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The impact of age at orchiopexy on testicular cancer outcomes

  • Margaret Higgins
  • Derek E. Smith
  • Dexiang Gao
  • Duncan Wilcox
  • Nicholas G. Cost
  • Amanda F. SaltzmanEmail author
Original Article
  • 15 Downloads

Abstract

Purpose

To estimate how many boys with UDT must undergo orchiopexy to prevent one case of TC, one death from TC and one exposure to TC treatment beyond radical orchiectomy as compared to being treated at an older age.

Methods

This retrospective study utilized data from a 2007 Swedish study of males who underwent orchiopexy for UDT (Pettersson et al.). TC incidence for boys undergoing orchiopexy for UDT was assessed based on the age at orchiopexy (0–6 years, 7–9 years, 10–12 years, 13–15 years). The incidence of TC in each age cohort was calculated and used to determine the number needed to treat (NNT) for each age group using assumptions based on published TC outcomes.

Results

For an index patient ≤ 6 years, 372 boys need to undergo orchiopexy to prevent a single case of TC, 1488 boys to prevent exposure to TC therapy beyond radical orchiectomy, and 5315 boys to prevent a single TC-related death compared to treatment at an older age.

Conclusion

While there is evidence supporting benefits of early orchiopexy, the NNT to affect TC outcomes is very high. Even those with delayed orchiopexies have low risk for TC poor outcomes. This information can be used when counseling patients and families faced with UDT about the risks related to TC, especially with comorbidities.

Keywords

Testicular cancer Undescended testicle Orchiopexy Number needed to treat 

Abbreviations

NNT

Number needed to treat

TC

Testicular cancer

UDT

Undescended testicle(s)

Notes

Author contributions

MH: data analysis and manuscript writing/editing. DES: protocol/project development, data collection or management, and data analysis. DG protocol/project development, data collection or management, and data analysis. DW protocol/project development, and manuscript writing/editing. NGC protocol/project development, data collection or management, data analysis, and manuscript writing/editing. AFS protocol/project development, data collection or management, data analysis, and manuscript writing/editing.

Funding

The study was funded by Etkin Family Fund of the Aspen Community Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest statement.

Ethical approval

IRB approval was not obtained for this study as it is a secondary analysis of published work.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyUniversity of KentuckyLexingtonUSA
  2. 2.Department of PediatricsUniversity of Colorado School of Medicine and University of Colorado Cancer CenterAuroraUSA
  3. 3.Division of Urology, Department of SurgeryUniversity of Colorado School of Medicine and Children’s Hospital ColoradoAuroraUSA

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