Oncological and functional outcomes after testis-sparing surgery in patients with germ cell tumors: a systematic review of 285 cases

Grogg, Josias Bastian; Dursun, Zeynep Hafza; Beyer, Jörg; Eberli, Daniel; Poyet, Cédric; Hermanns, Thomas; Fankhauser, Christian Daniel

doi:10.1007/s00345-022-04048-6

Cited by 6 publications

(8 citation statements)

References 42 publications

(20 reference statements)

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“…1 However, this option carries a higher risk of recurrence, for which additional adjuvant therapy (radiation therapy) may be required. 4 Radical orchiectomy was favored in this patient due to an elevation in serum β-hCG.…”

Section: Discussionmentioning

confidence: 92%

A middle-aged man with hyperandrogenic state

Kianian¹,

Jiang²,

Donin³

2023

Urology Case Reports

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Section: Discussionmentioning

confidence: 92%

A middle-aged man with hyperandrogenic state

Kianian¹,

Jiang²,

Donin³

2023

Urology Case Reports

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“…The authors conclude that TSS should only be offered to well-informed patients with a singular testicle, a singular tumor less than 2 cm located at the lower pole of the testicle, and normal preoperative endocrine function. Unless patients plan to father a child within a short time frame, adjuvant testicular radiotherapy should be recommended [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, it lacked information on preoperative endocrine function and the size of the removed lesion. Thus, no conclusions about hypogonadism prevention could be derived [ 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…Organ-sparing surgery, also known as testis-sparing surgery or partial orchiectomy, is a surgical approach that aims to remove the tumor while preserving the healthy tissue and the function of the testis. Organ-sparing surgery has gained increasing popularity in recent years as an alternative to radical orchiectomy for select cases of testicular tumors, with growing scientific evidence [ 9 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Organ-Sparing Surgery for Testicular Germ Cell Tumors: A Current Perspective

García Rojo,

Giannarini,

García Gómez

et al. 2023

Medicina

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Background and Objectives: We aimed to evaluate the oncological and functional outcomes of organ-sparing surgery for testicular germ cell tumors, a procedure that seeks to strike a balance between effective cancer control and organ preservation, in the treatment of testicular tumors. We aimed to discuss the surgical technique and complications, and determine the appropriate candidate selection for this approach. Material and Methods: A comprehensive literature search was conducted to identify relevant studies on organ-sparing surgery for testicular tumors. Various databases, including PubMed, Embase, and Cochrane Library, were used. Studies reporting on surgical techniques, complications, and oncologic and functional outcomes were included for analysis. Results: Current evidence suggests that organ-sparing surgery for testicular germ cell tumors can be considered a safe and efficacious alternative to radical orchiectomy. The procedure is associated with adequate oncological control, as indicated by low recurrence rates and low complication rates. Endocrine testicular function can be preserved in around 80–90% of patients and paternity can be achieved in approximately half of the patients. Candidate selection for this surgery is typically based on the following criteria: pre-surgery normal levels of testosterone and luteinizing hormone, synchronous or metachronous bilateral tumors, tumor in a solitary testis, and tumor size less than 50% of the testis. Conclusions: Organ-sparing surgery for testicular germ cell tumors offers a promising approach that balances oncological control and preservation of testicular function. Further research, including large-scale prospective studies and long-term follow-ups, is warranted to validate the effectiveness and durability of organ-sparing surgery and to identify optimal patient selection criteria.

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“…While palpable lesions in fertile men often warrant orchiectomy due to a high likelihood of malignancy [ 103 , 104 ], the management of non-palpable testicular lesions involves different treatment options. These options may include ultrasound follow-up, radical orchiectomy, or testicular exploration, with the final decision based on frozen section analysis results [ 105 , 106 , 107 ].…”

Section: How To Evaluate the Risk Of Tc In Male Infertile Patients?mentioning

confidence: 99%

Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review

et al. 2023

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Background and Objectives: The relationship between male infertility (MI) and testicular cancer (TC) is bilateral. On one hand, it is well-established that patients diagnosed with TC have a high risk of pre- and post-treatment infertility. On the other hand, the risk of developing TC in male infertile patients is not clearly defined. The objective of this review is to analyze the histopathological, etiological, and epidemiological associations between MI and the risk of developing testicular cancer. This review aims to provide further insights and offer a guide for assessing the risk factors for TC in infertile men. Materials and Methods: A comprehensive literature search was conducted to identify relevant studies discussing the relationship between MI and the risk of developing TC. Results: The incidence rates of germ cell neoplasia in situ (GCNIS) appear to be high in infertile men, particularly in those with low sperm counts. Most epidemiological studies have found a statistically significant risk of developing TC among infertile men compared to the general or fertile male populations. The concept of Testicular Dysgenesis Syndrome provides an explanatory model for the common etiology of MI, TC, cryptorchidism, and hypospadias. Clinical findings such as a history of cryptorchidism could increase the risk of developing TC in infertile men. Scrotal ultrasound evaluation for testis lesions and microlithiasis is important in infertile men. Sperm analysis parameters can be useful in assessing the risk of TC among infertile men. In the future, sperm and serum microRNAs (miRNAs) may be utilized for the non-invasive early diagnosis of TC and GCNIS in infertile men. Conclusions: MI is indeed a risk factor for developing testicular cancer, as demonstrated by various studies. All infertile men should undergo a risk assessment using clinical examination, ultrasound, and semen parameters to evaluate their risk of TC.

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Oncological and functional outcomes after testis-sparing surgery in patients with germ cell tumors: a systematic review of 285 cases

Cited by 6 publications

References 42 publications

A middle-aged man with hyperandrogenic state

A middle-aged man with hyperandrogenic state

Organ-Sparing Surgery for Testicular Germ Cell Tumors: A Current Perspective

Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review

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