Contemporary Role of Testis Sparing Surgery: A Systematic Review - European Medical Journal

Contemporary Role of Testis Sparing Surgery: A Systematic Review

Urology
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Authors:
*Giorgio Ivan Russo,1 Giulio Reale,1 Salvatore Privitera,1 Tommaso Castelli,1 Massimo Madonia,2 Sebastiano Cimino,1 Vincenzo Favilla,1 Giuseppe Morgia1
Disclosure:

No potential conflict of interest.

Received:
21.10.14
Accepted:
19.11.14
Citation
EMJ Urol. ;3[1]:34-40.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

Abstract

Testis-sparing surgery (TSS) represents a therapeutic choice for testicular cancer (TC). However,  international guidelines are very cautious about the use of the testis-sparing technique, namely due to the lack of certain indications and long-term oncological outcomes. The aim of this systematic-review is to illustrate current trends of what may today be the uses of organ-sparing surgery in TC, to evaluate the relationship between the organ-sparing safety and oncological features such as definitive histology, tumour size, and post-surgery oncological outcomes. This analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. An electronic search of the Medline and Embase was undertaken until September 2014. The search was limited to English-Language articles. Current indications of TSS are synchronous bilateral testicular tumours, metachronous contralateral tumours, or tumour in a solitary testis with normal preoperative testosterone levels. Moreover, histological characteristics should not be taken into account when performing a TSS approach. TSS outcomes for  germ cell tumours are encouraging and we reported high rates of disease-free survival and a few cases of patients receiving neoadjuvant chemotherapy or radiotherapy. In light of the examined, TSS could be considered a viable alternative to radical surgery of the testis but it should be performed in specialised centres with competence.

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