Related Experiment Video
Updated: Nov 8, 2025
Microsurgical Obstruction of Testes Fusion in Spodoptera litura
Published on: July 16, 2021
Testis-sparing surgery in children with testicular tumors: A systematic review and meta-analysis
Xuefeng Miao1, Yonglin Li1, Tingting Zhou2
1Yi Wu Maternity and Children Hospital, Jinhua City, China.
Abstract:
Testis-sparing surgery (TSS) has been increasingly used for treating a variety of testicular tumors (TTs) in children. However, the indications and feasibility associated with TSS remain uncertain. This study aimed to present the clinical outcomes of TSS in children with TTs. The PubMed, Cochrane Library, and Embase databases were reviewed for relevant articles on the clinical outcomes of TSS in children. Recurrence rate, benign rate, rate of TSS and its 95% confidence interval (CI) were calculated. A total of nine relevant studies with 320 patients were included in this study. The recurrence rate was 5.8% (95% CI: 2.3%-14.1%), benign rate was 70.9% (95% CI: 56.3%-82.1%), the rate of TSS (RTSS) was 36.2% (95% CI: 26.1%-47.8%), RTSS in benign tumor was 48.4% (95% CI: 34.3%-62.9%) and rate of elevated AFP was 29.3% (95% CI: 19.7%-41.3%) in children with TTs. Regarding the distribution of TTs, 159 (49.6%) were teratomas, 74 (23.1%) were yolk sac tumors, 36 (11.3%) were epidermoid cysts, 3 (0.9%) were rhabdomyosarcomas, 7 (2.2%) were leydig cell tumor, 6 (1.8%) were sex-cord stromal tumor, 8(2.5%) were mixed malignant germ cell tumors, 3(0.9%) were hemangioma, and 4(1.3%) were adrenal rest tumors. The findings of this meta-analysis suggested that most of the TTs in children were benign, and the most common histologic subtype was teratoma. TSS should be provided to children with benign lesions. This study confirmed that very low rates of tumor recurrence were observed in children with TTs.
Insights
Testis-sparing surgery (TSS) is a safe and effective treatment for pediatric testicular tumors (TTs), with most tumors being benign. This meta-analysis confirms low recurrence rates, supporting TSS for children with these conditions.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Clinical Outcomes Research
Background:
- Testis-sparing surgery (TSS) is increasingly utilized for pediatric testicular tumors (TTs).
- Uncertainty exists regarding the precise indications and feasibility of TSS in children.
- A comprehensive understanding of clinical outcomes is crucial for guiding treatment decisions.
Purpose of the Study:
- To evaluate the clinical outcomes of testis-sparing surgery (TSS) in pediatric patients with testicular tumors (TTs).
- To determine recurrence rates, benign tumor prevalence, and the rate of repeat TSS (RTSS).
- To analyze the distribution of different types of testicular tumors in children.
Main Methods:
- A systematic review and meta-analysis of relevant studies was conducted.
- Databases searched included PubMed, Cochrane Library, and Embase for articles on pediatric TSS outcomes.
- Recurrence rates, benign rates, RTSS, and elevated alpha-fetoprotein (AFP) rates were calculated with 95% confidence intervals (CIs).
Main Results:
- Nine studies involving 320 patients were included.
- The overall recurrence rate was 5.8% (95% CI: 2.3%-14.1%).
- The benign rate was 70.9% (95% CI: 56.3%-82.1%), with teratoma being the most common type (49.6%).
- The rate of repeat TSS (RTSS) was 36.2% (95% CI: 26.1%-47.8%), higher in benign tumors (48.4%).
- Elevated AFP was observed in 29.3% (95% CI: 19.7%-41.3%) of cases.
Conclusions:
- The majority of testicular tumors in children are benign, with teratoma being the most frequent histologic subtype.
- Testis-sparing surgery is a viable option for children with benign testicular lesions.
- This meta-analysis demonstrates very low tumor recurrence rates following TSS in pediatric patients, supporting its use.
