ESOU18: Organ Sparing Surgery in Testis Cancer

Amsterdam, The Netherlands (UroToday.com) Dr. Pfister gave an overview on the outcomes of organ sparing surgery for testicular cancer. Although organ sparing surgery (OSS) for testicular cancer is not indicated in the presence of a normal contralateral testis, it can be attempted in special cases with all the necessary precautions. In synchronous bilateral testicular tumors, metachronous contralateral tumors, or in a solitary testicular tumor with normal pre-operative testosterone levels, OSS can be performed, if the tumor volume is less than 30% (Figure 1). In these cases, the procedure can be undertaken without ischemia.

There have been several series describing outcomes of patients undergoing OSS (Figure 2). The largest one by Heindenreich et al. assessing the outcome of 73 patients.¹ The median follow in this study was 91 months, with 72/73 (98.6%) patients showing no evidence of disease during the follow-up period. 85% of the patients had physiologic testosterone levels and 15% had secondary hypogonadism. Half of the patients had succeeded in becoming biologic parents.

Figure 1: Organ sparing surgery for testicular cancer:
OrganSparing1

Figure 2: Studies describing oncological outcomes of patients undergoing organ sparing surgery for testicular cancer
OrganSparing2

Speaker: David Pfister, MD, Professor, Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University Hospital Cologne, Cologne, Germany

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at The 15th Meeting of the EAU Section of Oncological Urology ESOU18 - January 26-28, 2018 - Amsterdam, The Netherlands

References:

1. Heidenreich A, Weissbach L, Holtl W, et al. Organ sparing surgery for malignant germ cell tumor of the testis. The Journal of urology 2001; 166(6): 2161-5.

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