nach oben

02.07.2019 | Urology - Review | Ausgabe 10/2019

Organ-sparing procedures in GU cancer: part 2-organ-sparing procedures in testicular and penile tumors

Zeitschrift:: International Urology and Nephrology > Ausgabe 10/2019

Autoren:: Mohamed H. Kamel, Mahmoud I. Khalil, Ehab Eltahawy, Rodney Davis, Nabil K. Bissada

» Jetzt Zugang zum Volltext erhalten

Wichtige Hinweise

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Organ-sparing surgery (OSS) is recommended in selected patients with testicular tumors and penile cancer (PC). The functional and psychological impacts of organ excision for these genital tumors are profound. In this review, we summarize the indications, techniques and outcomes of OSS for these two tumors.

Methods

PubMed^® was searched for relevant articles up to December 2018. For Testicular sparing surgery (TSS) search, keywords used were; testicular tumors alone and in combination with “testicular sparing surgery”, “partial orchiectomy” and outcomes. For penile conserving surgery (PCS), keywords used were: penile cancer alone and in combination with “penile conserving surgery”, “partial penectomy” and outcomes. Because of the low quality of available evidence, a narrative rather that systematic review has been performed.

Results

Indications of TSS are tumors ≤ 2 cm in solitary testis or bilateral tumors and no rete testis invasion. Prerequisites include normal testosterone and luteinizing hormone levels and patient compliance with follow-up. Indications for PCS are distal penile lesions with clinical stage ≤ T1. Adequate penile stump (3 cm) is required after surgery to maintain forward urine stream. Frozen section helps to reduce the risk of recurrence. Local recurrence after PCS is not associated with reduced survival and can be managed with another PCS in selected patients. The reported oncological and functional outcomes following TSS and PCS are adequate.

Conclusions

In properly selected patient OSS in testicular and penile tumors has a comparable oncological outcome to total organ excision with added advantages of preserving organ function and psychological well-being.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Jetzt einloggen Kostenlos registrieren

★ PREMIUM-INHALT

e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt gratis testen * Jetzt kaufen

Sie können e.Med Interdisziplinär 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

e.Med Innere Medizin

Kombi-Abonnement

Mit e.Med Innere Medizin erhalten Sie Zugang zu CME-Fortbildungen des Fachgebietes Innere Medizin, den Premium-Inhalten der internistischen Fachzeitschriften, inklusive einer gedruckten internistischen Zeitschrift Ihrer Wahl.

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Jetzt testen ¹

e.Med Gynäkologie & Urologie

Kombi-Abonnement

Mit e.Med Gynäkologie & Urologie erhalten Sie Zugang zu CME-Fortbildungen der beiden Fachgebiete, den Premium-Inhalten der Fachzeitschriften, inklusive einer gedruckten gynäkologischen oder urologischen Zeitschrift Ihrer Wahl.

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Jetzt testen ²

https://www.cancer.org/cancer/testicular-cancer/detection-diagnosis-staging/survival-rates.html

Heidenreich A, Weissbach L, Holtl W, Albers P, Kliesch S, Kohrmann KU, KP DI, German Testicular Cancer Study G (2001) Organ sparing surgery for malignant germ cell tumor of the testis. J Urol 166(6):2161–2165 CrossRef

Haas GP, Shumaker BP, Cerny JC (1986) The high incidence of benign testicular tumors. J Urol 136(6):1219–1220 CrossRef

Muller T, Gozzi C, Akkad T, Pallwein L, Bartsch G, Steiner H (2006) Management of incidental impalpable intratesticular masses of < or = 5 mm in diameter. BJU Int 98(5):1001–1004. https://doi.org/10.1111/j.1464-410X.2006.06485.x CrossRefPubMed

Yossepowitch O, Baniel J (2004) Role of organ-sparing surgery in germ cell tumors of the testis. Urology 63(3):421–427. https://doi.org/10.1016/j.urology.2003.08.022 CrossRefPubMed

Heidenreich A, Engelmann UH, Vietsch HV, Derschum W (1995) Organ preserving surgery in testicular epidermoid cysts. J Urol 153(4):1147–1150 CrossRef

