Mohamed Ahmed Osama, Murtagh Kevin, Kockelbergh Roger, ElMalik Khalid
Department of Paediatric Surgery, Leicester Royal Infirmary, LE1 5WW, Leicester, LE1 6RT UK.
Department of Urology, Leicester General Hospital, Leicester, UK.
Indian J Surg Oncol. 2020 Sep;11(3):513-517. doi: 10.1007/s13193-020-01169-5. Epub 2020 Jul 12.
Paediatric surgeons are expected to counsel patients about the potential risk of cancer post-orchidopexy and the need to self-examine in adulthood. The study objectives were to examine if such advice is being given and identify the stage of cancer at presentation in adult patients with history of orchidopexy. This was a 5-year observational, retrospective collaborative study between a tertiary paediatric surgical unit and its regional adult testicular cancer service, examining the nature of counselling given by paediatric surgeons to orchidopexy patients and their carers and estimating the local incidence of testicular cancer in adults with previous orchidopexy during the same period. Orchidopexy was performed in 228 patients with a mean follow-up of 11.9 months. Twenty-two patients had documented advice to self-examine from puberty onwards. The advice was not influenced whether the surgery was staged or single ( = 0.39). During the 5 years, 133 adults were diagnosed with testicular cancer, 6 (4.5%) were cases of previous cryptorchidism, seminoma ( = 5) and non-seminoma germ cell tumour ( = 1). In our study, the incidence of cryptorchidism in testicular cancer was 4.5%, with all cancer patients presenting with early disease despite documented advice to self-examine being low (9.7%).
小儿外科医生应就睾丸固定术后患癌的潜在风险以及成年后自我检查的必要性向患者提供咨询。本研究的目的是检查是否提供了此类建议，并确定有睾丸固定术病史的成年患者就诊时的癌症阶段。这是一项为期5年的观察性回顾性合作研究，由一家三级小儿外科单位及其地区成人睾丸癌服务机构共同开展，研究小儿外科医生向睾丸固定术患者及其护理人员提供咨询的性质，并估计同期有既往睾丸固定术的成年人中睾丸癌的局部发病率。228例患者接受了睾丸固定术，平均随访11.9个月。22例患者有从青春期开始自我检查的书面建议。该建议不受手术是分期进行还是单次进行的影响（P = 0.39）。在这5年中，133名成年人被诊断为睾丸癌，其中6例（4.5%）既往有隐睾症病史，包括精原细胞瘤（n = 5）和非精原细胞瘤生殖细胞肿瘤（n = 1）。在我们的研究中，睾丸癌中隐睾症的发病率为4.5%，尽管有自我检查书面建议的患者比例较低（9.7%），但所有癌症患者均为早期疾病。
