extraction can be predicted and biopsy of the contralateral testis can be considered based on the results.
STUDY FUNDING/COMPETING INTEREST(S)
none.
TRIAL REGISTRATION NUMBER
none.</description><identifier>ISSN: 0268-1161</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/dev250</identifier><identifier>PMID: 26428212</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Fertility Preservation ; Humans ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal - pathology ; Neoplasms, Germ Cell and Embryonal - physiopathology ; Retrospective Studies ; Sperm Retrieval ; Spermatogenesis - physiology ; Testicular Neoplasms - pathology ; Testicular Neoplasms - physiopathology ; Testis - pathology ; Testis - physiopathology ; Young Adult</subject><ispartof>Human reproduction (Oxford), 2015-12, Vol.30 (12), p.2853-2858</ispartof><rights>The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2015</rights><rights>The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-282dd1977c53cf813b9e8fb8b78fd6f00406d03c15e47802c83e347cb459a2503</citedby><cites>FETCH-LOGICAL-c435t-282dd1977c53cf813b9e8fb8b78fd6f00406d03c15e47802c83e347cb459a2503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26428212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suzuki, K.</creatorcontrib><creatorcontrib>Shin, T.</creatorcontrib><creatorcontrib>Shimomura, Y.</creatorcontrib><creatorcontrib>Iwahata, T.</creatorcontrib><creatorcontrib>Okada, H.</creatorcontrib><title>Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients</title><title>Human reproduction (Oxford)</title><addtitle>Hum Reprod</addtitle><description>STUDY QUESTION
What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)?
SUMMARY ANSWER
Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with testicular germ cell tumors (TGCTs).
WHAT IS KNOWN ALREADY
Onco-TESE is a key modality for fertility preservation in cases of inadequate pretreatment sperm collection and azoospermic men with testicular cancer. TGCTs are known to reduce sperm quality such that ∼10% of these patients are azoospermic, making surgical TESE at the same time as orchiectomy their only means of fertility preservation.
STUDY DESIGN, SIZE, DURATION
This study is a retrospective analysis performed in a single university hospital from 2002 to 2014.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Participants were 102 male patients (104 testes) who underwent inguinal orchiectomy and were diagnosed with a germinoma. In each specimen, the Johnsen Score Count (JSC) in seminiferous tubules at each established distance from the tumor margin (1, 2.5, 5, 7.5, 10 and 12.5 mm) was determined. We analyzed the relations between age, tumor histopathologic type, tumor size (maximum diameter), distance from the tumor, non-tumor tissue width and JSC.
MAIN RESULTS AND THE ROLE OF CHANCE
The 104 specimens consisted of 78 seminomas and 26 non-seminomatous TGCTs. The mean ± SD JSC was 4.7 ± 2.4 in seminomas and 3.9 ± 2.5 in non-seminomatous germ cell tumors, with no significant difference between the two subtypes. Single regression analysis showed that tumor diameter was significantly negatively correlated with spermatogenesis (RC = −0.422, P < 0.001). Multiple linear regression analysis also showed that tumor diameter had a negative influence on spermatogenesis (RC = −0.437, P < 0.001). The greater the distance the seminiferous tubules from the tumor, the better the preservation of spermatogenesis. Mature spermatozoa were identified in 93.0% of patients with a NCTW ≥7.5 mm and in 41.3% of those with NCTW <7.5 mm (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
Study data were obtained retrospectively, which might have affected the quality of data. We were unable to compare spermatogenesis determined using preoperative seminograms with that determined histopathologically. It was not possible to evaluate spermatogenesis in the total volume of noncancerous testicular tissue.
WIDER IMPLICATIONS OF THE FINDINGS
When Onco-TESE is conducted at sites distant from tumors, the rate of sperm extraction is high and contamination by tumor cells can be prevented. By measuring non-testicular cancerous margin before the operation, the possibility of sperm extraction can be predicted and biopsy of the contralateral testis can be considered based on the results.
STUDY FUNDING/COMPETING INTEREST(S)
none.