Bang AK, Petersen JH, Petersen PM, Andersson AM, Daugaard G, Jorgensen N (2009) Testosterone production is better preserved after 16 than 20 Gray irradiation treatment against testicular carcinoma in situ cells. Int J Radiat Oncol Biol Phys 75(3):672–676. https://doi.org/10.1016/j.ijrobp.2008.11.057 CrossRefPubMed

Huyghe E, Soulie M, Escourrou G, Mieusset R, Plante P, Thonneau P (2005) Conservative management of small testicular tumors relative to carcinoma in situ prevalence. J Urol 173(3):820–823. https://doi.org/10.1097/01.ju.0000152532.34475.4e CrossRefPubMed

Fossa SD, Chen J, Schonfeld SJ, McGlynn KA, McMaster ML, Gail MH, Travis LB (2005) Risk of contralateral testicular cancer: a population-based study of 29,515 U.S. men. J Natl Cancer Inst 97(14):1056–1066. https://doi.org/10.1093/jnci/dji185 CrossRefPubMed

10.

Giannarini G, Mogorovich A, Menchini Fabris F, Morelli G, De Maria M, Manassero F, Loggini B, Pingitore R, Cavazzana A, Selli C (2007) Long-term followup after elective testis sparing surgery for Leydig cell tumors: a single center experience. J Urol 178(3 Pt 1):872–876. https://doi.org/10.1016/j.juro.2007.05.077 (quiz 1129) CrossRefPubMed

11.

Lagabrielle S, Durand X, Droupy S, Izard V, Marcelli F, Huyghe E, Ferriere JM, Ferretti L (2018) Testicular tumours discovered during infertility workup are predominantly benign and could initially be managed by sparing surgery. J Surg Oncol 118(4):630–635. https://doi.org/10.1002/jso.25203 CrossRefPubMed

12.

Kreydin EI, Barrisford GW, Feldman AS, Preston MA (2013) Testicular cancer: what the radiologist needs to know. AJR Am J Roentgenol 200(6):1215–1225. https://doi.org/10.2214/ajr.12.10319 CrossRefPubMed

13.

Heidenreich A, Albers P, Krege S (2006) Management of bilateral testicular germ cell tumours – experience of the German testicular cancer study group (GTCSG). Eur Urol Suppl 5(2):97. https://doi.org/10.1016/S1569-9056(06)60305-9 CrossRef

14.

Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP, Nicolai N, Oldenburg J, European Association of U (2015) Guidelines on testicular cancer: 2015 update. Eur Urol 68(6):1054–1068. https://doi.org/10.1016/j.eururo.2015.07.044 CrossRefPubMed

15.

Berney DM (2008) Staging and classification of testicular tumours: pitfalls from macroscopy to diagnosis. J Clin Pathol 61(1):20–24. https://doi.org/10.1136/jcp.2006.045732 CrossRefPubMed

16.

Tokuc R, Sakr W, Pontes JE, Haas GP (1992) Accuracy of frozen section examination of testicular tumors. Urology 40(6):512–516 CrossRef

17.

Elert A, Olbert P, Hegele A, Barth P, Hofmann R, Heidenreich A (2002) Accuracy of frozen section examination of testicular tumors of uncertain origin. Eur Urol 41(3):290–293 CrossRef

18.

Shilo Y, Zisman A, Raz O, Lang E, Strauss S, Sandbank J, Segal M, Siegel YI, Leibovici D (2012) Testicular sparing surgery for small masses. Urol Oncol 30(2):188–191. https://doi.org/10.1016/j.urolonc.2009.12.021 CrossRefPubMed

19.

Bojanic N, Bumbasirevic U, Vukovic I, Bojanic G, Milojevic B, Nale D, Durutovic O, Djordjevic D, Nikic P, Vuksanovic A, Tulic C, Micic S (2015) Testis sparing surgery in the treatment of bilateral testicular germ cell tumors and solitary testicle tumors: a single institution experience. J Surg Oncol 111(2):226–230. https://doi.org/10.1002/jso.23777 CrossRefPubMed

20.

