title: Testis sparing surgery in the treatment of bilateral testicular germ cell tumors and solitary testicle tumors: A single institution experience.
abstract: OBJECTIVE
  To assess the oncologic and functional outcomes of testicular sparing surgery (TSS) based on a single institution experience.
  
  
  METHODS
  Forty-one patients with bilateral and 3 patients with solitary testicle tumors were referred to our institution. The inclusion criteria for TSS were normal serum testosterone levels, and tumor size (<2 cm). Sperm analysis and hormone status evaluation were performed preoperatively and postoperatively. None of the patients underwent local radiation therapy following TSS for reasons of fertility preservation.
  
  
  RESULTS
  A total of 26 TSS were performed in 24 patients. The median follow-up period was 51.0 months. Seven patients developed local recurrence, of which 5 had TIN and were subjected to radical orchiectomy, whereas re-do TSS was done in remaining 2 patients. The overall survival of the study group was 100%, and the presence of testicular intraepithelial neoplasia (TIN) was associated with worse recurrence-free survival (P=0.031, log-rank). Testosterone values were normal in all of the patients, while 4 patients achieved conception.
  
  
  CONCLUSIONS
  TSS is acceptable from an oncological point of view, and it enables continuation of a patient's life without lifelong hormonal substitution. Additionally, local irradiation therapy could be delayed in patients with TIN who wish to father children, but with high local recurrence rate.
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Bojanic
authors.forename: Uros
authors.initials: U
authors.lastname: Bumbasirevic
authors.forename: Ivan
authors.initials: I
authors.lastname: Vukovic
authors.forename: Gordana
authors.initials: G
authors.lastname: Bojanic
authors.forename: Bogomir
authors.initials: B
authors.lastname: Milojevic
authors.forename: Djordje
authors.initials: D
authors.lastname: Nale
authors.forename: Otas
authors.initials: O
authors.lastname: Durutovic
authors.forename: Dejan
authors.initials: D
authors.lastname: Djordjevic
authors.forename: Predrag
authors.initials: P
authors.lastname: Nikic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Vuksanovic
authors.forename: Cane
authors.initials: C
authors.lastname: Tulic
authors.forename: Sava
authors.initials: S
authors.lastname: Micic
mesh_terms: D000293:Adolescent; D000328:Adult; D053713:Azoospermia / Q000209:etiology; D059247:Fertility Preservation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery*; D009919:Orchiectomy; D059351:Organ Sparing Treatments; D013076:Sperm Count; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D013739:Testosterone
keywords: bilateral testicular tumors; neoplasms, germ cell and embryonal; partial orchiectomy; testicular cancer; testis sparing surgery