Grogg, Josias; Schneider, Kym; Bode, Peter Karl; Kranzbühler, Benedikt; Eberli, Daniel; Sulser, Tullio; Lorch, Anja; Beyer, Joerg; Hermanns, Thomas; Fankhauser, Christian Daniel (2020). Sertoli Cell Tumors of the Testes: Systematic Literature Review and Meta-Analysis of Outcomes in 435 Patients. The oncologist, 25(7), pp. 585-590. AlphaMed Press 10.1634/theoncologist.2019-0692
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BACKGROUND
Sertoli cell tumors (SCTs) of the testes are rare, and the literature provides only weak evidence concerning their clinical course and management. The objective of this study was to summarize evidence on SCTs' clinical presentation, clinicopathological risk factors for malignancy, treatment options, and oncological outcomes.
MATERIALS AND METHODS
Data sources included Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and Web of Science. Published case reports, case series, and cohorts were included. Data on clinicopathological variables, treatment of local or metastatic disease, site of metastasis, or survival were extracted from each study considered in this paper, and associations between clinicopathological variables and metastatic disease were analyzed. Whenever feasible, data on individual patients were collected.
RESULTS
Of the 435 patients included, only one (<1%) showed local recurrence after testis-sparing surgery (TSS). Three patients underwent adjuvant retroperitoneal lymphadenectomy. Fifty patients presented with metastases, located in the retroperitoneal lymph nodes (76%), lungs (36%), and bones (16%); median time to recurrence was 12 months. Risk factors for metastatic disease included age, tumor size, necrosis, tumor extension to the spermatic cord, angiolymphatic invasion, and mitotic index. Patients with metastases had a median life expectancy of 20 months. In six patients, metastasectomy resulted in complete remission.
CONCLUSION
Our findings suggest that few local recurrences result after TSS, and no adjuvant therapy can be regarded as a standard of care. Several risk factors are predictive of metastatic disease. Surgery leads to remission in metastatic disease, whereas systemic treatment alone does not result in long-term remission.
IMPLICATIONS FOR PRACTICE
Testicular Sertoli cell tumors usually present without metastatic disease and show low local recurrence rates after testis-sparing surgery; no adjuvant therapy option can be regarded as a standard of care. Patients with risk factors should undergo staging investigations. Those with metastatic disease have poor prognoses, and metastasectomy may be offered in selected cases.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology |
UniBE Contributor: |
Beyer, Jörg |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1549-490X |
Publisher: |
AlphaMed Press |
Language: |
English |
Submitter: |
Rebeka Gerber |
Date Deposited: |
13 Jan 2021 17:57 |
Last Modified: |
05 Dec 2022 15:43 |
Publisher DOI: |
10.1634/theoncologist.2019-0692 |
PubMed ID: |
32043680 |
Uncontrolled Keywords: |
Lymph node excision Sertoli cell tumor Sex cord-gonadal stromal tumor Testicular neoplasm |
BORIS DOI: |
10.48350/150341 |
URI: |
https://boris.unibe.ch/id/eprint/150341 |