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Updated: Jan 17, 2026
An In Vivo Method to Study Mouse Blood-Testis Barrier Integrity
Published on: December 2, 2018
Histologic Concordance Between Post-chemotherapy RPLND and Orchiectomy When Performed Simultaneously: Insights Into
Parth U Thakker1, Jiping Zeng1, Connor Drake1
1Department of Urology, Indiana University School of Medicine, Indianapolis, IN.
Objective:
To compare the histology of patients undergoing concomitant orchiectomy and PC-RPLND to understand the interaction of chemotherapeutics with the blood-testis barrier.
Methods:
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.
Results:
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.
Conclusion:
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.
