Testis-sparing surgery (TSS) is a safe treatment for patients with benign testicular tumors. Presently, assessments for evaluating the suitability of TSS are poorly standardized, partially because testicular anatomical elements cannot be quantitatively described.
We developed a scoring method known as SAVE testis-sparing score based on four critical and accessible anatomical features of testicular tumor. The SAVE score ranges from 0 to 8 and is divided into four risk classes (low, medium, high, and extremely high) to evaluate the feasibility of TSS, wherein low risk indicates high feasibility and vice versa. This study included 444 testicular tumor patients from eight centers. Among them, 216 patients (model group: 151 patients, validation group: 65 patients) were included in the modeling analysis, and the other 228 patients from children's centers were included in the proportion analysis. Using retrospective data, patient characteristics associated with surgical methods were identified. Furthermore, multivariate logistic regression model was built quantify the associations between these characteristics and the surgery method. The receiver operator characteristic curve was used to evaluate the classification efficiency of SAVE.
The SAVE testis-sparing score includes size (tumor size as maximal diameter), available testicular tissue volume, volume ratio of the tumor to the testis, and the exophytic/endophytic properties of the tumor. The SAVE scoring system accurately classified the suitability of TSS based on the complexity of benign testicular tumors.
The SAVE score is a reproducible and robust tool for quantitatively describing the anatomical characteristics of benign testicular tumors and guide the preoperative evaluation of TSS.
International journal of surgery (London, England). 2023 Sep 22 [Epub ahead of print]
Zhenhua Liu, Junyi Xie, Xiaofeng Gao, Yuan Lin, Mengkui Sun, Yubo Sun, Ding Peng, Haibiao Xie, Xiangdong Li, Zhiyong Li, Taonong Cai, Pengyu Chen, Zhiming Wu, Shengjie Guo, Yonghong Li, Zhilin Zhang, Zike Qin, Hui Han, Zhisong He, Jiumin Liu, Wen Fu, Shoulin Li, Dan Xia, Xiang Wang, Chunhua Deng, Zhe Xu, Fangjian Zhou, Kai Yao, Wei Yu, Yunlin Ye, Zhuowei Liu
Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China., Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing 100034, China., Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou 510623, Guangdong Province, China., Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China., Department of Urology, Shenzhen Children's Hospital, Shenzhen 518031, Guangdong Province, China., Department of Pediatric Urology, Children's Hospital of Fudan University, Shanghai 201102, China., Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China., Department of Urology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China., Department of Urology and Andrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China., Department of Pediatric Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.