Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review.

Q2 Pharmacology, Toxicology and Pharmaceutics

F1000Research Pub Date : 2024-11-13 eCollection Date: 2023-01-01 DOI:10.12688/f1000research.134221.2

William Tendi, Putu Angga Risky Raharja, Irfan Wahyudi, Arry Rodjani, Gerhard Reinaldi Situmorang

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引用次数: 0

Abstract

Background: Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. In post-pubertal UDT, the current guideline recommends orchiectomy; however, the strength rating of this recommendation is weak. Therefore, this study aimed to provide a systematic review of post-pubertal UDT treatment, focusing on the malignancy risk point of view.

Methods: A systematic search was performed using PubMed, Wiley Online Library and the Cochrane Library up to 5 March 2023. Any study with either post-pubertal orchiectomy or orchidopexy in patients with UDT and reporting the testicular malignancy was included. The exclusion criteria were studies with lack of information of UDT correction time, no history of correction and the full text wasn't available. The data collected were the occurrence of testicular malignancy in post-pubertal UDT patients corrected with any method. Quality and bias assessment was assessed with Newcastle-Ottawa scale and Joanna Briggs Institute tools.

Results: Seven articles (three case reports and four observational studies) were reviewed with a total of 42 patients who underwent post-pubertal correction of either unilateral or bilateral UDT. The correction age ranged from 13 to 34 years old, with follow-up of 48.7-252 months. Among those who developed malignancies, the most common were seminoma, teratoma and carcinoma in situ of the testes. In addition, this study was able to propose an algorithm for post-pubertal UDT treatment strategy.

Conclusions: The scarce resource was the main limitation of this study. Nevertheless, this review showed that post-pubertal UDT management should be tailored individually. Several factors that should be considered include the condition of the contralateral descended testis, UDT location, serum testosterone level, patient's age, comorbidities, and interest in fertility.

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从恶性肿瘤风险的角度看青春期后未降睾丸的处理：系统综述。

背景：无睾丸症（UDT）是指阴囊内缺少一个或两个睾丸。由于存在不育和日后发生恶性肿瘤的风险，一般建议在 18 个月之前进行治疗。另一方面，对于青春期后的睾丸发育不全，目前的指南建议进行睾丸切除术，但这一建议并不充分。因此，本研究旨在从恶性肿瘤风险的角度，对青春期后尿失禁的治疗进行系统性回顾：方法：使用 PubMed、Wiley Online Library 和 Cochrane Library 对截至 2023 年 3 月 5 日的资料进行了系统性检索。任何对青春期后睾丸切除术或睾丸环切术的 UDT 患者进行研究并报告睾丸恶性肿瘤的研究均被纳入。排除标准是缺乏 UDT 矫正时间信息、无矫正史和全文不可用的研究。收集的数据是用任何方法矫正的青春期后尿失禁患者发生睾丸恶性肿瘤的情况。采用纽卡斯尔-渥太华量表和乔安娜-布里格斯研究所的工具进行了质量和偏倚评估：共审查了 7 篇文章（3 篇病例报告和 4 篇观察性研究），共有 42 名患者在青春期后接受了单侧或双侧 UDT 矫正。矫正年龄从 13 岁到 34 岁不等，随访时间为 48.7-252 个月。在发生恶性肿瘤的患者中，最常见的是精原细胞瘤、畸胎瘤和睾丸原位癌。此外，这项研究还提出了青春期后UT治疗策略的算法：资源稀缺是本研究的主要局限性。尽管如此，本综述表明，青春期后尿失禁的治疗应因人而异。应考虑的因素包括对侧下降睾丸的情况、UDT位置、血清睾酮水平、患者年龄、合并症以及对生育的兴趣。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

F1000Research Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)

CiteScore

5.00

自引率

0.00%

发文量

1646

审稿时长

1 weeks

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