Passarella M, Usta MF, Bivalacqua TJ, Hellstrom WJ, Davis R (2003) Testicular-sparing surgery: a reasonable option in selected patients with testicular lesions. BJU Int 91(4):337–340 CrossRef

21.

Leroy X, Rigot JM, Aubert S, Ballereau C, Gosselin B (2003) Value of frozen section examination for the management of nonpalpable incidental testicular tumors. Eur Urol 44(4):458–460 CrossRef

22.

Carmignani L, Gadda F, Gazzano G, Nerva F, Mancini M, Ferruti M, Bulfamante G, Bosari S, Coggi G, Rocco F, Colpi GM (2003) High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol 170(5):1783–1786. https://doi.org/10.1097/01.ju.0000092066.01699.90 CrossRefPubMed

23.

Müller T, Gozzi C, Akkad T, Pallwein L, Bartsch G, Steiner H (2006) Management of incidental impalpable intratesticular masses of ≤ 5 mm in diameter. BJU International 98(5):1001–1004. https://doi.org/10.1111/j.1464-410X.2006.06485.x CrossRefPubMed

24.

Galosi AB, Fulvi P, Fabiani A, Servi L, Filosa A, Leone L, Marronaro A, Caraceni E, Montironi R (2016) Testicular sparing surgery in small testis masses: a multi institutional experience. Arch Ital Urol Androl 88(4):320–324. https://doi.org/10.4081/aiua.2016.4.320 CrossRefPubMed

25.

Maddineni SB, Lau MM, Sangar VK (2009) Identifying the needs of penile cancer sufferers: a systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer. BMC Urol 9:8. https://doi.org/10.1186/1471-2490-9-8 CrossRefPubMedPubMedCentral

26.

Hernandez BY, Barnholtz-Sloan J, German RR, Giuliano A, Goodman MT, King JB, Negoita S, Villalon-Gomez JM (2008) Burden of invasive squamous cell carcinoma of the penis in the United States, 1998–2003. Cancer 113(10 Suppl):2883–2891. https://doi.org/10.1002/cncr.23743 CrossRefPubMedPubMedCentral

27.

Kamel MH, Bissada N, Warford R, Farias J, Davis R (2017) Organ sparing surgery for penile cancer: a systematic review. J Urol 198(4):770–779. https://doi.org/10.1016/j.juro.2017.01.088 CrossRefPubMed

28.

https://www.nccn.org/professionals/physician_gls/pdf/penile.pdf

29.

Bissada NK, Yakout HH, Fahmy WE, Gayed MS, Touijer AK, Greene GF, Hanash KA (2003) Multi-institutional long-term experience with conservative surgery for invasive penile carcinoma. J Urol 169(2):500–502. https://doi.org/10.1097/01.ju.0000043808.58188.52 CrossRefPubMed

30.

Minhas S, Kayes O, Hegarty P, Kumar P, Freeman A, Ralph D (2005) What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJU Int 96(7):1040–1043. https://doi.org/10.1111/j.1464-410X.2005.05769.x CrossRefPubMed

31.

Lont AP, Gallee MP, Meinhardt W, van Tinteren H, Horenblas S (2006) Penis conserving treatment for T1 and T2 penile carcinoma: clinical implications of a local recurrence. J Urol 176(2):575–580. https://doi.org/10.1016/j.juro.2006.03.063 (discussion 580) CrossRefPubMed

32.

Conejo-Mir JS, Munoz MA, Linares M, Rodriguez L, Serrano A (2005) Carbon dioxide laser treatment of erythroplasia of Queyrat: a revisited treatment to this condition. J Eur Acad Dermatol Venereol 19(5):643–644. https://doi.org/10.1111/j.1468-3083.2005.01217.x CrossRefPubMed

33.

Tewari M, Kumar M, Shukla HS (2007) Nd:YAG laser treatment of early stage carcinoma of the penis preserves form and function of penis. Asian J Surg 30(2):126–130. https://doi.org/10.1016/S1015-9584(09)60145-7 CrossRefPubMed

34.

