Does histopathologic tumor type or vascular invasion influence spermatogenesis in testicular cancer?

ObjectiveTo assess the quality and activity of spermatogenesis in the contralateral healthy testicle at the time of orchiectomy and to assess whether any tumor-related factor such as tumor type or vascular invasion is a risk factor for impaired spermatogenesis.DesignRetrospective cohort study.SettingUniversity hospital.Patient(s)Seventy-six patients undergoing orchiectomy for seminoma or nonseminomatous germ cell tumor (NSGCT).Intervention(s)Open biopsy of contralateral healthy testicle at the time of orchiectomy.Main Outcome Measure(s)Quality of spermatogenesis using median and highest Johnsen score in correlation with histopathologic tumor type, vascular invasion, and serum tumor markers and hormone levels.Result(s)Contralateral spermatogenesis is reduced in seminomas and in NSGCTs, with median Johnsen scores of 8.9 and 8.6, respectively. Similar results were seen in tumors with vascular invasion (median Johnsen score 8.8 [range 8.2–9.5]) and without vascular invasion (median Johnsen score 8.8 [range 8.1–9.2]). Areas with good-quality spermatogenesis were found in 88.9% of seminoma and 92.5% of NSGCT biopsies.Conclusion(s)Testicular cancer is associated with impaired spermatogenesis, but neither the histopathologic tumor type nor the presence of vascular invasion correlated with significantly reduced spermatogenesis.