Testicular‐sparing surgery for bilateral or monorchide testicular tumours: a multicenter study of long‐term oncological and functional results. (16th August 2014)

• Record Type: Journal Article
• Authors: Ferretti, Ludovic; Sargos, Paul; Gross‐Goupil, Marine; Izard, Vincent; Wallerand, Hervé; Huyghe, Eric; Rigot, Jean‐Marc; Durand, Xavier; Benoit, Gerard; Ferriere, Jean‐Marie; Droupy, Stéphane
• Is Part Of: BJU international. Volume 114:Number 6(2014:Dec.)
• Page Start: 860
• Page End: 864
• Publication Date: 2014-08-16
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12549
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12549-sec-0001" sec-type="section"> <title>Objective</title> <p>To review long‐term oncological and functional outcomes of testicular‐sparing surgery (TSS) in men presenting with bilateral or monorchide testicular tumours at one of five reference centres for testicular neoplasm and infertility.</p> </sec> <sec id="bju12549-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p>We review 25 cases of bilateral synchrone and metachrone testicular tumours treated in five academic centres between 1984 and 2013.</p> <p>Clinical, biological, ultrasonography and pathological tumour findings, overall survival (OS) times, local or metastatic recurrence, pre‐ and postoperative hormonal profile, paternity and the need for androgen substitution were assessed.</p> </sec> <sec id="bju12549-sec-0003" sec-type="section"> <title>Results</title> <p>Eleven patients with a bilateral synchrone tumour and 14 patients with a testicular tumour on a solitary testicle underwent a tumorectomy.</p> <p>The mean (<sc>sem</sc>) patient age was 31.9 (1.04) years, total testosterone level was 4.5 (0.57) ng.mL and tumour size was 11.66 (1.49) mm.</p> <p>Tumour types were as follows: 11 seminoma, nine non‐seminomatous or mixed germ cell tumours, four Leydig tumours, and one hamartoma. Frozen‐section examination was performed in 14 patients, and matched the final pathological analysis in 11 patients.</p> <p>There was an OS rate of 100% and three patients (12%) presented with a local recurrence after a mean follow‐up of 42.7 months.</p> <p>Radical orchiectomy was performed for six patients. No patient with a preserved testicle required androgen therapy; the mean postoperative total testosterone level was 4.0 ng/mL.</p> <p>No patient remained fertile after radiation therapy.</p> </sec> <sec id="bju12549-sec-0004" sec-type="section"> <title>Conclusions</title> <p>TSS for bilateral testicular tumour is safe and effective in selected patients, and should be considered to avoid definitive androgen therapy.</p> <p>Adjuvant radiotherapy remains poorly described in the literature, leading to adjuvant treatment heterogeneity for testicular tumours.</p> </sec> </abstract>