Morphological and laboratory factors associated with recurrence risk in non-metastatic seminoma pT1–pT2: a retrospective analysis
V. I. Shchekin,
I. N. Zaborsky,
K. N. Safiullin,
O. B. Karyakin,
A. A. Karavaytseva,
P. A. Koreneva,
I. A. Podkidishev,
S. L. Babich,
А. А. Krasheninnikov,
N. V. Vorobyev,
G. А. Demyashkin,
P. V. Shegai,
A. D. Kaprin https://doi.org/10.17709/2410-1893-2025-12-3-1
EDN: CMVYXJ
Abstract
Purpose of the study. To perform a comparative analysis of clinical data and morphological features in patients with non‑metastatic seminoma, as well as to identify prognostic criteria for the administration of adjuvant antitumor therapy.
Patients and methods. This retrospective study was conducted at the National Medical Radiological Research Centre and included data from patients with non‑metastatic seminoma (n = 96) who underwent orchifuniculectomy. Medical records were reviewed with assessment of clinical and anamnestic data, laboratory parameters (alpha‑fetoprotein (AFP), beta‑human chorionic gonadotropin (β‑hCG), and lactate dehydrogenase (LDH)), and morphological tumor characteristics. Patients were stratified into three recurrence risk groups (low, intermediate, and high) according to current clinical guidelines.
Results. Comparative analysis revealed statistically significant associations between the high‑risk recurrence group and several clinico‑morphological parameters: tunica albuginea invasion (χ² = 23.626, p < 0.001), tumor necrosis (χ² = 6.579, p = 0.038), and elevated β‑hCG levels (χ² = 1.039, p < 0.001). Analysis of AFP and LDH levels did not show significant differences between stages or risk groups.
Conclusion. The results of this retrospective study expand current understanding of factors associated with recurrence risk in non‑metastatic seminoma and emphasize the need for a personalized approach to risk group stratification.
About the Authors
V. I. Shchekin
https://new.nmicr.ru/mrrc
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
Vladimir I. Shchekin – MD, Resident Doctor of the Urology Department with Chemotherapy, P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre; Laboratory Assistant Researcher at the Laboratory of Experimental Morphology and Digital Pathology, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0003-3763-7454 eLibrary SPIN: 3664-8044, AuthorID: 1109647 Scopus Author ID: 57222109527
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
I. N. Zaborsky
https://new.nmicr.ru/mrrc
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Ivan N. Zaborsky – Cand. Sci. (Medicine), Senior Researcher at the Department of Radiation and Surgical Treatment of Urological Diseases with Prostate Cancer Brachytherapy Group, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0001-5988-8268 eLibrary SPIN: 2445-5967, AuthorID: 904809 Scopus Author ID: 57208279369
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
K. N. Safiullin
https://new.nmicr.ru/mrrc
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Kadir N. Safiullin – Dr. Sci. (Medicine), Leading Researcher at the Department of Radiation and Surgical Treatment of Urological Diseases with Prostate Cancer Brachytherapy Group, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-3029-9213 eLibrary SPIN: 1981-8709, AuthorID: 694287 Scopus Author ID: 57208960001
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
O. B. Karyakin
https://new.nmicr.ru/mrrc
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Oleg B. Karyakin – Dr. Sci. (Medicine), Professor, Honored Scientist of the Russian Federation, Head of the Department of Radiation and Surgical Treatment of Urological Diseases with Prostate Cancer Brachytherapy Group, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-6112-2840 eLibrary SPIN: 1486-9379, AuthorID: 339511 Scopus Author ID: 6506147764
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
A. A. Karavaytseva
https://www.sechenov.ru
Sechenov First Moscow State Medical University (Sechenov University)
Sechenov First Moscow State Medical University (Sechenov University)
Moscow, Russian Federation
Arina A. Karavaytseva – student at the N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
P. A. Koreneva
https://www.sechenov.ru
Sechenov First Moscow State Medical University (Sechenov University)
Sechenov First Moscow State Medical University (Sechenov University)
Moscow, Russian Federation
Polina A. Koreneva – student at the N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
I. A. Podkidishev
https://www.sechenov.ru
Sechenov First Moscow State Medical University (Sechenov University)
Sechenov First Moscow State Medical University (Sechenov University)
Moscow, Russian Federation
Ivan A. Podkidishev – student at the N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
S. L. Babich
https://www.sechenov.ru
