A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study.
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Keske Murat, Canda Abdullah Erdem, Karadag Mert Ali, Çiftçi Halil, Erturhan Sakip, Kactan Cagri, Soytas Mustafa, Özkaya Fatih, Ozbey Isa, Ordek Eser, Atmaca Ali Fuat, Yildirim Asif, Sahin Selcuk, Colakoglu Yunus, Boylu Ugur, Erol Bulent, Caskurlu Turhan, Kiremit Murat Can, Cakici Ozer Ural, Sonmez Gokhan, Kılıçarslan Hakan, Akbulut Ziya, Kaygısız Onur, Bedir Selahattin, Vuruskan Hakan, Bozkurt Yunus Erol, Aydin Hasan Riza, Oguz Ural, Basok Erem Kaan, Gumus Bilal Habes, Tuncel Altug, Aslan Yilmaz, Hamidi Nurullah, Müslümanoğlu Ahmet Yaser, Dinçer Murat, Balbay Derya, Albayrak Selami, Laguna Maria Pilar
Аннотация
METHODS: This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups.
RESULTS: TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 ± 10.32 years), pathological tumor size (14.67 ± 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 ± 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions.
CONCLUSION: TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling.