Testis-sparing surgery and scrotal violation for testicular masses suspicious for malignancy: A systematic review and meta-analysis

Patel, Hiten D.; Gupta, Mohit; Cheaib, Joseph G.; Sharma, Ritu; Zhang, Allen; Bass, Eric B.; Pierorazio, Phillip M.

doi:10.1016/j.urolonc.2020.02.023

Cited by 24 publications

(20 citation statements)

References 27 publications

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“…In some series, postoperative hormone levels were not available, yet prescription of testosterone therapy was used as a clinical indicator of hypogonadism. A recent meta‐analysis on TSS revealed 7.1% of patients received testosterone therapy following treatment (17/238 men from 10 studies) 35 . Whether or not these men received adjuvant therapy is unclear.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of organ‐sparing surgery for adult testicular tumors: A systematic review of the literature

et al. 2021

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Objective To perform a systematic review on the effects of testicular sparing surgery (TSS) on the oncological, functional, and hormonal outcomes of adults with testicular tumors. Methods A literature search was performed after PROSPERO registration (CRD42020200842) and reported in compliance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methods. We conducted a systematic search of Medline (Ovid), Embase, Cochrane CENTRAL, CINAHL, Scopus, Web of Science, ClinicalTrials.gov, and the WHO/ICTRP from inception to November 20, 2020. Manuscripts and published abstracts were included if they involved testis‐sparing surgery (TSS) and contained data on any outcomes related to fertility, hormonal parameters, or oncological control, or if they evaluated surgical technique. Results Our initial search yielded 3,370 manuscripts, with 269 of these screened for full‐text eligibility. After our exclusion criteria were applied, 32 studies were included in the final analysis. Oncological outcomes were obtained from 12 studies (average follow‐up 57.8 months), functional data from 26 studies (average follow‐up 49.6 months), fertility information from 10 studies (average follow‐up 55.8 months), and data on nonpalpable tumors from 11 studies (average follow‐up 32.1 months). Oncological control appears to be excellent in studies that reported these outcomes. Presence of germ cell neoplasia in situ was controlled with adjuvant radiation in nearly all cases. Functional outcomes are also promising, as development of primary and compensated hypogonadism was rare. Semen parameters are poor preoperatively among men with benign and malignant testis tumors, with occasional decline after TSS. Frozen section analysis at the time of surgery appears to be very reliable, and the majority of nonpalpable tumors appear to be benign. Conclusions TSS is a safe and efficacious technique with regards to oncological control and postoperative hormonal function based on retrospective, noncontrolled studies. TSS avoids unnecessary removal of benign testicular tissue, and should be given serious consideration in cases of nonpalpable, small tumors under 2 cm. In cases of malignancy, TSS can safely avoid anorchia in men with bilateral tumors and in men with solitary testicles. The use of the operating microscope, while theoretically promising, does not necessarily lead to better outcomes, however data are limited.

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Section: Resultsmentioning

confidence: 99%

Outcomes of organ‐sparing surgery for adult testicular tumors: A systematic review of the literature

et al. 2021

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“…A meta-analysis was conducted for the outcomes of septic, nonseptic, and overall infectious complications after biopsy using random-effect modeling. Freeman-Tukey double arcsine transformation was applied to stabilize variances for binomial data [18] . A subgroup analysis was conducted by stratifying the number of biopsy cores.…”

Section: Discussionmentioning

confidence: 99%

“…Risk of bias was assessed based on AHRQ guidelines, which suggest evaluation of design, enrollment/exposure, and outcome assessment for noncomparative single-arm studies [16] , [18] . Three investigators independently rated the included studies considering three items: design (specifying details on prostate biopsy template and antibiotic use), consecutive enrollment, and objective measurement of outcome (sufficient follow-up and method of assessment).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Basourakos

Alshak

Lewicki

et al. 2022

European Urology Open Science

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“…If the imaging shows a mass that is suspected of being malignant, an inguinal orchiectomy would be carried out for further diagnosis. It is usually recommended not to damage the scrotum during the procedure, as it can lead to complications during treatment, but recent meta-analyses discard these negative effects at least for short-term survival [ 40 , 41 ].…”

Section: Testicular Germ-cell Tumours (Tgct)mentioning

confidence: 99%

Testicular Germ Cell Tumours and Proprotein Convertases

Velado-Eguskiza

Gomez-Santos

Badiola

et al. 2022

Cancers

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Testicular Germ Cell Tumours (TGCT) are widely considered a “curable cancer” due to their exceptionally high survival rate, even if it is reduced by many years after the diagnosis due to metastases and relapses. The most common therapeutic approach to TGCTs has not changed in the last 50 years despite its multiple long-term side effects, and because it is the most common malignancy in young Caucasian men, much research is needed to better the quality of life of the many survivors. Proprotein Convertases (PC) are nine serine proteases responsible for the maturation of inactive proproteins with many diverse functions. Alterations in their expression have been associated with various diseases, including cancer and inflammation. Many of their substrates are adhesion molecules, metalloproteases and proinflammatory molecules, all of which are involved in tumour development. Inhibition of certain convertases has also been shown to slow tumour formation, demonstrating their involvement in this process. Considering the very established link between PCs and inflammation-related malignancies and the recent studies carried out into the immune microenvironment of TGCTs, the study of the involvement of PCs in testicular cancer may open up avenues for being both a biomarker for diagnosis and a therapeutic target.

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Testis-sparing surgery and scrotal violation for testicular masses suspicious for malignancy: A systematic review and meta-analysis

Cited by 24 publications

References 27 publications

Outcomes of organ‐sparing surgery for adult testicular tumors: A systematic review of the literature

Outcomes of organ‐sparing surgery for adult testicular tumors: A systematic review of the literature

Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis

Testicular Germ Cell Tumours and Proprotein Convertases

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