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- Publisher Website: 10.1111/bju.15874
- Scopus: eid_2-s2.0-85138321741
- PMID: 35986901
- WOS: WOS:000855734400001
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Article: Management of small testicular masses: outcomes from a single-centre specialist multidisciplinary team
Title | Management of small testicular masses: outcomes from a single-centre specialist multidisciplinary team |
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Authors | |
Keywords | #TesticularCancer #tscsm #uroonc frozen section examination radical orchidectomy small testicular masses surveillance testicular biopsy testicular cancer |
Issue Date | 2023 |
Citation | BJU International, 2023, v. 131, n. 1, p. 73-81 How to Cite? |
Abstract | Objectives: To report the management outcomes of men with ≤20-mm small testicular masses (STMs) and to identify clinical and histopathological factors associated with malignancy. Patients and methods: A retrospective analysis of men managed at a single centre between January 2010 and December 2020 with a STM ≤20 mm in size was performed. Results: Overall, 307 men with a median (interquartile range [IQR]) age of 36 (30–44) years were included. Of these, 161 (52.4%), 82 (26.7%), 62 (20.2%) and 2 men (0.7%) underwent surveillance with interval ultrasonography (USS), primary excisional testicular biopsy (TBx) or primary radical orchidectomy (RO), or were discharged, respectively. The median (IQR) surveillance duration was 6 (3–18) months. The majority of men who underwent surveillance had lesions <5 mm (59.0%) and no lesion vascularity (67.1%) on USS. Thirty-three (20.5%) men undergoing surveillance had a TBx based on changes on interval USS or patient choice; seven (21.2%) were found to be malignant. The overall rate of malignancy in the surveillance cohort was 4.3%. The majority of men who underwent primary RO had lesions ≥10 mm (85.5%) and the presence of vascularity (61.7%) on USS. Nineteen men (23.2%) who underwent primary TBx (median lesion size 6 mm) had a malignancy confirmed on biopsy and underwent RO. A total of 88 men (28.7%) underwent RO, and malignancy was confirmed in 73 (83.0%) of them. The overall malignancy rate in the whole STM cohort was 23.8%. Malignant RO specimens had significantly larger lesion sizes (median [IQR] 11 [8–15] mm, vs benign: median [IQR] 8 [5–10] mm; P = 0.04). Conclusions: Small testicular masses can be stratified and managed based on lesion size and USS features. The overall malignancy rate in men with an STM was 23.8% (4.3% in the surveillance group). Surveillance should be considered in lesions <10 mm in size, with a TBx or frozen-section examination offered prior to RO in order to preserve testicular function. |
Persistent Identifier | http://hdl.handle.net/10722/328838 |
ISSN | 2023 Impact Factor: 3.7 2023 SCImago Journal Rankings: 1.337 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wardak, Shafi | - |
dc.contributor.author | Pang, Karl H. | - |
dc.contributor.author | Castiglione, Fabio | - |
dc.contributor.author | Lindsay, Jamie | - |
dc.contributor.author | Walkden, Miles | - |
dc.contributor.author | Ho, Dan Heffernan | - |
dc.contributor.author | Kirkham, Alex | - |
dc.contributor.author | Hadway, Paul | - |
dc.contributor.author | Nigam, Raj | - |
dc.contributor.author | Rees, Rowland | - |
dc.contributor.author | Alifrangis, Constantine | - |
dc.contributor.author | Alnajjar, Hussain M. | - |
dc.contributor.author | Muneer, Asif | - |
dc.date.accessioned | 2023-07-22T06:24:30Z | - |
dc.date.available | 2023-07-22T06:24:30Z | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | BJU International, 2023, v. 131, n. 1, p. 73-81 | - |
dc.identifier.issn | 1464-4096 | - |
dc.identifier.uri | http://hdl.handle.net/10722/328838 | - |
dc.description.abstract | Objectives: To report the management outcomes of men with ≤20-mm small testicular masses (STMs) and to identify clinical and histopathological factors associated with malignancy. Patients and methods: A retrospective analysis of men managed at a single centre between January 2010 and December 2020 with a STM ≤20 mm in size was performed. Results: Overall, 307 men with a median (interquartile range [IQR]) age of 36 (30–44) years were included. Of these, 161 (52.4%), 82 (26.7%), 62 (20.2%) and 2 men (0.7%) underwent surveillance with interval ultrasonography (USS), primary excisional testicular biopsy (TBx) or primary radical orchidectomy (RO), or were discharged, respectively. The median (IQR) surveillance duration was 6 (3–18) months. The majority of men who underwent surveillance had lesions <5 mm (59.0%) and no lesion vascularity (67.1%) on USS. Thirty-three (20.5%) men undergoing surveillance had a TBx based on changes on interval USS or patient choice; seven (21.2%) were found to be malignant. The overall rate of malignancy in the surveillance cohort was 4.3%. The majority of men who underwent primary RO had lesions ≥10 mm (85.5%) and the presence of vascularity (61.7%) on USS. Nineteen men (23.2%) who underwent primary TBx (median lesion size 6 mm) had a malignancy confirmed on biopsy and underwent RO. A total of 88 men (28.7%) underwent RO, and malignancy was confirmed in 73 (83.0%) of them. The overall malignancy rate in the whole STM cohort was 23.8%. Malignant RO specimens had significantly larger lesion sizes (median [IQR] 11 [8–15] mm, vs benign: median [IQR] 8 [5–10] mm; P = 0.04). Conclusions: Small testicular masses can be stratified and managed based on lesion size and USS features. The overall malignancy rate in men with an STM was 23.8% (4.3% in the surveillance group). Surveillance should be considered in lesions <10 mm in size, with a TBx or frozen-section examination offered prior to RO in order to preserve testicular function. | - |
dc.language | eng | - |
dc.relation.ispartof | BJU International | - |
dc.subject | #TesticularCancer | - |
dc.subject | #tscsm | - |
dc.subject | #uroonc | - |
dc.subject | frozen section examination | - |
dc.subject | radical orchidectomy | - |
dc.subject | small testicular masses | - |
dc.subject | surveillance | - |
dc.subject | testicular biopsy | - |
dc.subject | testicular cancer | - |
dc.title | Management of small testicular masses: outcomes from a single-centre specialist multidisciplinary team | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1111/bju.15874 | - |
dc.identifier.pmid | 35986901 | - |
dc.identifier.scopus | eid_2-s2.0-85138321741 | - |
dc.identifier.volume | 131 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | 73 | - |
dc.identifier.epage | 81 | - |
dc.identifier.eissn | 1464-410X | - |
dc.identifier.isi | WOS:000855734400001 | - |