Department of Urology, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain.
ROC Clinic Direction, Martínez Campos 17, 28010 Madrid, Spain.
Medicina (Kaunas). 2023 Jul 5;59(7):1249. doi: 10.3390/medicina59071249.
We aimed to evaluate the oncological and functional outcomes of organ-sparing surgery for testicular germ cell tumors, a procedure that seeks to strike a balance between effective cancer control and organ preservation, in the treatment of testicular tumors. We aimed to discuss the surgical technique and complications, and determine the appropriate candidate selection for this approach. A comprehensive literature search was conducted to identify relevant studies on organ-sparing surgery for testicular tumors. Various databases, including PubMed, Embase, and Cochrane Library, were used. Studies reporting on surgical techniques, complications, and oncologic and functional outcomes were included for analysis. Current evidence suggests that organ-sparing surgery for testicular germ cell tumors can be considered a safe and efficacious alternative to radical orchiectomy. The procedure is associated with adequate oncological control, as indicated by low recurrence rates and low complication rates. Endocrine testicular function can be preserved in around 80-90% of patients and paternity can be achieved in approximately half of the patients. Candidate selection for this surgery is typically based on the following criteria: pre-surgery normal levels of testosterone and luteinizing hormone, synchronous or metachronous bilateral tumors, tumor in a solitary testis, and tumor size less than 50% of the testis. Organ-sparing surgery for testicular germ cell tumors offers a promising approach that balances oncological control and preservation of testicular function. Further research, including large-scale prospective studies and long-term follow-ups, is warranted to validate the effectiveness and durability of organ-sparing surgery and to identify optimal patient selection criteria.
我们旨在评估保留器官手术在睾丸生殖细胞肿瘤治疗中的肿瘤学和功能结果，这种手术旨在有效控制癌症和保留器官之间取得平衡。我们旨在讨论手术技术和并发症，并确定这种方法的合适候选者选择。 进行了全面的文献检索，以确定有关睾丸肿瘤保留器官手术的相关研究。使用了各种数据库，包括 PubMed、Embase 和 Cochrane Library。纳入了报告手术技术、并发症以及肿瘤学和功能结果的研究进行分析。 目前的证据表明，对于睾丸生殖细胞肿瘤，保留器官手术可以被视为根治性睾丸切除术的一种安全有效的替代方法。该手术与足够的肿瘤学控制相关，复发率和并发症率较低。大约 80-90%的患者可以保留内分泌睾丸功能，大约一半的患者可以实现生育。该手术的候选者选择通常基于以下标准：术前睾酮和黄体生成素水平正常、同步或异时性双侧肿瘤、孤立睾丸肿瘤和肿瘤大小小于睾丸的 50%。 睾丸生殖细胞肿瘤的保留器官手术提供了一种有前途的方法，在肿瘤学控制和保留睾丸功能之间取得平衡。需要进一步的研究，包括大规模的前瞻性研究和长期随访，以验证保留器官手术的有效性和耐久性，并确定最佳的患者选择标准。
