title: Predictors of spermatogenesis in orchiectomy specimens.
abstract: OBJECTIVE
  To evaluate the presence of spermatogenesis in orchiectomy specimens of patients with testicular cancer to determine possible predictors of success with oncologic testicular sperm extraction of the cancerous testis at orchiectomy.
  
  
  METHODS
  We retrospectively reviewed the pathology reports and slides from 83 men who underwent radical orchiectomy for testicular cancer at 2 institutions from 1999 to 2010. The presence or absence of spermatogenesis in each specimen was determined. Data on tumor histopathologic type, serum tumor markers, and tumor size were also obtained and analyzed to detect any associations with the presence of spermatogenesis.
  
  
  RESULTS
  The 83 specimens included 41 pure seminomas, 36 nonseminomatous and mixed germ cell tumors, and 6 benign lesions. Overall, spermatogenesis was detected in 48 of 77 (62%) cancerous specimens. Spermatogenesis was present in 22 of 41 (54%) pure seminomas and 26 of 36 (72%) nonseminomatous and mixed germ cell tumors, with no significant difference found between the 2 subtypes (P = .11). No association was found between tumor marker levels and the presence of spermatogenesis. A logistic regression model revealed a statistically significant inverse relationship between tumor size and spermatogenesis presence (P = .004).
  
  
  CONCLUSIONS
  At orchiectomy, most cancerous testes contained active spermatogenesis and, thus, represent a viable source for sperm cryopreservation with oncologic testicular sperm extraction. A small tumor size proved to be a positive prognostic indicator for the presence of spermatogenesis, although a larger tumor size did not preclude the presence of spermatogenesis.
authors: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: Jeremy T
authors: JT
authors: Choy
authors: H Joseph
authors: HJ
authors: Wiser
authors: Stephen W
authors: SW
authors: Bell
authors: John
authors: J
authors: Cashy
authors: Robert E
authors: RE
authors: Brannigan
authors: Tobias S
authors: TS
authors: Köhler
mesh_terms: D018254:Adenomatoid Tumor / Q000473:pathology / Q000601:surgery; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D006801:Humans; D007984:Leydig Cell Tumor / Q000473:pathology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D011336:Probability; D012189:Retrospective Studies; D018239:Seminoma / Q000473:pathology / Q000601:surgery; D053625:Sperm Retrieval; D013091:Spermatogenesis; D013736:Testicular Neoplasms / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins