Long-term Results of Patients with Testicular Tumors Undergoing Testis Sparing Surgery: A Single-center Experience

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.
Amaç: Kliniğimizde testis-koruyucu cerrahi (TKC) uygulanan hastaların verilerini değerlendirerek bu yöntemin klinikopatolojik ve onkolojik sonuçlarını belirlemek. Gereç ve Yöntem: Son 16 yılda TKC uygulanan toplam 24 hasta (27 testis) çalışmaya alındı. Tüm hastaların soliter testisinde kitlesi veya bilateral testiküler kitlesi mevcuttu. Tüm hastalarda preoperatif tümör belirteçleri bakıldı ve skrotal ultrasonografi yapıldı. Cerrahi işlem, inguinal insizyon, spermatik kordun geçici olarak klemplenmesi ve lezyonun frozen kesit analizi (FKA) ile yapıldı. İntraoperatif veriler, histopatolojik bulgular ve nüks durumu analiz edildi. Bulgular: Hastaların ortalama takip süresi 96 aydı. Hastaların yaş ortalaması 29,7 (18-66) idi. Ortalama tümör çapı 11 mm (2-18) idi. TKC, 3 hastada bilateral olarak ve 24 hastada tek taraflı olarak uygulandı. Son patoloji raporuna göre kitlelerin 18’i (%66,7) benign, 9’u (%33,3) malign histopatolojiye sahipti. İntraoperatif FKA, 17 hastada (%70,8) gerçekleştirildi. FKA uygulanan altı hastada malign histopatoloji mevcuttu ve bu hastaların 4’ünde tamamlayıcı orşiektomi yapıldı. Cerrahi sınır, 14 hastada (%51,9) pozitifti. Bu hastaların ikisinde seminom teşhisi mevcuttu ve bu hastalarda takipte nüks nedeniyle radikal orşiektomi yapıldı. TKC, tüm hastalarda anlamlı bir intra-, postoperatif komplikasyon olmaksızın gerçekleştirildi. Sonuç: TKC, uygun hastalarda onkolojik sonuçları kötüleştirmeden önemli fonksiyonel ve kozmetik faydalar sağlayabilir.