Reporting and staging of testicular germ cell tumors

The international society of urological pathology (ISUP) testicular cancer consultation conference recommendations

Members of the International Society of Urological Pathology Testicular Tumor Panel

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The International Society of Urological Pathology held a conference devoted to issues in testicular and penile pathology in Boston in March 2015, which included a presentation and discussion led by the testis microscopic features working group. This conference focused on controversies related to staging and reporting of testicular tumors and was preceded by an online survey of the International Society of Urological Pathology members. The survey results were used to initiate discussions, but decisions were made by expert consensus rather than voting. A number of recommendations emerged from the conference, including that lymphovascular invasion (LVI) should always be reported and no distinction need be made between lymphatic or blood invasion. If LVI is equivocal, then it should be regarded as negative to avoid triggering unnecessary therapy. LVI in the spermatic cord is considered as category pT2, not pT3, unless future studies provide contrary evidence. At the time of gross dissection, a block should be taken just superior to the epididymis to define the base of the spermatic cord, and direct invasion of tumor in this block indicates a category of pT3. Pagetoid involvement of the rete testis epithelium must be distinguished from rete testis stromal invasion, with only the latter being prognostically useful. Percentages of different tumor elements in mixed germ cell tumors should be reported. Although consensus was reached on many issues, there are still areas of practice that need further evidence on which to base firm recommendations.

Original languageEnglish (US)
Pages (from-to)e22-e32
JournalAmerican Journal of Surgical Pathology
Volume41
Issue number6
DOIs
StatePublished - May 1 2017

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Testicular Neoplasms
Rete Testis
Spermatic Cord
Referral and Consultation
Pathology
Epididymis
Germ Cell and Embryonal Neoplasms
Politics
Testis
Dissection
Neoplasms
Epithelium
Testicular Germ Cell Tumor
Surveys and Questionnaires
Therapeutics

All Science Journal Classification (ASJC) codes

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Reporting and staging of testicular germ cell tumors : The international society of urological pathology (ISUP) testicular cancer consultation conference recommendations. / Members of the International Society of Urological Pathology Testicular Tumor Panel.

In: American Journal of Surgical Pathology, Vol. 41, No. 6, 01.05.2017, p. e22-e32.

Research output: Contribution to journalArticle

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abstract = "The International Society of Urological Pathology held a conference devoted to issues in testicular and penile pathology in Boston in March 2015, which included a presentation and discussion led by the testis microscopic features working group. This conference focused on controversies related to staging and reporting of testicular tumors and was preceded by an online survey of the International Society of Urological Pathology members. The survey results were used to initiate discussions, but decisions were made by expert consensus rather than voting. A number of recommendations emerged from the conference, including that lymphovascular invasion (LVI) should always be reported and no distinction need be made between lymphatic or blood invasion. If LVI is equivocal, then it should be regarded as negative to avoid triggering unnecessary therapy. LVI in the spermatic cord is considered as category pT2, not pT3, unless future studies provide contrary evidence. At the time of gross dissection, a block should be taken just superior to the epididymis to define the base of the spermatic cord, and direct invasion of tumor in this block indicates a category of pT3. Pagetoid involvement of the rete testis epithelium must be distinguished from rete testis stromal invasion, with only the latter being prognostically useful. Percentages of different tumor elements in mixed germ cell tumors should be reported. Although consensus was reached on many issues, there are still areas of practice that need further evidence on which to base firm recommendations.",
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