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. 2024 Feb 16;14(2):257.
doi: 10.3390/life14020257.

Multifocality in Testicular Cancer: Clinicopathological Correlations and Prognostic Implications

Uros Bumbasirevic  1   2 , Milos Petrovic  1 , Milica Zekovic  3 , Vesna Coric  4   5 , Bogomir Milojevic  1   2 , Nikola Lisicic  1 , David Obucina  1 , Nenad Vasilic  1 , Petar Bulat  1 , Marko Zivkovic  1 , Milica Cekerevac  6 , Nebojsa Bojanic  1   2 , Aleksandar Janicic  1   2
Affiliations

Multifocality in Testicular Cancer: Clinicopathological Correlations and Prognostic Implications

Uros Bumbasirevic et al. Life (Basel). .

Abstract

There are limited data regarding the significance of multifocality in testicular cancer patients. This study evaluated the relationship between multifocality and clinicopathological features determined at the time of radical orchiectomy. The study involved 280 consecutive patients who underwent radical orchiectomy between 2018 and 2023. Multifocality was defined as a distinct tumor focus characterized by a group of malignant cells > 1 mm, clearly differentiated from the primary tumor mass. Uni- and multivariate logistic regression analyses were employed to investigate the association between multifocality and histopathological parameters along with potential risk factors for clinical stages II + III. Multifocality was identified in 44 (15.7%) patients. Significantly smaller primary tumors were observed in subjects with multifocality (20.0 mm vs. 30.0 mm, p = 0.0001), while those exhibiting monofocality presented a markedly elevated rate of tumors exceeding 4 cm (40.3% vs. 18.2%, p = 0.005). Furthermore, multifocality was associated with a significantly higher rate of primary tumors < 2 cm (52.3% vs. 29.2%, p = 0.003). Univariate logistic regression analysis revealed a substantial decrease in the likelihood of multifocality occurrence in seminoma patients with tumors > 4 cm (OR = 0.38, p = 0.017). Meanwhile, in multivariate logistic regression, multifocality did not emerge as a significant risk factor for clinical stages II + III in either seminoma (p = 0.381) or non-seminoma (p = 0.672) cases. Our study suggests that multifocality holds no substantial prognostic relevance for clinically advanced disease in testicular cancer patients. The findings indicate that multifocality is associated with smaller primary tumors, particularly those measuring less than 2 cm.

Keywords: multifocality; prognostic factors; testicular GCT; testicular cancer.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of this study; in the collection, analyses or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Percentage of multifocality (blue) and monofocality (orange) in regard to specific index tumor size; SD—standard deviation.
See this image and copyright information in PMC

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