Orchidectomy for Suspected Testicular Cancer: Can we predict benign pathology?
A real-life experience from a tertiary centre
BAUS ePoster online library. Yassin M. 06/21/21; 319080; p4-2
Disclosure(s): Nothing to disclose
A real-life experience from a tertiary centre
Mr. Musaab Yassin
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Abstract
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Introduction
Incidence of testicular cancer is increasing. Radical inguinal orchidectomy is the gold standard of care when there is suspicion of malignancy. The loss of testicle might result in long-term sequelae like reduced fertility and body dysmorphia. This study evaluates the rate of benign pathology in radical orchidectomy and identifies any predictive factors.
Patients and Methods
We conducted a retrospective single centre review of 113 consecutive patients who underwent radical inguinal orchidectomy for malignancy suspicion from April 2014 – June 2019. All our patients underwent a multidisciplinary team review before their operation. Pre-operative biochemical and radiological data items in addition to histology outcomes, were recorded. Univariable analysis (complete case and after multiple imputation) was performed to identify benign histology predictors.
Results
113 patients were identified. Median age was 36 years (IQR: 30-46). 23% (26/113) returned benign histology. In patients with malignancy, 5.6% had positive spermatic cord margins (Table 1). Univariable analysis demonstrated increasing age and lack of vascularity on ultrasound to be significant predictors of benign histology (Table 2). No patients with benign histology had AFP or BHCG (hence ORs could not be calculated).
Conclusion
23% of men undergoing radical orchidectomy for malignancy suspicion did not have cancer. Careful assessment (with particular emphasis on age and vascularity) may reduce unnecessary orchidectomy.
Incidence of testicular cancer is increasing. Radical inguinal orchidectomy is the gold standard of care when there is suspicion of malignancy. The loss of testicle might result in long-term sequelae like reduced fertility and body dysmorphia. This study evaluates the rate of benign pathology in radical orchidectomy and identifies any predictive factors.
Patients and Methods
We conducted a retrospective single centre review of 113 consecutive patients who underwent radical inguinal orchidectomy for malignancy suspicion from April 2014 – June 2019. All our patients underwent a multidisciplinary team review before their operation. Pre-operative biochemical and radiological data items in addition to histology outcomes, were recorded. Univariable analysis (complete case and after multiple imputation) was performed to identify benign histology predictors.
Results
113 patients were identified. Median age was 36 years (IQR: 30-46). 23% (26/113) returned benign histology. In patients with malignancy, 5.6% had positive spermatic cord margins (Table 1). Univariable analysis demonstrated increasing age and lack of vascularity on ultrasound to be significant predictors of benign histology (Table 2). No patients with benign histology had AFP or BHCG (hence ORs could not be calculated).
Conclusion
23% of men undergoing radical orchidectomy for malignancy suspicion did not have cancer. Careful assessment (with particular emphasis on age and vascularity) may reduce unnecessary orchidectomy.
Introduction
Incidence of testicular cancer is increasing. Radical inguinal orchidectomy is the gold standard of care when there is suspicion of malignancy. The loss of testicle might result in long-term sequelae like reduced fertility and body dysmorphia. This study evaluates the rate of benign pathology in radical orchidectomy and identifies any predictive factors.
Patients and Methods
We conducted a retrospective single centre review of 113 consecutive patients who underwent radical inguinal orchidectomy for malignancy suspicion from April 2014 – June 2019. All our patients underwent a multidisciplinary team review before their operation. Pre-operative biochemical and radiological data items in addition to histology outcomes, were recorded. Univariable analysis (complete case and after multiple imputation) was performed to identify benign histology predictors.
Results
113 patients were identified. Median age was 36 years (IQR: 30-46). 23% (26/113) returned benign histology. In patients with malignancy, 5.6% had positive spermatic cord margins (Table 1). Univariable analysis demonstrated increasing age and lack of vascularity on ultrasound to be significant predictors of benign histology (Table 2). No patients with benign histology had AFP or BHCG (hence ORs could not be calculated).
Conclusion
23% of men undergoing radical orchidectomy for malignancy suspicion did not have cancer. Careful assessment (with particular emphasis on age and vascularity) may reduce unnecessary orchidectomy.
Incidence of testicular cancer is increasing. Radical inguinal orchidectomy is the gold standard of care when there is suspicion of malignancy. The loss of testicle might result in long-term sequelae like reduced fertility and body dysmorphia. This study evaluates the rate of benign pathology in radical orchidectomy and identifies any predictive factors.
Patients and Methods
We conducted a retrospective single centre review of 113 consecutive patients who underwent radical inguinal orchidectomy for malignancy suspicion from April 2014 – June 2019. All our patients underwent a multidisciplinary team review before their operation. Pre-operative biochemical and radiological data items in addition to histology outcomes, were recorded. Univariable analysis (complete case and after multiple imputation) was performed to identify benign histology predictors.
Results
113 patients were identified. Median age was 36 years (IQR: 30-46). 23% (26/113) returned benign histology. In patients with malignancy, 5.6% had positive spermatic cord margins (Table 1). Univariable analysis demonstrated increasing age and lack of vascularity on ultrasound to be significant predictors of benign histology (Table 2). No patients with benign histology had AFP or BHCG (hence ORs could not be calculated).
Conclusion
23% of men undergoing radical orchidectomy for malignancy suspicion did not have cancer. Careful assessment (with particular emphasis on age and vascularity) may reduce unnecessary orchidectomy.
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