In many urological cancers there is currently more and more inclination for organ-preserving surgery but in patients with germ cell tumours (GCT), radical orchidectomy remains the gold standard. Can we somehow save the testes? This study aims to summarise published case series assessing oncological and functional outcomes after testes-sparing surgery (TSS) in GCT cases. Four clinical scenarios were illustrated with diagrams: I) unilateral TSS in single testes; II) Unilateral TSS in bilateral tumours plus orchidectomy of big tumour; III) Bilateral TSS in bilateral tumours; IV) Unilateral TSS in unilateral tumour. Adjuvant radiotherapy / chemotherapy as required was given after TSS.Of over 2000 reports, 32 reports were included with data on 285 cases (306 testicles) treated with TSS. Patients were treated with adjuvant radiotherapy after TSS showed lower local recurrence. Distant metastasis after TSS was 2%. As per current data, TSS should be considered and offered to a selected group of cases – 1) Single testicle; 2) Good patient compliance; 3) Solitary tumour less than 2cm located at lower pole; 4) Normal preoperative endocrine function; 5) Close and regular follow-up with testicular ultrasound by an experienced uro-radiologist.This article will make interesting reading to urologists, oncologists, cancer nurses, family physicians and allied health workers.
