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    Current Approach to the Prognostic Parameters of Testicular Germ Cell Tumors Accompanied by Our Cases
    (2020) Adıllı, Adila; Akçay, Muzaffer; Sezal, Zeynep; Çoban, Ganime; Yıldız, Pelin; Beşiroğlu, Mehmet; Gücin, Zühal
    Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult menand an important cause of cancer-related deaths during this period. Revisions inhistopathological classification and staging affect prognosis and treatment. The aim of thisstudy was to analyze our TGCT cases, to review prognostic parameters, and their relationshipbetween germ cell neoplasia in situ (GCNIS), intratubular and intertubular tumors.Material and Methods: In this study, Hematoxylin&Eosin-stained sections of 77 TGCTswere re-evaluated. The presence of GCNIS, intratubular and intertubular germ cell tumorswere recorded. Histopathological classification and staging were revised based on the changesin the 8th edition of American Joint Committee on Cancer (AJCC).Results: The majority of the patients were diagnosed as seminoma (n=42), followed by mixedgerm cell tumors (n=33) and spermatocytic tumors (n=2). Rete testis invasion in 30 cases,epididymal invasion in 6 cases, hilar soft tissue invasion in 10 cases, tunica vaginalis invasionin 1 case, spermatic cord invasion in 4 cases, and lymphovascular invasion in 22 cases weredetected. Intertubular seminoma in 25 cases, intratubular carcinoma in 16 cases, and GCNISin 73 cases were detected.Conclusion: The major criteria to determine treatment choices are histopathological diagnosis,pathological tumor stage, serum tumor markers and presence of metastasis. According toAJCC 8th edition, addition of hilar soft tissue invasion to staging has increased the number ofour pT2 cases. Moreover, assuming discontinuous tumor invasion of spermatic cord byvascular invasion as pM1 has also increased the number of metastatic testis tumors.