TRIAL REGISTRATION NUMBER
none.</description><subject>Adult</subject><subject>Fertility Preservation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms, Germ Cell and Embryonal - pathology</subject><subject>Neoplasms, Germ Cell and Embryonal - physiopathology</subject><subject>Retrospective Studies</subject><subject>Sperm Retrieval</subject><subject>Spermatogenesis - physiology</subject><subject>Testicular Neoplasms - pathology</subject><subject>Testicular Neoplasms - physiopathology</subject><subject>Testis - pathology</subject><subject>Testis - physiopathology</subject><subject>Young Adult</subject><issn>0268-1161</issn><issn>1460-2350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1LxDAQxYMo7rp69Co9eombjzZNj7K4KizsQT2HNJ2ukX6ZNIL_vVm76lEYmGH48ebNQ-iSkhtKCr58Da2DYVnBB8vIEZrTVBDMeEaO0ZwwITGlgs7QmfdvhMRRilM0YyJlklE2R9unAVyrx34HHXjrE9slY2h7h0vQzna7ZAQfa7_fRTIx0DTfO2tCo11idGfAJYMeLXSjP0cntW48XBz6Ar2s755XD3izvX9c3W6wSXk24ni9qmiR5ybjppaUlwXIupRlLutK1ISkRFSEG5pBmkvCjOTA09yUaVbo-ChfoOtJd3D9e4h2VGv93pvuoA9e0ZxzWnApeUTxhBrXe--gVoOzrXafihK1z1BNGaopw8hfHaRD2UL1S_-E9ne7D8M_Wl_JRX00</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Suzuki, K.</creator><creator>Shin, T.</creator><creator>Shimomura, Y.</creator><creator>Iwahata, T.</creator><creator>Okada, H.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients</title><author>Suzuki, K. ; Shin, T. ; Shimomura, Y. ; Iwahata, T. ; Okada, H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-282dd1977c53cf813b9e8fb8b78fd6f00406d03c15e47802c83e347cb459a2503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Fertility Preservation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms, Germ Cell and Embryonal - pathology</topic><topic>Neoplasms, Germ Cell and Embryonal - physiopathology</topic><topic>Retrospective Studies</topic><topic>Sperm Retrieval</topic><topic>Spermatogenesis - physiology</topic><topic>Testicular Neoplasms - pathology</topic><topic>Testicular Neoplasms - physiopathology</topic><topic>Testis - pathology</topic><topic>Testis - physiopathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, K.</creatorcontrib><creatorcontrib>Shin, T.</creatorcontrib><creatorcontrib>Shimomura, Y.</creatorcontrib><creatorcontrib>Iwahata, T.</creatorcontrib><creatorcontrib>Okada, H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, K.</au><au>Shin, T.</au><au>Shimomura, Y.</au><au>Iwahata, T.</au><au>Okada, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients</atitle><jtitle>Human reproduction (Oxford)</jtitle><addtitle>Hum Reprod</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>30</volume><issue>12</issue><spage>2853</spage><epage>2858</epage><pages>2853-2858</pages><issn>0268-1161</issn><eissn>1460-2350</eissn><abstract>STUDY QUESTION
What are the factors that might indicate a greater likelihood of success in oncologic testicular sperm extraction (onco-TESE)?
SUMMARY ANSWER
Smaller tumor diameter and greater noncancerous testicular tissue width (NCTW) are positive predictors of spermatogenesis in patients with testicular germ cell tumors (TGCTs).
WHAT IS KNOWN ALREADY
Onco-TESE is a key modality for fertility preservation in cases of inadequate pretreatment sperm collection and azoospermic men with testicular cancer. TGCTs are known to reduce sperm quality such that ∼10% of these patients are azoospermic, making surgical TESE at the same time as orchiectomy their only means of fertility preservation.
STUDY DESIGN, SIZE, DURATION
This study is a retrospective analysis performed in a single university hospital from 2002 to 2014.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Participants were 102 male patients (104 testes) who underwent inguinal orchiectomy and were diagnosed with a germinoma. In each specimen, the Johnsen Score Count (JSC) in seminiferous tubules at each established distance from the tumor margin (1, 2.5, 5, 7.5, 10 and 12.5 mm) was determined. We analyzed the relations between age, tumor histopathologic type, tumor size (maximum diameter), distance from the tumor, non-tumor tissue width and JSC.
MAIN RESULTS AND THE ROLE OF CHANCE
The 104 specimens consisted of 78 seminomas and 26 non-seminomatous TGCTs. The mean ± SD JSC was 4.7 ± 2.4 in seminomas and 3.9 ± 2.5 in non-seminomatous germ cell tumors, with no significant difference between the two subtypes. Single regression analysis showed that tumor diameter was significantly negatively correlated with spermatogenesis (RC = −0.422, P < 0.001). Multiple linear regression analysis also showed that tumor diameter had a negative influence on spermatogenesis (RC = −0.437, P < 0.001). The greater the distance the seminiferous tubules from the tumor, the better the preservation of spermatogenesis. Mature spermatozoa were identified in 93.0% of patients with a NCTW ≥7.5 mm and in 41.3% of those with NCTW <7.5 mm (P < 0.001).
LIMITATIONS, REASONS FOR CAUTION
Study data were obtained retrospectively, which might have affected the quality of data. We were unable to compare spermatogenesis determined using preoperative seminograms with that determined histopathologically. It was not possible to evaluate spermatogenesis in the total volume of noncancerous testicular tissue.
WIDER IMPLICATIONS OF THE FINDINGS
When Onco-TESE is conducted at sites distant from tumors, the rate of sperm extraction is high and contamination by tumor cells can be prevented. By measuring non-testicular cancerous margin before the operation, the possibility of sperm extraction can be predicted and biopsy of the contralateral testis can be considered based on the results.
STUDY FUNDING/COMPETING INTEREST(S)
none.
TRIAL REGISTRATION NUMBER
none.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>26428212</pmid><doi>10.1093/humrep/dev250</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Human reproduction (Oxford), 2015-12, Vol.30 (12), p.2853-2858 |
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| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Fertility Preservation Humans Male Middle Aged Neoplasms, Germ Cell and Embryonal - pathology Neoplasms, Germ Cell and Embryonal - physiopathology Retrospective Studies Sperm Retrieval Spermatogenesis - physiology Testicular Neoplasms - pathology Testicular Neoplasms - physiopathology Testis - pathology Testis - physiopathology Young Adult |
| title | Spermatogenesis in tumor-bearing testes in germ cell testicular cancer patients |
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