MP55-08 OUTCOMES IN PEDIATRIC TESTICULAR MASSES: TESTIS-SPARING SURGERY VS. RADICAL ORCHIECTOMY AT A LARGE, TERTIARY CARE CENTER

You have accessJournal of UrologyPediatric Urology V (MP55)1 Sep 2021MP55-08 OUTCOMES IN PEDIATRIC TESTICULAR MASSES: TESTIS-SPARING SURGERY VS. RADICAL ORCHIECTOMY AT A LARGE, TERTIARY CARE CENTER Ruchika Talwar, Karl Godlewski, Matthew Herzig, Jay Shah, Arun Srinivasan, Aseem Shukla, Mark Zaontz, Dana Weiss, Jason Van Batavia, Stephen Zderic, Gregory Tasian, Douglas Canning, Robert Caleb Kovell, Christopher Long, Sameer Mittal, and Thomas Kolon Ruchika TalwarRuchika Talwar More articles by this author , Karl GodlewskiKarl Godlewski More articles by this author , Matthew HerzigMatthew Herzig More articles by this author , Jay ShahJay Shah More articles by this author , Arun SrinivasanArun Srinivasan More articles by this author , Aseem ShuklaAseem Shukla More articles by this author , Mark ZaontzMark Zaontz More articles by this author , Dana WeissDana Weiss More articles by this author , Jason Van BataviaJason Van Batavia More articles by this author , Stephen ZdericStephen Zderic More articles by this author , Gregory TasianGregory Tasian More articles by this author , Douglas CanningDouglas Canning More articles by this author , Robert Caleb KovellRobert Caleb Kovell More articles by this author , Christopher LongChristopher Long More articles by this author , Sameer MittalSameer Mittal More articles by this author , and Thomas KolonThomas Kolon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002085.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2020, testis-sparing surgery was included in the Testis Cancer AUA Guidelines for adults with masses <2 cm, equivocal ultrasound (US), negative tumor markers, solitary testis, or bilateral tumors. Although an option in pediatric population prior to this, its utility in clinical practice varies and has not been well described in the literature. We describe a large, tertiary care pediatric hospital experience with partial orchiectomy (PO) as compared to radical orchiectomy (RO) for testis masses in a pediatric population. METHODS: We performed a retrospective review of consecutive patients who underwent RO or PO from 1/2013 until 12/2020 at our institution, including 10 surgeons. We analyzed pre-, intra-, and postoperative clinical and pathologic characteristics. We further ran a sub analysis on the patients with benign final pathology to determine if these patients were being overtreated with RO. RESULTS: We identified 54 patients scheduled to undergo RO (n=32) or PO (n=22). Median follow-up was 3.5 months. Two cases were converted from PO to RO intraoperatively. Older age, presence of a palpable mass, and larger mass on US were associated with planned RO (Table 1). Patients who underwent PO had significantly longer operative time, interval to surgery and were more likely to have benign or (prepubertal) teratoma final pathology (Table 1). There were no differences in complications, emergency room visits or recurrence (all p>0.05). Upon logistic regression, older age (p=0.045), palpable mass (p=0.006), and larger size on US (p=0.008) were predictive of RO. Of patients with benign final pathology, no differences were noted between patient age, mass size, palpable mass on presentation, pre-op tumor markers, or surgeon between patients scheduled to undergo PO vs. RO. CONCLUSIONS: PO is a safe, potentially beneficial option for children. The majority of PO patients had benign, pre-pubertal teratoma, or non-GCT pathology. No patients with GCT were undertreated with PO. Further, younger patients, those with no palpable mass and smaller masses tended to undergo PO as compared to RO. Our data has important implications in the consideration of pediatric PO, and can be extrapolated to shared-decision making in the adult population also. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e961-e961 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruchika Talwar More articles by this author Karl Godlewski More articles by this author Matthew Herzig More articles by this author Jay Shah More articles by this author Arun Srinivasan More articles by this author Aseem Shukla More articles by this author Mark Zaontz More articles by this author Dana Weiss More articles by this author Jason Van Batavia More articles by this author Stephen Zderic More articles by this author Gregory Tasian More articles by this author Douglas Canning More articles by this author Robert Caleb Kovell More articles by this author Christopher Long More articles by this author Sameer Mittal More articles by this author Thomas Kolon More articles by this author Expand All Advertisement PDF downloadLoading ...

Topic: Testicular diseases and treatments
Subfield: Surgery
Field: Medicine
Domain: Health Sciences