Is testis sparing surgery safe in patients with incidental small testicular lesions referring to a fertility center? A retrospective analysis reporting factors correlated to malignancy and long-term oncological outcomes

Gobbo, Andrea; Negri, L; Casale, Paolo; Fasulo, Vittorio; Lughezzani, Giovanni; Saitta, Cesare; Benaglia, Renzo; Buffi, Nicolò Maria; Setti, Paolo Levi

doi:10.1016/j.urolonc.2022.08.002

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…More than 50% of all testicular tumours in the size category ≤10 mm consist of benign tumours, and we also noted a significant trend towards higher proportions of benign tumours with decreasing tumour size. Thus, small size of a testicular lesion appears to be a strong indicator of benign histology, and this result is in line with several previous reports [ 7 , 16 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. The very high proportion of benign tumours among incidentally found small testicular masses had already been noted some decades ago [ 43 ], but this knowledge became clinically relevant only with the ever-growing number of small testicular neoplasms incidentally detected by improved ultrasonography technology.…”

Section: Discussionsupporting

confidence: 92%

“…Accordingly, the logistic regression curve revealed all tumours sized ≥ 39 mm to represent malignancy, while tumours ≤ 8 mm involved a 50% chance of being benign. Seven previous studies reporting results from ROC analyses are listed in Table 16 ([ 7 , 23 , 31 , 37 , 41 , 44 , 45 ]). Only one study reported on more than 100 patients [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Testicular Neoplasms: Primary Tumour Size Is Closely Interrelated with Histology, Clinical Staging, and Tumour Marker Expression Rates—A Comprehensive Statistical Analysis

Dieckmann

Isbarn

Grobelny

et al. 2022

Cancers

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The role of primary tumour size (TS) in the clinical course of testicular tumours is incompletely understood. We retrospectively evaluated 641 consecutive patients with testicular neoplasms with regard to TS, histology, clinical stage (CS), serum tumour marker (STM) expression and patient age using descriptive statistical methods. TS ≤ 10 mm was encountered in 13.6% of cases. Median TS of 10 mm, 30 mm, 35 mm, and 53 mm were found in benign tumours, seminomas, nonseminomas, and other malignant tumours, respectively. In cases with TS ≤ 10 mm, 50.6% had benign tumours. Upon receiver operating characteristics analysis, TS of > 16 mm revealed 81.5% sensitivity and 81.0% specificity for detecting malignancy. In subcentimeter germ cell tumours (GCTs), 97.7% of cases had CS1, and CS1 frequency dropped with increasing TS. Expression rates of all STMs significantly increased with TS. MicroRNA-371a-3p (M371) serum levels had higher expression rates than classical STMs, with a rate of 44.1% in subcentimeter GCTs. In all, TS is a biologically relevant factor owing to its significant associations with CS, STM expression rates and histology. Importantly, 50% of subcentimeter testicular neoplasms are of benign nature, and M371 outperforms the classical markers even in subcentimeter tumours.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Testicular Neoplasms: Primary Tumour Size Is Closely Interrelated with Histology, Clinical Staging, and Tumour Marker Expression Rates—A Comprehensive Statistical Analysis

Dieckmann

Isbarn

Grobelny

et al. 2022

Cancers

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show abstract

“…Likewise, a study from Wessex, UK, reported an arithmetical mean age of benign gonadal stromal tumors of 43 years but in view of the wide range of 18 – 79 years, no particular age predisposition was noted (Featherstone et al 2009 ). An Italian study on small testicular tumors occurring in 64 infertile males reported a median age of 40 years in patients with benign tumors compared to the significantly younger age of 36 years in malignant tumors (Gobbo et al 2022 ). Similarly, an Austrian study reported mean ages of 41.1 years and 32.5 years in benign and malignant tumors, respectively (Staudacher et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Testicular neoplasms: the interrelationships of serum levels of microRNA-371a-3p (M371) and classical tumor markers with histology, clinical staging, and age—a statistical analysis

Dieckmann

Dumlupinar

Grobelny

et al. 2023

J Cancer Res Clin Oncol

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Purpose In testicular neoplasms, the interrelationship of elevations of the novel serum tumor marker microRNA-371a-3p (M371) and traditional markers with other clinical features is still incompletely understood. The present study evaluated marker expression rates in relation to various other clinical parameters. Methods The following data were retrospectively registered from 641 consecutive patients with testicular neoplasms: histology, such as seminoma (n = 365), nonseminoma (n = 179), benign tumor (n = 79), other malignant tumor (n = 18); patients age (years); clinical stage (CS1, CS2a/b, CS2c, CS3); and preoperative elevation of beta HCG, AFP, LDH, M371 (yes/no). Descriptive statistical methods were employed with comparisons of various subgroups to disclose associations of marker expression rates with age, histology and CS, and of age with histology. Results The histologic subgroups revealed significantly different expression rates of tumor markers. M371 performed best with expression rates of 82.69% and 93.58% in seminoma and in nonseminoma, respectively. In germ cell tumors, all markers had significantly higher expression rates in metastasized stages than in localized disease. All markers except LDH have significantly higher expression rates in younger than in older patients. Nonseminoma is most prevalent in the youngest age category, seminoma predominates in patients > 40 years, other malignancies were restricted to patients > 50 years. Conclusion The study documented significant associations of serum marker expression rates with histology, age and clinical staging, with highest rates in nonseminomas, young age and advanced clinical stages. M371 showed significantly higher expression rates than other markers suggesting its superior clinical usefulness.

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Small Testicular Masses: Contemporary Diagnostic and Treatment Strategies, Future Directions, and Knowledge Gaps

Chavarriaga

Hamilton

2023

Urologic Oncology: Seminars and Original Investigations

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Is testis sparing surgery safe in patients with incidental small testicular lesions referring to a fertility center? A retrospective analysis reporting factors correlated to malignancy and long-term oncological outcomes

Cited by 4 publications

References 29 publications

Testicular Neoplasms: Primary Tumour Size Is Closely Interrelated with Histology, Clinical Staging, and Tumour Marker Expression Rates—A Comprehensive Statistical Analysis

Testicular Neoplasms: Primary Tumour Size Is Closely Interrelated with Histology, Clinical Staging, and Tumour Marker Expression Rates—A Comprehensive Statistical Analysis

Testicular neoplasms: the interrelationships of serum levels of microRNA-371a-3p (M371) and classical tumor markers with histology, clinical staging, and age—a statistical analysis

Small Testicular Masses: Contemporary Diagnostic and Treatment Strategies, Future Directions, and Knowledge Gaps

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