Clinical outcomes of local and metastatic testicular sex cord-stromal tumors Journal Article

Authors: Silberstein, J. L.; Bazzi, W. M.; Vertosick, E.; Carver, B. S.; Bosl, G. J.; Feldman, D. R.; Bajorin, D. F.; Motzer, R. J.; Al-Ahmadie, H.; Reuter, V. E.; Sheinfeld, J.
Article Title: Clinical outcomes of local and metastatic testicular sex cord-stromal tumors
Abstract: Purpose We evaluated pathological variables of testicular sex cord-stromal tumors, management options and clinical outcomes. Materials and Methods We retrospectively reviewed the records of 48 patients with testicular sex cord-stromal tumors treated at Memorial Sloan-Kettering Cancer Center between 1997 and 2012. Clinical outcomes were compared based on treatment and previously described pathological factors associated with metastatic potential. Results Of the 48 patients 37 underwent surveillance without retroperitoneal lymph node dissection, including 34 with no high risk feature and 3 with 1. Median followup was 14.5 months (IQR 6.9-32.5). No patient experienced recurrence. Retroperitoneal lymph node dissection was performed in 11 patients, including 6 with clinical stage I disease and 2 or more high risk features who underwent early dissection, 2 with clinical stage IIa disease at diagnosis who underwent early dissection and 3 with clinical stage I disease and 2 or more high risk features who were observed elsewhere but referred to our institution due to retroperitoneal disease. Six patients with clinical stage I disease underwent early dissection, 4 had no evidence of disease at a median followup of 6.6 years and 2 experienced recurrence and died of disease. Neither of the 2 patients with IIa disease at diagnosis experienced relapse. All 3 patients with delayed dissection experienced relapse and 1 died of disease. Conclusions Patients with testicular sex cord-stromal tumors and 1 or no high risk feature can be safely observed without retroperitoneal lymph node dissection but longer followup is needed. Given the lack of effective alternative treatments, early retroperitoneal lymph node dissection may be beneficial in those with 2 or more high risk features, or clinical stage IIa disease. © 2014 by American Urological Association Education and Research, Inc.
Keywords: lymph node excision; risk; orchiectomy; testis; sex cord-gonadal stromal tumors
Journal Title: Journal of Urology
Volume: 192
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2014-08-01
Start Page: 415
End Page: 419
Language: English
DOI: 10.1016/j.juro.2014.01.104
PROVIDER: scopus
PUBMED: 24518791
Notes: Export Date: 1 August 2014 -- CODEN: JOURA -- Source: Scopus
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MSK Authors
  1. Dean Bajorin
    416 Bajorin
  2. Robert Motzer
    769 Motzer
  3. Darren Richard Feldman
    172 Feldman
  4. Joel Sheinfeld
    197 Sheinfeld
  5. Brett Stewart Carver
    109 Carver
  6. Victor Reuter
    922 Reuter
  7. George Bosl
    270 Bosl
  8. Wassim Mousa Bazzi
    14 Bazzi