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Partial orchiectomy: The Princess Margaret cancer centre experience
G J Nason1, I Aditya1, R Leao1
1Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada.
Urologic Oncology
|April 15, 2020
Summary
Partial orchiectomy (PO) is a safe organ-sparing option for small testis lesions, potentially avoiding radical orchiectomy (RO). This approach is feasible even for some malignant cases, with low complication rates.
Area of Science:
- Urology
- Surgical Oncology
- Oncology
Background:
- Radical orchiectomy (RO) is the standard treatment for testicular cancer.
- Organ-sparing surgery, such as partial orchiectomy (PO), is considered for specific cases like solitary or bilateral functioning testes, and for small lesions.
- PO is explored as an alternative to RO for small testicular lesions.
Purpose of the Study:
- To report the experience and outcomes of partial orchiectomy (PO) for testis lesions.
- To evaluate the feasibility and safety of organ-sparing surgery for testicular lesions.
- To determine if PO can be an alternative to RO in selected patients.
Main Methods:
- A retrospective review of a prospectively maintained database was conducted.
- Data from 77 patients who underwent PO between 1983 and 2018 were analyzed.
- Patient demographics, lesion characteristics, reasons for PO, follow-up, and outcomes were assessed.
Main Results:
- 77 patients underwent PO, with a median follow-up of 43.5 months.
- Benign histology was found in 32.5% of cases.
- Positive surgical margins occurred in 7.8% with no recurrence; 20.8% required salvage RO, with 75% of those specimens showing malignancy. No severe complications were reported.
Conclusions:
- Organ-sparing surgery, specifically PO, is a safe and feasible approach for small testis lesions.
- PO can help avoid radical orchiectomy (RO) in carefully selected patients, including those with benign disease and some with malignant histology.
- The study supports PO as a viable organ-sparing option in testicular oncology.