Frimberger D, Hungerhuber E, Zaak D, Waidelich R, Hofstetter A, Schneede P (2002) Penile carcinoma. Is Nd:YAG laser therapy radical enough? J Urol 168(6):2418–2421. https://doi.org/10.1097/01.ju.0000036629.28231.85 (discussion 2421) CrossRefPubMed

35.

Porter WM, Francis N, Hawkins D, Dinneen M, Bunker CB (2002) Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases. Br J Dermatol 147(6):1159–1165 CrossRef

36.

Mohs FE, Snow SN, Larson PO (1992) Mohs micrographic surgery for penile tumors. Urol Clin N Am 19(2):291–304

37.

Shindel AW, Mann MW, Lev RY, Sengelmann R, Petersen J, Hruza GJ, Brandes SB (2007) Mohs micrographic surgery for penile cancer: management and long-term followup. J Urol 178(5):1980–1985. https://doi.org/10.1016/j.juro.2007.07.039 CrossRefPubMed

38.

Li J, Zhu Y, Zhang SL, Wang CF, Yao XD, Dai B, Ye DW (2011) Organ-sparing surgery for penile cancer: complications and outcomes. Urology 78(5):1121–1124. https://doi.org/10.1016/j.urology.2011.08.006 CrossRefPubMed

39.

Philippou P, Shabbir M, Malone P, Nigam R, Muneer A, Ralph DJ, Minhas S (2012) Conservative surgery for squamous cell carcinoma of the penis: resection margins and long-term oncological control. J Urol 188(3):803–808. https://doi.org/10.1016/j.juro.2012.05.012 CrossRefPubMed

40.

Bissada NK (1992) Conservative extirpative treatment of cancer of the penis. Urol Clin N Am 19(2):283–290

41.

Shabbir M, Muneer A, Kalsi J, Shukla CJ, Zacharakis E, Garaffa G, Ralph D, Minhas S (2011) Glans resurfacing for the treatment of carcinoma in situ of the penis: surgical technique and outcomes. Eur Urol 59(1):142–147. https://doi.org/10.1016/j.eururo.2010.09.039 CrossRefPubMed

42.

Palminteri E, Berdondini E, Lazzeri M, Mirri F, Barbagli G (2007) Resurfacing and reconstruction of the glans penis. Eur Urol 52(3):893–900. https://doi.org/10.1016/j.eururo.2007.01.047 CrossRefPubMed

43.

Brown CT, Minhas S, Ralph DJ (2005) Conservative surgery for penile cancer: subtotal glans excision without grafting. BJU Int 96(6):911–912. https://doi.org/10.1111/j.1464-410X.2005.05751.x CrossRefPubMed

44.

Parnham AS, Albersen M, Sahdev V, Christodoulidou M, Nigam R, Malone P, Freeman A, Muneer A (2018) Glansectomy and split-thickness skin graft for penile cancer. Eur Urol 73(2):284–289. https://doi.org/10.1016/j.eururo.2016.09.048 CrossRefPubMed

45.

Horenblas S, van Tinteren H, Delemarre JF, Boon TA, Moonen LM, Lustig V (1992) Squamous cell carcinoma of the penis. II. Treatment of the primary tumor. J Urol 147(6):1533–1538 CrossRef

46.

Mazza ON, Cheliz GM (2001) Glanuloplasty with scrotal flap for partial penectomy. J Urol 166(3):887–889 CrossRef

47.

Bissada NK (1987) Penile reconstruction after total penectomy or urethra-sparing total penectomy. J Urol 137(6):1173–1175 CrossRef

48.

Djajadiningrat RS, van Werkhoven E, Meinhardt W, van Rhijn BW, Bex A, van der Poel HG, Horenblas S (2014) Penile sparing surgery for penile cancer-does it affect survival? J Urol 192(1):120–125. https://doi.org/10.1016/j.juro.2013.12.038 CrossRefPubMed

49.

