The Safe Surgical Margin for the Testis Sparing Surgery in Testicular Cancer

Abstract

Background: Testis sparing surgery (TSS) has an important role in preserving the functional capacity of testicular cancer (TC). Germ cell  neoplasia in situ (GCNIS) lesions in the remaining testis have a significant risk for local recurrence.

Aim: We aimed to evaluate the  presence of satellite GCNIS lesions around the primary tumor and to measure the distance of the furthest  GCNIS lesion to the primary tumor.

Subject and Methods: The radical orchiectomy specimens of patients (n = 37)  with a tumor size of ≤3 cm were reevaluated by the same pathologist. The satellite GCNIS lesions located around the primary tumor were  detected, and the furthest GCNIS lesion distance to the primary tumor was measured under light microscopy.

Results: The mean  tumor size was 1,9 ± 0,6 cm. The mean furthest GCNIS distance to the primary tumor was 5,08 ± 2,77 mm. A total of 19  (51,4%) patients had the furthest GCNIS lesions <5 mm, and 28 (75,6%) patients had the furthest GCNIS lesions <7 mm away from the  primary lesion. 

Conclusions: Leaving a 5 mm safety margin during TSS would lead to excise the satellite GCNIS lesions in half of the  patients. Increasing the safety margin to 7 mm would lead to excise the satellite GCNIS lesions at 75% of the patients.