Organ Sparing Surgery in Testicular Cancer

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Lily Whitehurst, MBBCH, MRCS
Andrew Chetwood, MBCHB, FRCS

ABSTRACT


Testicular cancer is the most common cancer amongst young adult men. The gold standard of treatment for a testicular tumor is a radical orchidectomy, where the testis and spermatic cord are removed, however up to 50% of testicular pathology is benign and these patients are being overtreated. Organ-sparing surgery can be an alternative for patients with small, indeterminate testicular lesions and normal tumor markers. It can also be considered as an option for patients with tumors in a solitary testis, or where bilateral tumors are present. Combined with frozen section examination, tumors can safely be removed, and any residual disease identified intraoperatively. Organ-sparing surgery has safe oncological outcomes, with low recurrence rates on follow up data. It also provides a beneficial effect on the fertility and the hormonal profile of these patients. As these patients have a >95% survival rate, providing a high quality of life should be prioritized.

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Section
Chapter 10