Naufal Naushad, Tarek Shendy, Tanveer Mahmood, Abdalla Deb, Hosam Serag, Abraham Vinod Peedikayil
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引用次数: 0
Abstract
Objective: To conduct the largest and most comprehensive individual patient data (IPD) meta-analysis to date on testicular metastases from renal cell carcinoma (RCC), with the aim of characterizing clinical features, quantifying survival outcomes, and identifying predictors of recurrence and mortality.
Methods: A systematic review was performed in April 2025 using PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies included histologically confirmed testicular metastases from RCC with extractable patient-level data. Fifty-three cases from 40 articles were included. One unpublished case from our institution was included. We extracted demographics, pathology, treatment, imaging, and outcome data. Tumor volume was calculated from ultrasound dimensions using the ellipsoid formula. For bilateral metastases, the mean volume was used in regression analysis.
Results: The median overall survival was 17 months (interquartile ranges [IQR], 7.4-26), and progression-free survival was 9 months (IQR, 6-18.5). Lymph node metastasis (odds ratio [OR] = 15.7, P = .019) and presence of metastases at RCC diagnosis (OR = 6.5, P = .034) were associated with mortality. Synchronous metastases (OR = 38.5, P = .002) and lung involvement (OR = 28.0, P = .004) were predictors of recurrence. Survival differed significantly across Fuhrman grades (P = .032) and T stages (P = .047). In Cox regression, metastasis at diagnosis predicted shorter overall survival, while lung and lymph node involvement were the strongest predictors of recurrence.
Conclusion: This meta-analysis provides the first pooled survival estimates and prognostic modeling for testicular RCC metastases. Findings support the value of early detection and confirm the prognostic impact of synchronous disease and nodal spread. These results establish a foundation for clinical risk stratification and long-term surveillance strategies in affected patients.
期刊介绍：
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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