Sechenov First Moscow State Medical University (Sechenov University)
Sechenov First Moscow State Medical University (Sechenov University)
Moscow, Russian Federation
Sofya L. Babich – student at the N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
А. А. Krasheninnikov
https://new.nmicr.ru/mnioi
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre
Moscow, Russian Federation
Aleksei A. Krasheninnikov – Cand. Sci. (Medicine), Oncologist, Head of the Department of Urology and Chemotherapy, P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
N. V. Vorobyev
https://new.nmicr.ru/mnioi
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre
Moscow, Russian Federation
Nikolay V. Vorobyev – Cand. Sci. (Medicine), Oncologist, Deputy Director General for Surgery, P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation ORCID: https://orcid.org/0000-0003-2040-0493 eLibrary SPIN: 3426-9843, AuthorID: 195018 Scopus Author ID: 57188637765
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
G. А. Demyashkin
https://new.nmicr.ru/mnioi
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
Grigory A. Demyashkin – Dr. Sci. (Medicine), MD, Pathologist, Head of the Department of Digital Oncomorphology, P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Moscow, Russian Federation; Leading Researcher at the Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis (molecular morphology), Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation ORCID: http://orcid.org/0000-0001-8447-2600 SPIN: 5157-0177, AuthorID: 645433 Scopus Author ID: 57200415197 Web of Science ResearcherID: ABD-7650-2021
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
P. V. Shegai
https://new.nmicr.ru
National Medical Research Radiological Centre
Competing Interests:
National Medical Research Radiological Centre
Petr V. Shegai – Cand. Sci. (Medicine), MD, Oncologist, Deputy General Director for Science, National Medical Research Radiological Centre, Ministry of Health of the Russian Federation, Moscow, Russian Federation
ORCID: https://orcid.org/0000-0001-9755-1164
SPIN: 6849-3221, AuthorID: 708894
Scopus Author ID: 16025544200
Web of Science ResearcherID: E-9611-2014
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
A. D. Kaprin
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
National Medical Research Radiological Centre, Moscow, Russian Federation
Andrey D. Kaprin – Dr. Sci. (Medicine), Professor, Academician of the Russian Academy of Sciences, Academician of the Russian Academy of Education, Director of P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation, General Director of National Medical Research Radiological Centre, Obninsk, Russian Federation, Head of the Department of Oncology and Radiology named after V.P. Kharchenko at the Medical Institute, Peoples' Friendship University of Russia, Moscow, Russian Federation ORCID: https://orcid.org/0000-0001-8784-8415 eLibrary SPIN: 1759-8101, AuthorID: 96775 Scopus Author ID: 6602709853 Web of Science ResearcherID: K-1445-2014
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. The article has passed the review procedure accepted in the Journal by independent experts. The authors did not declare any other conflicts of interest.
References
1. Kaprin AD, Starinsky VV, Shakhzadova AO. Malignant neoplasms in Russia in 2021 (incidence and mortality). Moscow: P.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, 2022, 252 p. Available at: https://oncology‑association.ru/wp‑content/uploads/2022/11/zlokachestvennye‑novoobrazovaniya‑v‑rossii‑v‑2021‑g_zabolevaemost‑i‑smertnost.pdf (In Russ.).
2. Matveev V. B., Volkova M. I., Gladkov O. A., Klimov A. V., Protsenko S. A., Rumyantsev A. A., et al. Germ Cell Tumors in Men. Practical Recommendations of RUSSCO, Part 1.2. Malignant Tumoursis. 2024;14(3S2):267–299. (In Russ.). https://doi.org/10.18027/2224‑5057‑2024‑14‑3s2‑1.2‑11
3. Yazici S, Del Biondo D, Napodano G, Grillo M, Calace FP, Prezioso D, Crocetto F, Barone B. Risk Factors for Testicular Cancer: Environment, Genes and Infections‑Is It All? Medicina (Kaunas). 2023 Apr 7;59(4):724. https://doi.org/10.3390/medicina59040724
4. Turnbull C, Rapley EA, Seal S, Pernet D, Renwick A, Hughes D, et al.; UK Testicular Cancer Collaboration. Variants near DMRT1, TERT and ATF7IP are associated with testicular germ cell cancer. Nat Genet. 2010 Jul;42(7):604–607. https://doi.org/10.1038/ng.607
5. Gell JJ, Zhao J, Chen D, Hunt TJ, Clark AT. PRDM14 is expressed in germ cell tumors with constitutive overexpression altering human germline differentiation and proliferation. Stem Cell Res. 2018 Mar;27:46–56. https://doi.org/10.1016/j.scr.2017.12.016
6. Pyle L., Nathanson K. Genetic changes associated with testicular cancer susceptibility. Semin Oncol. 2016 Oct;43(5):575–581. https://doi.org/10.1053/j.seminoncol.2016.08.004
