title: Predictors of spermatogenesis in radical orchiectomy specimen and potential implications for patients with testicular cancer.
abstract: To assess the ability of semen analysis and other patients' characteristics to predict the presence of spermatozoa in radical orchiectomy pathological specimen, and describe potential implications for patients with azoospermia and testis cancer.
  
  
  
  Retrospective cohort study.
  
  
  
  Tertiary hospital.
  
  
  
  A total of 214 consecutive patients with testicular cancer who underwent radical orchiectomy between 1997 and 2015.
  
  
  
  None.
  
  
  
  Histologic slides were reviewed and the presence of mature spermatozoa was documented. Clinical, laboratory, and radiographic characteristics were recorded. Logistic regression analyses were used to identify factors associated with the presence of spermatozoa in the noninvolved ipsilateral testicular parenchyma.
  
  
  
  Spermatozoa were found in the pathological specimen of 145 patients (67.8%). At multivariate analysis, increased tumor size was the only factor associated with lower rates of spermatozoa in the specimen. Mean tumor diameter was 4.06 cm, and spermatozoa were found in 83% and 49% of testes with tumor diameters <4 and ≥4 cm, respectively. Preoperative semen analysis records were available for 107 patients. Oligozoospermia, severe oligozoospermia, azoospermia, and cryptozoospermia were observed in 17 (16%), 18 (17%), 9 (8%) and 3 (3%) patients, respectively. Sperm concentration and motility were not associated with complete spermatogenesis. Seven of 12 patients (58%) with either azoospermia or cryptozoospermia had mature sperm in their pathological sections.
  
  
  
  Larger testicular cancers are associated with lower rates of spermatozoa in the ipsilateral testis. Given the substantial likelihood (∼60%) of spermatozoa to be present in the cancerous testis of patients with azoospermia and cryptozoospermia, concomitant oncologic testicular sperm extraction (TESE) can be considered in these selected patients.
authors.affiliation: Department of Urology, Rabin Medical Center, Petah Tikva, Israel. Electronic address: ohadsh10@gmail.com.
authors.forename: Ohad
authors.initials: O
authors.lastname: Shoshany
authors.affiliation: Department of Urology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Shtabholtz
authors.affiliation: Faculty of Medicine, Bar-Ilan University, Safed, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Schreter
authors.affiliation: Department of Pathology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Maxim
authors.initials: M
authors.lastname: Yakimov
authors.affiliation: Male infertility and Sperm bank, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Pinkas
authors.affiliation: Male infertility and Sperm bank, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Stein
authors.affiliation: Department of Urology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Jack
authors.initials: J
authors.lastname: Baniel
authors.affiliation: Department of Urology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Shay
authors.initials: S
authors.lastname: Golan
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009845:Oligospermia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009919:Orchiectomy; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013076:Sperm Count; D013081:Sperm Motility; D053625:Sperm Retrieval; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology*; D062606:Tertiary Care Centers; D013736:Testicular Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D047368:Tumor Burden
keywords: Testis cancer; fertility preservation; onco-TESE; spermatogenesis