Journal article
Histologic Concordance Between Post-chemotherapy RPLND and Orchiectomy when performed simultaneously: Insights Into the Blood-Testis Barrier
Urology (Ridgewood, N.J.), Vol.207, pp.203-206
01/2026
DOI: 10.1016/j.urology.2025.09.013
PMID: 40946924
Abstract
To compare the histology of patients undergoing concomitant orchiectomy and PC-RPLND to understand the interaction of chemotherapeutics with the blood-testis barrier.
We identified patients undergoing orchiectomy at the time of PC-RPLND using an institutional database. Concordance between the PC-RPLND and orchiectomy histology was assessed. Univariable logistic regression for age, mass size, pre-chemotherapy RP biopsy and testis mass size, and receipt of bleomycin chemotherapy on detecting teratoma in the orchiectomy specimen was performed.
Fifty-seven patients undergoing orchiectomy at the time of PC-RPLND were identified. Concordance between PC-RPLND and orchiectomy pathology was observed in 29 (50.9%) patients. Univariable analysis demonstrated that pre-operative RP mass size (OR 0.93, 95% CI 0.80 - 1.07), receipt of bleomycin (OR 1.56, 95% CI 0.42 - 5.8), pre-chemotherapy testis mass size (OR 1.11, 95% CI 0.83 - 1.47), age at surgery (OR 0.99, 95% CI 0.70 - 1.39), pre-chemotherapy RP histology (OR 2.4, 95% CI 0.48 - 11.8), nor time from chemotherapy to surgery (OR 1.0, 95% CI 0.72 - 1.39) were associated with finding teratoma on orchiectomy.
With 60% of testis masses revealing necrosis, chemotherapy appears to penetrate the blood-testis barrier, however with a 1.5% incidence of ITGCN, its ability to do so is not predictable. Since identifying teratoma in the testis remains a challenge, delayed orchiectomy in patients undergoing upfront chemotherapy should remain a standard of care.
Details
- Title: Subtitle
- Histologic Concordance Between Post-chemotherapy RPLND and Orchiectomy when performed simultaneously: Insights Into the Blood-Testis Barrier
- Creators
- Parth U Thakker - Indiana University – Purdue University IndianapolisJiping Zeng - Indiana University – Purdue University IndianapolisConnor Drake - Indiana University – Purdue University IndianapolisJames Brown - University of IowaTimothy A Masterson - Indiana University – Purdue University IndianapolisClint Cary - Indiana University – Purdue University Indianapolis
- Resource Type
- Journal article
- Publication Details
- Urology (Ridgewood, N.J.), Vol.207, pp.203-206
- DOI
- 10.1016/j.urology.2025.09.013
- PMID
- 40946924
- NLM abbreviation
- Urology
- ISSN
- 0090-4295
- eISSN
- 1527-9995
- Publisher
- ELSEVIER SCIENCE INC
- Language
- English
- Electronic publication date
- 09/12/2025
- Date published
- 01/2026
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Urology
- Record Identifier
- 9984964233402771
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