7. Facchini G, Rossetti S, Cavaliere C, D'Aniello C, Di Franco R, Iovane G, et al. Exploring the molecular aspects associated with testicular germ cell tumors: a review. Oncotarget. 2017 Nov 3;9(1):1365–1379. https://doi.org/10.18632/oncotarget.22373
8. van der Meer DJ, Karim‑Kos HE, Elzevier HW, Dinkelman‑Smit M, Kerst JM, Atema V, et al. The increasing burden of testicular seminomas and non‑seminomas in adolescents and young adults (AYAs): incidence, treatment, disease‑specific survival and mortality trends in the Netherlands between 1989 and 2019. ESMO Open. 2024 Feb;9(2):102231. https://doi.org/10.1016/j.esmoop.2023.102231
9. Kholbobozoda RF, Kostin AA, Vorobyev NV, Tolkachev AO, Krasheninnikov AA, Taraki IA, Kaprin AD. Preoperative level of sex hormones as a predictor (prognostic factor) of the morphological characteristics of testicular malignancies. Siberian Journal of Oncology. 2024;23(1):63–74. (In Russ.). https://doi.org/10.21294/1814‑4861‑2024‑23‑1‑63‑74
10. Daneshmand S, Cary C, Masterson T, Einhorn L, Adra N, Boorjian SA, et al. Surgery in Early Metastatic Seminoma: A Phase II Trial of Retroperitoneal Lymph Node Dissection for Testicular Seminoma With Limited Retroperitoneal Lymphadenopathy. J Clin Oncol. 2023 Jun 1;41(16):3009–3018. https://doi.org/10.1200/jco.22.00624
11. Matulewicz RS, Oberlin DT, Sheinfeld J, Meeks JJ. The Evolving Management of Patients With Clinical Stage I Seminoma. Urology. 2016 Dec;98:113–119. https://doi.org/10.1016/j.urology.2016.07.037
12. Kvammen U, Myklebust TA, Solberg A, Muller B, Klepp OH, Fossa SD, Tandstad T. Long‑term Relative Survival after Diagnosis of Testicular Germ Cell Tumor. Cancer Epidemiol Biomarkers Prev. 2016 May;25(5):773–779. https://doi.org/10.1158/1055‑9965.EPI‑15‑1153
13. Boormans JL, Sylvester R, Anson‑Cartwright L, Glicksman RM, Hamilton RJ, Hahn E, et al. Prognostic Factor Risk Groups for Clinical Stage I Seminoma: An Individual Patient Data Analysis by the European Association of Urology Testicular Cancer Guidelines Panel and Guidelines Office. Eur Urol Oncol. 2024 Jun;7(3):537–543. https://doi.org/10.1016/j.euo.2023.10.014
14. Wagner T, Toft BG, Lauritsen J, Bandak M, Christensen IJ, Engvad B, et al. Prognostic Factors for Relapse in Patients With Clinical Stage I Testicular Seminoma: A Nationwide, Population‑Based Cohort Study. J Clin Oncol. 2024 Jan 1;42(1):81–89. https://doi.org/10.1200/JCO.23.00959
15. Smith ZL, Werntz RP, Eggener SE. Testicular Cancer: Epidemiology, Diagnosis, and Management. Med Clin North Am. 2018 Mar;102(2):251–264. https://doi.org/10.1016/j.mcna.2017.10.003
16. Selvi I, Ozturk E, Yikilmaz TN, Sarikaya S, Basar H. Effects of testicular dysgenesis syndrome components on testicular germ cell tumor prognosis and oncological outcomes. Int Braz J Urol. 2020 Sep‑Oct;46(5):725–740. https://doi.org/10.1590/s1677‑5538.ibju.2019.0387
17. McGlynn KA, Trabert B. Adolescent and adult risk factors for testicular cancer. Nat Rev Urol. 2012 Apr 17;9(6):339–349. https://doi.org/10.1038/nrurol.2012.61
18. Dieckmann KP, Anheuser P, Simonsen H, Höflmayer D. Pure Testicular Seminoma with Non‑Pathologic Elevation of Alpha Fetoprotein: A Case Series. Urol Int. 2017;99(3):353–357. https://doi.org/10.1159/000478706
19. Fero KE, Lec PM, Sharma V, Lenis AT, Low J, Litwin MS, Leapman MS, Chamie K. When is a Seminoma not a Seminoma? The Incidence, Risk Factors and Management of Patients With Testicular Seminoma With Discordant Elevated Serum Alpha‑fetoprotein. Urology. 2021 Nov;157:188–196. https://doi.org/10.1016/j.urology.2021.05.101
20. Azizi M, Peyton CC, Boulware DC, Gilbert SM, Sexton WJ. Primary tumor size thresholds in stage IA testicular seminoma: Implications for adjuvant therapy after orchiectomy and survival. Urol Oncol. 2020 Jan;38(1):7.e9–7.e18. https://doi.org/10.1016/j.urolonc.2019.09.022
21. Lerro CC, McGlynn KA, Cook MB. A systematic review and meta‑analysis of the relationship between body size and testicular cancer. Br J Cancer. 2010 Oct 26;103(9):1467–1474. https://doi.org/10.1038/sj.bjc.6605934
22. Hu M, Guan H, Lau CC, Terashima K, Jin Z, Cui L, et al. An update on the clinical diagnostic value of β‑hCG and αFP for intracranial germ cell tumors. Eur J Med Res. 2016 Mar 12;21:10. https://doi.org/10.1186/s40001‑016‑0204‑2
Review
For citations:
Shchekin V.I., Zaborsky I.N., Safiullin K.N., Karyakin O.B., Karavaytseva A.A., Koreneva P.A., Podkidishev I.A., Babich S.L., Krasheninnikov А.А., Vorobyev N.V., Demyashkin G.А., Shegai P.V., Kaprin A.D. Morphological and laboratory factors associated with recurrence risk in non-metastatic seminoma pT1–pT2: a retrospective analysis. Research and Practical Medicine Journal. 2025;12(3):8-20. (In Russ.) https://doi.org/10.17709/2410-1893-2025-12-3-1. EDN: CMVYXJ
Views:
165
Email this article 