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Review
. 2020 Oct 6;12(10):2867.
doi: 10.3390/cancers12102867.

Testis Sparing Surgery in Pediatric Testicular Tumors

Cezanne D Kooij  1 , Caroline C C Hulsker  1 , Mariëtte E G Kranendonk  1 , József Zsiros  1 , Annemieke S Littooij  1   2 , Leendert H J Looijenga  1 , Aart J Klijn  3 , Annelies M C Mavinkurve-Groothuis  1
Affiliations
Review

Testis Sparing Surgery in Pediatric Testicular Tumors

Cezanne D Kooij et al. Cancers (Basel). .

Abstract

Objective: The purpose of this review is to evaluate the outcomes of testis sparing surgery (TSS) and to investigate under which circumstances TSS can be considered a safe treatment option in pediatric patients with testicular tumors.

Methods: A database search was performed in Cochrane, Pubmed, and Embase for studies that focused on TSS as treatment for testicular tumors in the pediatric population, excluding reviews and single case reports.

Results: Twenty studies, describing the surgical treatment of 777 patients with testicular tumors, were included in the analysis. The majority of pediatric patients with benign germ cell tumors (GCTs) (mean age: 3.7 years) and sex cord-stromal tumors (SCSTs) (mean age: 6.6 years) were treated with TSS, 61.9% and 61.2%, respectively. No cases of testicular atrophy occurred. Four of the benign GCTs, i.e., three teratomas and one epidermoid cyst, recurred. No cases of recurrence were reported in patients with SCSTs. Of the 243 malignant GCTs (mean age: 4.2 years), only one patient had TSS (0.4%).

Conclusion: TSS is a safe treatment option for prepubertal patients less than 12 years of age with benign GCTs and low grade SCSTs.

Keywords: Testis sparing surgery; algorithm; germ cell tumor; pediatric; recurrence; testicular atrophy; testicular tumors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of included and excluded articles during the search process.
Figure 2
Figure 2
Our proposed algorithm for the surgical approach in prepubertal patients less than 12 years of age with testicular tumors. STM = Serum tumor markers; US = Ultrasonographic; MRI = Magnetic resonance imaging; FSE = Frozen section examination; ^ = According to the age specific range; ● = Preoperative; ● = Preoperative and intraoperative; ● = Intraoperative.
See this image and copyright information in PMC

References

    1. Kusler K.A., Poynter J.N. International testicular cancer incidence rates in children, adolescents and young adults. Cancer Epidemiology. 2018;56:106–111. doi: 10.1016/j.canep.2018.08.002. - DOI - PubMed
    1. Ahmed H.U., Arya M., Muneer A., Mushtaq I., Sebire N.J. Testicular and paratesticular tumours in the prepubertal population. Lancet Oncol. 2010;11:476–483. doi: 10.1016/S1470-2045(10)70012-7. - DOI - PubMed
    1. Looijenga L., Van der Kwast T.H., Grignon D., Egevad L., Kristiansen G., Kao C.S., Idrees M.T. Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers, IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors. Am. J. Surg. Pathol. 2020;44:e66–e79. doi: 10.1097/PAS.0000000000001465. - DOI - PMC - PubMed
    1. Calaminus G., Schneider D.T., von Schweinitz D., Jürgens H., Infed N., Schönberger S., Olson T.A., Albers P., Vokuhl C., Stein R., et al. Age-Dependent Presentation and Clinical Course of 1465 Patients Aged 0 to Less than 18 Years with Ovarian or Testicular Germ Cell Tumors; Data of the MAKEI 96 Protocol Revisited in the Light of Prenatal Germ Cell Biology. Cancers. 2020;12:611. doi: 10.3390/cancers12030611. - DOI - PMC - PubMed
    1. Moch H., Cubilla A.L., Humphrey P.A., Reuter V.E., Ulbright T.M. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur. Urol. 2016;70:93–105. doi: 10.1016/j.eururo.2016.02.029. - DOI - PubMed

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