Long-term Results of Patients with Testicular Tumors Undergoing Testis Sparing Surgery: A Single-center Experience/Testis Koruyucu Cerrahi Uygulanan Testis Tumorlu Hastalarin Uzun Donem Sonuclari: Tek-merkez Deneyimi

• Published in: Journal of urological surgery Vol. 6; no. 2; p. 93
• Main Authors: Kizilay, Fuat, Kalemci, Serdar, Simsir, Adnan, Andabil, Hamed Jafarzadeh, Sarsik, Banu, Sen, Sait, Cal, Cag, Cureklibatir, Ibrahim
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2019
• Subjects: Analysis; Histochemistry; Postoperative complications; Retirement benefits; Tumor markers; Ultrasound imaging
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.galenos.2018.2345

Objective: To determine the clinicopathologic and oncologic outcomes of testis-sparing surgery (TSS) by evaluating the data of patients who underwent TSS in our clinic. Materials and Methods: A total of 24 patients (27 testes) who underwent TSS in the last 16 years were included in the study. All the patients presented with a solitary testicular mass or bilateral testicular mass. Preoperative tumor markers were investigated and scrotal ultrasonography was performed in all patients. Surgery was performed with inguinal incision, temporary clamping of the spermatic cord and frozen section analysis (FSA) of the lesion. Intraoperative data, histopathological findings, and recurrence status were analyzed. Results: The mean follow-up period was 96 months. The mean age of the patients was 29.7 (18-66) years. The mean tumor diameter was 11 mm (2-18). TSS was performed bilaterally in 3 patients and unilaterally in 24 patients. According to the final pathology report, 18 (66.7%) of the masses were benign and 9 (33.3%) were malignant. Intraoperative FSA was performed in 17 patients (70.8%). FSA revealed malign histopathology in 6 patients and complementary orchiectomy was performed in 4 of these patients. 14 patients (51.9%) were detected to have positive surgical margins. Two of these patients had seminoma diagnosis and radical orchiectomy was performed due to recurrence on follow-up in these patients. TSS was performed in all patients without any significant intra-postoperative complications. Conclusion: TSS may have significant functional and cosmetic benefits without worsening oncologic results in appropriately selected patients. Keywords: Testicular tumor, Testis-sparing surgery, Orchiectomy, Frozen section, Organ-sparing treatment, Positive surgical margin Amac: Klinigimizde testis-koruyucu cerrahi (TKC) uygulanan hastalarin verilerini degerlendirerek bu yontemin klinikopatolojik ve onkolojik sonuclarini belirlemek. Gerec ve Yontem: Son 16 yilda TKC uygulanan toplam 24 hasta (27 testis) calismaya alindi. Tum hastalarin soliter testisinde kitlesi veya bilateral testikuler kitlesi mevcuttu. Tum hastalarda preoperatif tumor belirtecleri bakildi ve skrotal ultrasonografi yapildi. Cerrahi islem, inguinal insizyon, spermatik kordun gecici olarak klemplenmesi ve lezyonun frozen kesit analizi (FKA) ile yapildi. Intraoperatif veriler, histopatolojik bulgular ve nuks durumu analiz edildi. Bulgular: Hastalarin ortalama takip suresi 96 aydi. Hastalarin yas ortalamasi 29,7 (18-66) idi. Ortalama tumor capi 11 mm (2-18) idi. TKC, 3 hastada bilateral olarak ve 24 hastada tek tarafli olarak uygulandi. Son patoloji raporuna gore kitlelerin 18'i (%66,7) benign, 9'u (%33,3) malign histopatolojiye sahipti. Intraoperatif FKA, 17 hastada (%70,8) gerceklestirildi. FKA uygulanan alti hastada malign histopatoloji mevcuttu ve bu hastalarin 4'unde tamamlayici orsiektomi yapildi. Cerrahi sinir, 14 hastada (%51,9) pozitifti. Bu hastalarin ikisinde seminom teshisi mevcuttu ve bu hastalarda takipte nuks nedeniyle radikal orsiektomi yapildi. TKC, tum hastalarda anlamli bir intra-, postoperatif komplikasyon olmaksizin gerceklestirildi. Sonuc: TKC, uygun hastalarda onkolojik sonuclari kotulestirmeden onemli fonksiyonel ve kozmetik faydalar saglayabilir. Anahtar Kelimeler: Testis tumoru, Testis koruyucu cerrahi, Orsiektomi, Frozen kesit, Organ koruyucu tedavi, Pozitif cerrahi sinir