Kamel MH, Tao J, Su J, Khalil MI, Bissada NK, Schurhamer B, Spiess PE, Davis R (2018) Survival outcomes of organ sparing surgery, partial penectomy, and total penectomy in pathological T1/T2 penile cancer: report from the National Cancer Data Base. Urol Oncol 36(2):82.e87-82.e15. https://doi.org/10.1016/j.urolonc.2017.10.017 CrossRef

50.

Kieffer JM, Djajadiningrat RS, van Muilekom EA, Graafland NM, Horenblas S, Aaronson NK (2014) Quality of life for patients treated for penile cancer. J Urol 192(4):1105–1110. https://doi.org/10.1016/j.juro.2014.04.014 CrossRefPubMed

51.

Clark PE, Spiess PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE, Herr HW, Inman BA, Kuban DA, Kuzel TM, Lele SM, Michalski J, Pagliaro L, Pal SK, Patterson A, Plimack ER, Pohar KS, Porter MP, Richie JP, Sexton WJ, Shipley WU, Small EJ, Trump DL, Wile G, Wilson TG, Dwyer M, Ho M, National Comprehensive Cancer N (2013) Penile cancer: clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 11(5):594–615 CrossRef

52.

Leijte JA, Kirrander P, Antonini N, Windahl T, Horenblas S (2008) Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a two-centre analysis of 700 patients. Eur Urol 54(1):161–168. https://doi.org/10.1016/j.eururo.2008.04.016 CrossRefPubMed

53.

Hakenberg OW, Comperat EM, Minhas S, Necchi A, Protzel C, Watkin N, European Association of U (2015) EAU guidelines on penile cancer: 2014 update. Eur Urol 67(1):142–150. https://doi.org/10.1016/j.eururo.2014.10.017 CrossRefPubMed

54.

Shabbir MHB, Swallow T, Corbishley C, Perry M, Watkin N (2008) Management of chronic ulceration after radiotherapy for penile cancer. J Urol 179(Supplement 4):273 CrossRef

55.

Veeratterapillay R, Sahadevan K, Aluru P, Asterling S, Rao GS, Greene D (2012) Organ-preserving surgery for penile cancer: description of techniques and surgical outcomes. BJU Int 110(11):1792–1795. https://doi.org/10.1111/j.1464-410X.2012.11084.x CrossRefPubMed

56.

Feldman AS, McDougal WS (2011) Long-term outcome of excisional organ sparing surgery for carcinoma of the penis. J Urol 186(4):1303–1307. https://doi.org/10.1016/j.juro.2011.05.084 CrossRefPubMed

57.

Bandieramonte G, Colecchia M, Mariani L, Lo Vullo S, Pizzocaro G, Piva L, Nicolai N, Salvioni R, Lezzi V, Stefanon B, De Palo G (2008) Peniscopically controlled CO ₂ laser excision for conservative treatment of in situ and T1 penile carcinoma: report on 224 patients. Eur Urol 54(4):875–882. https://doi.org/10.1016/j.eururo.2008.01.019 CrossRefPubMed

58.

59.

Smith Y, Hadway P, Biedrzycki O, Perry MJ, Corbishley C, Watkin NA (2007) Reconstructive surgery for invasive squamous carcinoma of the glans penis. Eur Urol 52(4):1179–1185. https://doi.org/10.1016/j.eururo.2007.02.038 CrossRefPubMed

Titel: Organ-sparing procedures in GU cancer: part 2-organ-sparing procedures in testicular and penile tumors
Autoren:: Mohamed H. Kamel
Mahmoud I. Khalil
Ehab Eltahawy
Rodney Davis
Nabil K. Bissada
Publikationsdatum: 02.07.2019
DOI: https://doi.org/10.1007/s11255-019-02182-6
Verlag: Springer Netherlands
Zeitschrift: International Urology and Nephrology
Ausgabe 10/2019
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584

Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.
Sie können e.Med Gynäkologie & Urologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Innere Medizin

19.04.2021 | DGIM 2021 | Nachrichten

Newsletter bestellen

Bildnachweise

Mail Icon II

Springer Medizin

Organ-sparing procedures in GU cancer: part 2-organ-sparing procedures in testicular and penile tumors

Publisher's Note