Abstract
No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1995Original Articles: Testis Cancer: A Review of Scrotal Violation in Testicular Cancer: Is Adjuvant Local Therapy Necessary? Carl C. Capelouto, Peter E. Clark, Bernard J. Ransil, and Kevin R. Loughlin Carl C. CapeloutoCarl C. Capelouto , Peter E. ClarkPeter E. Clark , Bernard J. RansilBernard J. Ransil , and Kevin R. LoughlinKevin R. Loughlin View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67617-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail High inguinal orchiectomy is the standard initial treatment for suspected testicular carcinoma. Nonstandard surgical approaches (scrotal violations), including scrotal orchiectomy, open testicular biopsy and fine needle aspiration, have historically been condemned as significantly compromising patient prognosis. Patients with scrotal violation are often subjected to potentially morbid or disfiguring local therapies. In addition, patients with scrotal violations are usually disqualified from surveillance protocols. A review was conducted of all published series of testicular cancer patients in whom scrotal violation occurred. A meta-analysis was then performed to choose a subset for critical analysis on the effect of scrotal violation on patient prognosis. Of 1,182 cases included in the final analysis scrotal violation occurred in 206. The rates for local recurrence, distant recurrence and survival were analyzed separately for all patients, patients with stage I disease and patients with pure seminoma or nonseminomatous germ cell tumor. Additionally, the effect of local treatment for scrotal violation on prognosis was examined. Although statistically significant differences were found in the local recurrence rate among the scrotal violation and inguinal group studies, the overall local recurrence rates were small (2.9% versus 0.4%, respectively). There were no statistical differences in distant recurrence or survival rates in all groups analyzed. Patients with scrotal violation who did not receive any local therapy fared as well as those who did receive local therapy. Although the standard treatment of primary testicular cancer remains high inguinal orchiectomy, these data suggest that scrotal violation does not impart a significantly worse overall prognosis. These data would also indicate that patients with stage I disease and scrotal violation should not necessarily be disqualified from surveillance protocols or subjected to adjuvant local therapy. References 1 : Sarcoma of the testicle, conclusions based upon 114 cases. Amer. J. Med.1899; 117: 535. 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Google Scholar From the Division of Urology, Department of Medicine, Brigham and Women’s Hospital and Beth Israel Hospital, Boston, Massachusetts© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySeitz G, Dantonello T, Kosztyla D, Klingebiel T, Leuschner I, Fuchs J and Koscielniak E (2014) Impact of Hemiscrotectomy on Outcome of Patients with Embryonal Paratesticular Rhabdomyosarcoma: Results from the Cooperative Soft Tissue Sarcoma Group Studies CWS-86, 91, 96 and 2002PJournal of Urology, VOL. 192, NO. 3, (902-907), Online publication date: 1-Sep-2014.LaMontagne A (2018) Spontaneous Rupture Of A Testicular TumorJournal of Urology, VOL. 167, NO. 4, (1787-1788), Online publication date: 1-Apr-2002.Arcadi J (2018) Re: The Climical Implications of Procedural Deviations during Orchiectomy for Nonseminomatous Testis CancerJournal of Urology, VOL. 156, NO. 2, (484-484), Online publication date: 1-Aug-1996.Loughlin K (2018) Editorial: Testis Cancer—Shibboleths ReconsideredJournal of Urology, VOL. 154, NO. 3, (1050-1051), Online publication date: 1-Sep-1995. Volume 153Issue 3SMarch 1995Page: 981-985 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Carl C. Capelouto More articles by this author Peter E. Clark More articles by this author Bernard J. Ransil More articles by this author Kevin R. Loughlin More articles by this author Expand All Advertisement PDF downloadLoading ...