Kooij Cezanne D, Hulsker Caroline C C, Kranendonk Mariëtte E G, Zsiros József, Littooij Annemieke S, Looijenga Leendert H J, Klijn Aart J, Mavinkurve-Groothuis Annelies M C
Princess Máxima Center for Pediatric Oncology, 3584 Utrecht, The Netherlands.
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 Utrecht, The Netherlands.
Cancers (Basel). 2020 Oct 6;12(10):2867. doi: 10.3390/cancers12102867.
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.
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.
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%).
TSS is a safe treatment option for prepubertal patients less than 12 years of age with benign GCTs and low grade SCSTs.
本综述的目的是评估保留睾丸手术（TSS）的治疗效果，并探讨在何种情况下TSS可被视为小儿睾丸肿瘤患者的一种安全治疗选择。
在Cochrane、Pubmed和Embase数据库中进行检索，以查找专注于TSS治疗小儿睾丸肿瘤的研究，排除综述和单例报告。
分析纳入了20项描述777例睾丸肿瘤患者手术治疗情况的研究。大多数患有良性生殖细胞肿瘤（GCT）（平均年龄：3.7岁）和性索间质肿瘤（SCST）（平均年龄：6.6岁）的小儿患者接受了TSS治疗，分别为61.9%和61.2%。未发生睾丸萎缩病例。4例良性GCT复发，即3例畸胎瘤和1例表皮样囊肿。SCST患者未报告复发病例。在243例恶性GCT（平均年龄：4.2岁）中，只有1例患者接受了TSS（0.4%）。
TSS是12岁以下患有良性GCT和低级别SCST的青春期前患者的一种安全治疗选择。
