Management of testicular cancer: Practice survey in localized stage

Authors

  • Benoît Mesnard Nantes University Hospital
  • Jean-François Hetet Clinique Jules Verne, Nantes
  • Emmanuel Couteau Santé Atlantique, Nantes
  • Arthur Fosse Hôpital Privé du Confluent, Nantes
  • Vincent Bocquillon Polyclinique de l’Europe, Nantes
  • Alexis Gignoux Clinique Saint-Charles, La Roche-Sur-Yon
  • Michel Baron Clinique Mutualiste, Saint-Nazaire
  • Nicolas Gaschignard Centre Hospitalier Départemental Vendée, La Roche-Sur-Yon
  • Jérôme Rigaud Nantes University Hospital

DOI:

https://doi.org/10.5489/cuaj.8239

Keywords:

Testicular Neoplasms, Practice Guidelines as Topic, Guidelines Adherence

Abstract

INTRODUCTION: Management of testicular cancer requires a complete evaluation to confirm the localized stage and effective treatment according to guidelines to ensure the best outcome. The primary objective of this study was to evaluate practices at each stage of care in patients with a localized testicular tumor. The secondary objective was to evaluate the oncological prognosis of these patients according to the modalities of care.

METHODS: We conducted a multicenter practice evaluation study with retrospective collection and evaluation of patient records. The study was conducted in two French departments (population pool of 2 million inhabitants) between January 1, 2010, and January 31, 2015, enabling a five-year followup of patients. Patients presenting with stage I testicular tumor according to the American Joint Committee on Cancer classification were included in the analysis.

RESULTS: A total of 226 records were analyzed; 93% of patients underwent bilateral scrotal ultrasound and 93.25% had a chest-abdomen-pelvis computed tomography scan. A total of 29.65% of patients had a preoperative tumor marker assay in accordance with guidelines; 94% of patients had a total orchiectomy, with a median time of 15 days. At the end of the followup period, 17 patients had suffered a recurrence of their disease. Providing adjuvant care in accordance with guidelines reduced the risk of recurrence in patients with a seminomatous tumor.

CONCLUSIONS: Our study showed heterogeneity in compliance with guidelines for evaluation and effective treatment of patients with a localized testicular tumor. Some essential practices, such as assays of tumor markers and fertility preservation for patients over 40 years, were not well carried out. Adjuvant management of localized tumors appears to be an important predictor of recurrence.

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Published

2023-05-30

How to Cite

Mesnard, B., Hetet, J.-F. ., Couteau, E. ., Fosse, A. ., Bocquillon, V. ., Gignoux, A. ., Baron, M. ., Gaschignard, N. ., & Rigaud, J. . (2023). Management of testicular cancer: Practice survey in localized stage. Canadian Urological Association Journal, 17(8), E236–43. https://doi.org/10.5489/cuaj.8239

Issue

Vol. 17 No. 8 (2023): CUAJ August

Section

Original Research

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