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A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis


Grogg, Josias Bastian; Schneider, Kym; Bode, Peter-Karl; Wettstein, Marian Severin; Kranzbühler, Benedikt; Eberli, Daniel; Sulser, Tullio; Beyer, Joerg; Hermanns, Thomas; Fankhauser, Christian Daniel (2019). A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis. Journal of Cancer Research and Clinical Oncology, 145(12):3037-3045.

Abstract

INTRODUCTION
Because spermatocytic tumors of the testis are rare, only limited evidence exists regarding the malignant potential and the optimal management of localized and metastatic disease.
MATERIALS AND METHODS
We performed a systematic review through MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Web of Science to identify reports including patients with testicular spermatocytic tumors.
RESULTS
From originally 7863 studies, we extracted data of 146 patients of which 99% were treated with radical orchiectomy. Metastases in patients with initially localised disease were diagnosed in 7% of patients and detected after a median follow-up of 5.5 months (range 2-21 months). Patients with aggressive histology (sarcoma or anaplastic subtype) were more likely to have metastatic disease (6/124 (5%) vs 9/22 (41%), p < 0.001). Patients with metastatic disease had larger primary tumors (92.5 vs 67.5 mm, p = 0.05). Life expectancy in patients with metastatic disease ranged from 1 to 25 months.
CONCLUSION
The published literature does neither support the use of testis sparing surgery nor adjuvant therapy. Patients with aggressive variants or larger tumors were more likely to have metastases and develop recurrences within the first few years. Patients with metastatic disease have a limited life expectancy and metastatic spermatocytic tumors are not as responsive to chemotherapy as germ cell cancers.

Abstract

INTRODUCTION
Because spermatocytic tumors of the testis are rare, only limited evidence exists regarding the malignant potential and the optimal management of localized and metastatic disease.
MATERIALS AND METHODS
We performed a systematic review through MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Web of Science to identify reports including patients with testicular spermatocytic tumors.
RESULTS
From originally 7863 studies, we extracted data of 146 patients of which 99% were treated with radical orchiectomy. Metastases in patients with initially localised disease were diagnosed in 7% of patients and detected after a median follow-up of 5.5 months (range 2-21 months). Patients with aggressive histology (sarcoma or anaplastic subtype) were more likely to have metastatic disease (6/124 (5%) vs 9/22 (41%), p < 0.001). Patients with metastatic disease had larger primary tumors (92.5 vs 67.5 mm, p = 0.05). Life expectancy in patients with metastatic disease ranged from 1 to 25 months.
CONCLUSION
The published literature does neither support the use of testis sparing surgery nor adjuvant therapy. Patients with aggressive variants or larger tumors were more likely to have metastases and develop recurrences within the first few years. Patients with metastatic disease have a limited life expectancy and metastatic spermatocytic tumors are not as responsive to chemotherapy as germ cell cancers.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Pathology and Molecular Pathology
04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Oncology
Life Sciences > Cancer Research
Language:English
Date:23 October 2019
Deposited On:29 Nov 2019 15:24
Last Modified:23 Oct 2020 00:00
Publisher:Springer
ISSN:0171-5216
OA Status:Hybrid
Publisher DOI:https://doi.org/10.1007/s00432-019-03056-1
PubMed ID:31646373

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Download PDF  'A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis'.
Preview
Content: Accepted Version
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Download PDF  'A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis'.
Preview
Content: Accepted Version
Filetype: PDF
Size: 1MB