Contemporary Role of Testis Sparing Surgery: A Systematic Review

*Giorgio Ivan Russo,1 Giulio Reale,1 Salvatore Privitera,1 Tommaso Castelli,1 Massimo Madonia,2 Sebastiano Cimino,1 Vincenzo Favilla,1  Giuseppe Morgia1

1. Department of Urology, University of Catania, Catania, Italy
2. Department of Urology, University of Sassari, Sassari, Italy
*Correspondence to

Disclosure: No potential conflict of interest.
Received: 21.10.14 Accepted: 19.11.14
Citation: EMJ Urol. 2015;3[1]:34-40.


Testis-sparing surgery (TSS) represents a therapeutic choice for testicular cancer (TC). However,  international guidelines are very cautious about the use of the testis-sparing technique, namely due to the lack of certain indications and long-term oncological outcomes. The aim of this systematic-review is to illustrate current trends of what may today be the uses of organ-sparing surgery in TC, to evaluate the relationship between the organ-sparing safety and oncological features such as definitive histology, tumour size, and post-surgery oncological outcomes. This analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. An electronic search of the Medline and Embase was undertaken until September 2014. The search was limited to English-Language articles. Current indications of TSS are synchronous bilateral testicular tumours, metachronous contralateral tumours, or tumour in a solitary testis with normal preoperative testosterone levels. Moreover, histological characteristics should not be taken into account when performing a TSS approach. TSS outcomes for  germ cell tumours are encouraging and we reported high rates of disease-free survival and a few cases of patients receiving neoadjuvant chemotherapy or radiotherapy. In light of the examined, TSS could be considered a viable alternative to radical surgery of the testis but it should be performed in specialised centres with competence.

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