Artículo de revisiónPapel de la cirugía conservadora testicular en el manejo conservador de masas testiculares pequeñas: perspectivas oncológicas y funcionalesRole of testis sparing surgery in the conservative management of small testicular masses: oncological and functional perspectives
Section snippets
Introducción
El cáncer de testículo representa aproximadamente el 5% de los tumores urológicos, con una incidencia estimada de 3-10 nuevos casos por cada 100.000 varones/año en los países occidentales1. La orquiectomía radical (OR) se considera todavía la opción estándar de atención para las masas testiculares sintomáticas, sólidas y palpables2 que resultaron ser malignas en la gran mayoría de casos en el análisis histológico definitivo. No obstante, un manejo quirúrgico radical podría ser considerablemente
Conclusiones
El enfoque conservador testicular para pequeñas lesiones testiculares permite conservar tanto parénquima sano como sea posible, pero debería llevarse a cabo solo en casos seleccionados y en centros experimentados. El enfoque quirúrgico es seguro y viable y se obtienen resultados óptimos en caso de lesiones benignas. Cuando se realiza por pequeños tumores malignos de células germinales, la CCT se debería ofrecer cuidadosamente a pacientes seleccionados y la radioterapia testicular adyuvante
Conflicto de intereses
Los autores declaran que no tienen ningún conflicto de intereses.
Bibliografía (45)
- et al.
Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975
Ann Oncol
(2010) - et al.
European Association of Urology. EAU guidelines on testicular cancer: 2011 update
Eur Urol
(2011) - et al.
Organ sparing surgery for malignant germ cell tumor of the testis
J Urol
(2001) - et al.
Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer
Eur Urol
(2003) - et al.
Frozen section analysis-guided organ-sparing approach in testicular tumors: Technique, feasibility, and long-term results
Urology
(2003) - et al.
High incidence of benign testicular neoplasms diagnosed by ultrasound
J Urol
(2003) - et al.
Management of bilateral testicular germ cell tumours–experience of the German testicular cancer study group (GTCSG) [abstract 299]
Eur Urol Suppl
(2006) - et al.
Long-term follow-up after elective testis sparing surgery for Leydig cell tumors: A single center experience
J Urol
(2007) - et al.
Conservative surgical therapy for Leydig cell tumor
J Urol
(2007) - et al.
Leydig cell tumor recurrence after enucleation
J Urol
(1996)
Microsurgical «testis sparing» surgery for non palpable hypoechoic testicular lesions
Urology
Testicular sparing surgery for small masses
Urol Oncol
Microsurgical testis-sparing surgery in small testicular masses: Seven years retrospective management and results
Urology
Ultrasound guided needle localization and microsurgical exploration for incidental nonpalpable testicular tumors
J Urol
Organ-sparing surgery for adult testicular tumours: a systematic review of the literature
Eur Urol
Organ-sparing surgery for testicular lesions
Eur Urol Suppl
Perioperative complications and mortality after radical cystectomy when using a standardized reporting methodology
Clin Genitourin Cancer
Accuracy of frozen section examination of testicular tumors
Urology
Handling and reporting of biopsy and surgical specimens of testicular cancer
Eur Urol
Management of testicular masses incidentally discovered by ultrasound
J Urol
Nonpalpable intratesticular masses detected sonographically
J Urol
Role of organ-sparing surgery in germ cell tumors of the testis
Urology
Cited by (24)
Testis Sparing Surgery for Benign Testicular Masses: Diagnostics and Therapeutic Approaches
2018, Journal of UrologyCitation Excerpt :Previous studies identified tumor size as an important predictor of malignant disease since 80% of all small lesions were reported to be of benign origin.2,10,12,16–18 Nevertheless, most groups have used random cutoffs ranging from less than 2 to less than 2.5 cm to predict histology.19–23 Furthermore, in a recent study in 131 patients a lesion size of 18.5 mm was defined as most accurate to predict benign vs malignant histology with 87% sensitivity and 83% specificity.14
Testicular tumours in children: Indications for testis-sparing surgery
2018, Anales de PediatriaReliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn?
2017, Clinical Genitourinary CancerCitation Excerpt :On the contrary, the European Association of Urology consensus-based guidelines consider TSS as an alternative for “synchronous bilateral tumors, metachronous contralateral tumors, or in solitary testis and tumor volume of < 30% of testicular volume together with normal preoperative testosterone levels.”25,26 Despite the optimistic data shown from the mentioned retrospective studies, expansion of indications for TSS from treatment of benign and nontumoral masses to malignant tumors is not justified because of the lack of supportive, prospective randomized trial data, as other authors have already suggested.20,27,28 In published studies (Table 7), nontumor and benign lesions generally have been considered together.
The role of testis-sparing surgery in children and adolescents with testicular tumors
2016, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :For adolescent males who are more likely to harbor malignant germ cell tumors, radical orchiectomy remains the standard of care. Organ-sparing surgery in select cases, such as for small testicular masses, bilateral tumors, or tumors occurring in a solitary testis, has been reported with greater frequency in the adult literature, though it is yet unclear whether this approach should be extrapolated to teenage boys [10–12]. Testis-sparing surgery (TSS) for prepubertal testis tumor was initially described in the early 1980s, for the management of primary testicular teratoma, an invariably benign tumor in the prepubertal patient [13].
Organ-Sparing Surgery for Testicular Germ Cell Tumors: A Current Perspective
2023, Medicina (Lithuania)Surgical management of prepubertal testicular tumors: A 30-year study in our institution
2023, International Journal of Urology