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Intratumoral Heterogeneity, Chemoresistance and Lymph Node Landing Zone Prognosis in Testicular Tumors Based on Histopathological Characteristics

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Existing data on the histopathological correlation of testicular tumors with lymph node prognosis have been poorly explored. We aimed to investigate the relationship of the histopathological properties of testicular tumors with lymph nodes and their involvement with chemoresistance and heterogeneity of testicular tumors.

Methods

Patients with non-seminomatous germ cell tumor (NSGCT) were selected for histopathological correlation of testicular tumor with lymph nodes and its relationship with chemoresistance and heterogeneity. Histopathological and radiological parameters associated with the risk of chemoresistance and tumor progression were measured pre- and post-chemotherapy. Binomial logistic regression and Kaplan–Meier analysis were implemented to determine the predictors of progression and adverse overall patient survival. All categorical variables were analyzed using the Chi-square test, while Pearson’s R coefficient determined the correlation.

Results

Male patients who were diagnosed with NSGCT from March 2017 to December 2018 at Guwahati Medical College, Guwahati, India, were included in this study. Lymph node groups were predominantly incriminated with the EYST or EYS groups and minimally linked with the pure E and YCS groups. Furthermore, the highest number of lymph node stations was associated with pre-chemotherapy. In salvage chemotherapy in the form of VIP, we found exciting outcomes, as approximately 41% of cases responded positively, especially in the EYS group.

Conclusion

Our study classifies NSGCT according to the most favorable histopathological grouping and explores the tumoral response in different intrinsic and extrinsic variables. Our analysis can serve as a triumphant histopathological nomogram for a sublime management protocol to deal with the onerous histological pairing in NSGCT.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. This manuscript has data included as electronic supplementary material.

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Acknowledgment

The authors thank the patients who participated in this study and all research support staff and investigators. This work uses data provided by patients and collected by the Guwahati Medical College Hospital, Guwahati, Assam, India, as part of their care and support. Dr. Neha Garg would like to acknowledge the seed grant under the Institute of Eminence Scheme, Banaras Hindu University, for financial support.

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Authors and Affiliations

  1. Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Yashasvi Singh MBBS, MS, Sameer Trivedi MBBS, MS & Sridhar Reddy Koti MBBS, MS

  2. Department of Urology, Gauhati Medical College and Hospital, Guwahati, India

    Sasanka Kumar Barua MBBS, MS & T. P. Rajeev MBBS, MS

  3. School of Biosciences and Bioengineering, Indian Institute of Technology Mandi, Mandi, HP, India

    Vipendra Kumar Singh MSc, PhD

  4. Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Neha Garg BSc, MSc, PhD

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  1. Yashasvi Singh MBBS, MS
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  2. Sasanka Kumar Barua MBBS, MS
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  3. Vipendra Kumar Singh MSc, PhD
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Contributions

Conceptualization: YS, SKB. Data curation: YS. Formal analysis: YS, SKB, NG. Investigation: YS, SKB, VKS, ST, RTP, SRK, NG. Methodology: YS, SKB, VKS, ST, RTP, SRK, NG. Project administration: YS, SKB, NG. Software: YS. Supervision: YS, NG. Validation: YS, SKB, VKS, ST, RTP, SRK, NG. Roles/writing—original draft: YS, VKS, NG. Writing—review and editing: All authors.

Corresponding authors

Correspondence to Yashasvi Singh MBBS, MS or Neha Garg BSc, MSc, PhD.

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Disclosure

Yashasvi Singh, Sasanka Kumar Barua, Vipendra Kumar Singh, Sameer Trivedi, Rajeev TP, Sridhar Reddy Koti, and Neha Garg have no relevant financial or non-financial interests to disclose.

Ethical statement

This study was approved by the Ethics Committee of Gauhati Medical College Hospital, Guwahati, Assam (MC/190/2007/PA-I/138). Prior consent was received from all patients who were involved in this study.

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Singh, Y., Barua, S.K., Singh, V.K. et al. Intratumoral Heterogeneity, Chemoresistance and Lymph Node Landing Zone Prognosis in Testicular Tumors Based on Histopathological Characteristics. Ann Surg Oncol 31, 3544–3553 (2024). https://doi.org/10.1245/s10434-024-15051-z

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