title: Organ-sparing surgery for testicular tumours.
abstract: OBJECTIVE
  Testicular cancer represents the majority of testicular masses, and radical orchiectomy is still considered the standard-of-care. Testis-sparing surgery (TSS) can be an alternative to radical surgery in patients with small testicular tumours, bilateral or solitary testis masses. The aim of this manuscript is to review the current indications, oncological and functional outcomes of TSS.
  
  
  RESULTS
  Our review confirmed that literature lacks studies with a high level of evidence on comparing TSS with radical surgery. Indications for TSS are controversial, specifically for patients with normal contralateral testis. For nonpalpable testicular masses less than 2 cm, bilateral tumours and solitary testis mass, TSS seems to be a viable treatment option. Frozen-section examination is a critical tool for assessment at the time of TSS that allows for diagnosis of benign from malignant tumours and evaluation of margin. TSS has been shown to be associated with less fertility alterations, hormonal deficit and potential lower impact on sexual and psychosocial aspects. Intermediate to long-term follow-up results have not revealed any significant risk of local and/or distant recurrences after TSS.
  
  
  CONCLUSIONS
  TSS is well tolerated and feasible for selected patients with testicular mass without compromising oncological and functional outcomes. Further studies with a higher level of evidence are needed to confirm these findings.
authors.affiliation: Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Hooman
authors.initials: H
authors.lastname: Djaladat
mesh_terms: D005629:Frozen Sections; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery*; D009919:Orchiectomy / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods*; D018310:Sertoli-Leydig Cell Tumor / Q000473:pathology / Q000601:surgery*; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome