title: Prevalence of intratubular germ cell neoplasia and multifocality in testicular germ cell tumors ≤ 2 cm: relationship with other pathological features.
abstract: BACKGROUND
  The aim of this study was to determine the prevalence of TIN and multifocality in men undergoing radical orchiectomy for testicular germ cell tumor (TGCT), and among those with a main tumor size ≤ 2 cm, potentially eligible for testis-sparing surgery.
  
  
  METHODS
  Orchiectomy specimens from 126 consecutive patients treated for TGCT tumor between 2003 and 2012 were included. Multifocality was defined as a distinct tumor focus with a diameter ≥ 1 mm separable from the main tumor mass. Uni- and multivariate logistic regression was performed to identify the association between pathological variables and multifocality and to identify variables for predicting clinical stage II to III and pathological stage ≥ pT2.
  
  
  RESULTS
  Of the 126 patients, 103 (82.0%) had clinical stage I cancer at presentation and 23 (18.0%) had clinical stage II to III. The median size of the primary tumor mass was 3.7 cm (range, 0.5-12 cm) in multifocality and 3.0 cm (range, 0.6-8.0 cm) in monofocality, respectively (P < .05). The prevalence of multifocality and TIN was lower in the presence of a smaller main tumor mass (≤ 1 cm) compared with tumors 1.1 to 2.0 cm (P < .05), and increased when the index mass tumor diameter was ≥ 2 cm (P trend < .05). No association was found between tumor histology and multifocality (P = .95) or TIN (P = .54) using the χ(2) test.
  
  
  CONCLUSIONS
  The prevalence of multifocality and TIN was decreased in smaller tumors (≤ 1 cm) and increased when the index mass tumor diameter was ≥ 1.1 cm.
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Favilla
authors.affiliation: Department of Urology, University of Catania, Catania, Italy. Electronic address: giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Spitaleri
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Urzì
authors.affiliation: Department of Urology, University of Sassari, Sassari, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Madonia
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: Rosita
authors.initials: R
authors.lastname: Condorelli
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000601:surgery; D009919:Orchiectomy; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Multifocality; TIN; Testicular cancer; Testis-sparing; Tumor size