Testis-Sparing Surgery: A Single Institution Experience.
Citation: Urology. 147:192-198, 2021 01.PMID: 33137349Institution: MedStar Washington Hospital CenterDepartment: UrologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Neoplasm Recurrence, Local/ep [Epidemiology] | *Neoplasms, Germ Cell and Embryonal/su [Surgery] | *Orchiectomy/mt [Methods] | *Organ Sparing Treatments/mt [Methods] | *Testicular Neoplasms/su [Surgery] | Adult | Disease-Free Survival | Follow-Up Studies | Humans | Male | Neoplasm Recurrence, Local/pc [Prevention & Control] | Neoplasms, Germ Cell and Embryonal/di [Diagnosis] | Neoplasms, Germ Cell and Embryonal/mo [Mortality] | Neoplasms, Germ Cell and Embryonal/pa [Pathology] | Orchiectomy/sn [Statistics & Numerical Data] | Organ Sparing Treatments/sn [Statistics & Numerical Data] | Prospective Studies | Registries/sn [Statistics & Numerical Data] | Retrospective Studies | Testicular Neoplasms/di [Diagnosis] | Testicular Neoplasms/mo [Mortality] | Testicular Neoplasms/pa [Pathology] | Testis/pa [Pathology] | Testis/su [Surgery] | Tumor BurdenYear: 2021Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:- 0090-4295
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33137349 | Available | 33137349 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
CONCLUSIONS: TSS is safe and effective for small, benign masses and in the setting of bilateral disease or tumors in a solitary testis. Copyright (c) 2020. Published by Elsevier Inc.
METHODS: Our IRB-approved testicular cancer registry was reviewed for men who underwent inguinal exploration with intent for TSS (2013-2020). The attempted TSS and completed TSS groups were evaluated for differences using Student's t-test for normally-distributed variables, chi-squared and Fisher's exact tests for proportions, and Wilcoxon rank-sum test for non-parametric variables.
OBJECTIVE: To demonstrate safety and efficacy of testis sparing surgery (TSS) in two specific circumstances: small, non-palpable masses suspected to be benign and masses suspicious for germ cell tumor (GCT) in a solitary or functionally solitary testicle or bilateral disease.
RESULTS: TSS was attempted in 28 patients and completed in 14. TSS was completed only if intraoperative frozen section demonstrated benign disease, except for one patient with stage I seminoma and solitary testicle. Sensitivity and specificity of frozen section analysis was 100% and 93%, respectively. There were no significant differences in demographics between attempted vs. completed TSS cohorts. Median tumor size was significantly smaller in the completed TSS cohort (1.0 cm vs 1.7 cm, p=0.03). In patients with unilateral masses without history of testis cancer, the testis was successfully spared in 9/22 (41%) cases. In patients with bilateral disease or germ cell tumor in solitary testis, the testis was spared in 5/6 (83%) cases. At a median follow up of 12.2 months, all patients were alive, and 27/28 (96%) had no evidence of disease.
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