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Our study aimed to identify clinical, biochemical, and radiological risk factors for mB\u2010GCT in a cohort of patients with GCT at a single tertiary referral centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective case\u2010control study included patients with GCT referred to Policlinico Umberto I\u2014Sapienza University of Rome, from 2005 to 2023. We evaluated clinical history, testicular ultrasound features, hormone levels, semen analysis, histological characteristics, staging, and treatments. mB\u2010GCTs were compared with unilateral GCT patients with a follow\u2010up longer than the median time\u2010to\u2010onset of the second tumour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 319 patients, 52 experienced B\u2010GCT, with a median time\u2010to\u2010onset of the second tumour of 62 months (range: 8\u2013229). The mB\u2010GCT group showed higher gonadotropin levels (FSH 13.6mUI\/mL vs. 7.4mUI\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001; LH 6.6mUI\/mL vs. 3.9mUI\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004), lower sperm concentration (27\u00a0\u00d7\u00a010\n                      <jats:sup>6<\/jats:sup>\n                      \/ejaculate vs. 78\u00a0\u00d7\u00a010\n                      <jats:sup>6<\/jats:sup>\n                      \/ejaculate,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.009), smaller residual testis volume (10.4\u00a0mL vs. 16.3\u00a0mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), more inhomogeneous echotexture [57.5% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001], and presence of microlithiasis (75% vs. 19.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Kaplan\u2013Meier curves confirmed that ultrasound features of the residual testis increased the cumulative risk of developing a second tumour. Microlithiasis was a strong independent predictor (OR 30.712, 95% CI 3.357\u2013280.942,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Histological features of the first tumour or its treatment do not influence the onset of a second tumour. However, low residual testis volume, inhomogeneous echotexture, and microlithiasis significantly increase this risk. A comprehensive evaluation of the residual testis at baseline is essential for developing a personalised surveillance programme in GCT survivors, with regular ultrasound follow\u2010up recommended beyond the conventional 5\u2010year limit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.13704","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T09:29:07Z","timestamp":1722331747000},"page":"587-599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Testicular ultrasonographic features predict future risk for bilateral testicular germ cell tumour: A long\u2010term single centre follow\u2010up study"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7476-0737","authenticated-orcid":false,"given":"Marta","family":"Tenuta","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Andrology, Department of Experimental 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