Rete Testis Invasion Is Consistent With Pathologic Stage T1 in Germ Cell Tumors

Abstract Objectives Rete testis invasion by germ cell tumors is frequently concomitant with lymphovascular or spermatic cord invasion (LVI/SCI); independent implications for staging are uncertain. Methods In total, 171 seminomas and 178 nonseminomatous germ cell tumors (NSGCTs; 46 had 1%-60% seminom...

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Bibliographic Details
Published in:American journal of clinical pathology 2019-04, Vol.151 (5), p.479-485
Main Authors: Farooq, Ayesha, Jorda, Merce, Whittington, Elizabeth, Kryvenko, Oleksandr N, Braunhut, Beth L, Pavan, Nicola, Procházková, Kristýna, Zhang, Lian, Rai, Samarpit, Miller, Tegan, Liu, Joy, Szabo, Aniko, Iczkowski, Kenneth A
Format: Article
Language:English
Subjects:
Development and progression
Diagnosis
Epididymis - pathology
Germ cell tumors
Humans
Male
Metastases
Metastasis
Methods
Neoplasm Invasiveness
Neoplasm Staging
Neoplasms, Germ Cell and Embryonal - pathology
Rete Testis - pathology
Seminoma
Spermatic cord
Testicular cancer
Testicular Neoplasms - pathology
Tumor staging
Tumors
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Summary:Abstract Objectives Rete testis invasion by germ cell tumors is frequently concomitant with lymphovascular or spermatic cord invasion (LVI/SCI); independent implications for staging are uncertain. Methods In total, 171 seminomas and 178 nonseminomatous germ cell tumors (NSGCTs; 46 had 1%-60% seminoma component) came from five institutions. Metastatic status at presentation, as a proxy for severity, was available for all; relapse data were unavailable for 152. Rete direct invasion (ReteD) and rete pagetoid spread (ReteP) were assessed. Results ReteP and ReteD were more frequent in seminoma than NSGCT. In seminoma, tumor size bifurcated at 3 cm or more or less than 3 cm predicted metastatic status. Tumors with ReteP or ReteD did not differ in size from those without invasions but were less than with LVI/SCI; metastatic status or relapse did not show differences. In NSGCT, ReteP/ReteD did not correlate with size, metastatic status, or relapse. Conclusions Findings support retaining American Joint Committee for Cancer pathologic T1 stage designation for rete testis invasion and pT1a/pT1b substaging of seminoma.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqy168