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Testicle-sparing surgery versus radical orchiectomy in the management of Leydig cell tumors: results from a multicenter study

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Abstract

Objective

To compare the oncological outcomes of testicle-sparing surgery (TSS) and radical orchiectomy (RO) in patients with Leydig cell tumor (LCT) of the testis.

Patients and methods

A multicenter retrospective clinical study was conducted in 12 centers in France. All the patients with histologically proven LCT were included and analyzed according to treatment (organ-sparing surgery or radical orchiectomy). Patients underwent preoperative clinical, biological and imaging assessment. Demographic, clinical, and pathological variables were collected at baseline and compared between groups according to surgical treatment. Follow-up was calculated using the reverse Kaplan–Meier estimation and was updated at the end of 2015.

Results

Between 1986 and 2014, 56 patients presented with LCT were identified and included in the study. Twenty-one patients (37.5%) underwent TSS and 35 (62.5%) RO. Demographics and tumor characteristics were not significantly different between the groups. Median follow-up was 62 months after TSS, but only 35 months after RO. Two patients (9.5%) developed local recurrence 15 and 34 months after TSS and underwent secondary RO. No local recurrence or metastasis was observed after complementary treatment. No recurrence was observed after RO. Disease-free survival did not differ between the groups (95.2% in TSS versus 77.1% in the RO group, p = 0.23). No patient died in the TSS group, but three patients (8.6%) in the RO group died from other diseases without evidence of relapse. One patient (4.8%) in the TSS group versus five (14.3%) in the RO group were lost to follow-up.

Conclusion

Long-term follow-up suggests that testicle-sparing surgery does not compromise relapse-free survival in the treatment of Leydig cell tumor of the testis.

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Acknowledgements

The authors thank A. Atassi, I. Bedgedjian, P. Birembaut, M. Boulenger, J. Champigneulle, C. Enoch, M. Funes De La Vega, J. Hubert, Y. Jeffredo, F. Lecuyer, V. Lindner, A. Petitjean, J. Raffoul, general practitioners and secretaries for their contribution to this study. The authors thank Fiona Ecarnot, MSc (EA3920, Dept of Cardiology, University Hospital Jean Minjoz, Besancon, France) for editorial assistance and critical review.

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Authors and Affiliations

  1. Department of Urology and Renal Transplantation, University Hospital of Besancon, 3 Boulevard Fleming, 25000, Besancon, France

    Florian Laclergerie, Alexandre Frontczak, Loïc Balssa & François Kleinclauss

  2. University of Burgundy Franche-Comté, 25000, Besancon, France

    Florian Laclergerie, Alexandre Frontczak, Loïc Balssa, Antoine Thiery Vuillemin & François Kleinclauss

  3. Department of Medical Oncology, University Hospital of Besancon, 25000, Besancon, France

    Guillaume Mouillet & Antoine Thiery Vuillemin

  4. Department of Urology, University Hospital of Nancy, 54000, Nancy, France

    Pascal Eschwege

  5. Department of Urology, University Hospital of Strasbourg, 67000, Strasbourg, France

    Christian Saussine

  6. Department of Urology, University Hospital of Reims, 51000, Reims, France

    Stéphane Larré

  7. Department of Urology, University Hospital of Dijon, 21000, Dijon, France

    Luc Cormier

  8. INSERM, UMR 1098, Besancon, France

    Antoine Thiery Vuillemin & François Kleinclauss

Authors
  1. Florian Laclergerie
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  2. Guillaume Mouillet
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  3. Alexandre Frontczak
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  4. Loïc Balssa
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  5. Pascal Eschwege
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  6. Christian Saussine
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  7. Stéphane Larré
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  8. Luc Cormier
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  9. Antoine Thiery Vuillemin
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  10. François Kleinclauss
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Contributions

Study design: FL, FK, ATV, GM. Data collection: FL, AF, LB.  Statistical analysis: GM, FK. Manuscript writing: FL, FK. Manuscript reviewing: FK, ATV, LB, PE, CS, SL, LC.

Corresponding author

Correspondence to François Kleinclauss.

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The authors have no conflict of interest related to this study.

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Laclergerie, F., Mouillet, G., Frontczak, A. et al. Testicle-sparing surgery versus radical orchiectomy in the management of Leydig cell tumors: results from a multicenter study. World J Urol 36, 427–433 (2018). https://doi.org/10.1007/s00345-017-2151-0

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  • DOI: https://doi.org/10.1007/s00345-017-2151-0

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