Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn?

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Abstract

In this report, we assessed the reliability of frozen section examination of testicular masses in determining whether patients could receive surgery that would save their testicle or have surgery to remove the testicle and the mass. The results showed that the frozen section examination could greatly aid in making this decision. Background Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses. Patients and Methods From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors. Results Intraoperative FSE was conducted on 21% of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93% and 98%, respectively, for malignant tumors, and 90% and 99%, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40%) patients, including 6 of 23 monorchid patients. Conclusion FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes.

Original languageEnglish
Pages (from-to)e689-e696
JournalClinical Genitourinary Cancer
Volume15
Issue number4
DOIs
Publication statusPublished - Aug 1 2017

Fingerprint

Frozen Sections
Testis
Pathology
Sensitivity and Specificity
Neoplasms
Seminoma
Orchiectomy
Decision Making

Keywords

  • Frozen section
  • Orchiectomy
  • Small testicular masses
  • Testicle
  • Testis-sparing surgery

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

@article{23cad934124d4d3b9b76ced1adf2d23b,
title = "Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn?",
abstract = "In this report, we assessed the reliability of frozen section examination of testicular masses in determining whether patients could receive surgery that would save their testicle or have surgery to remove the testicle and the mass. The results showed that the frozen section examination could greatly aid in making this decision. Background Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses. Patients and Methods From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors. Results Intraoperative FSE was conducted on 21{\%} of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93{\%} and 98{\%}, respectively, for malignant tumors, and 90{\%} and 99{\%}, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40{\%}) patients, including 6 of 23 monorchid patients. Conclusion FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes.",
keywords = "Frozen section, Orchiectomy, Small testicular masses, Testicle, Testis-sparing surgery",
author = "Matei, {Deliu Victor} and Vartolomei, {Mihai Dorin} and Giuseppe Renne and Tringali, {Valeria Maria Lucia} and Andrea Russo and Roberto Bianchi and Gabriele Cozzi and Danilo Bottero and Gennaro Musi and Giovanni Mazzarol and Matteo Ferro and {de Cobelli}, Ottavio",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.clgc.2017.01.012",
language = "English",
volume = "15",
pages = "e689--e696",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses

T2 - What Did We Learn?

AU - Matei, Deliu Victor

AU - Vartolomei, Mihai Dorin

AU - Renne, Giuseppe

AU - Tringali, Valeria Maria Lucia

AU - Russo, Andrea

AU - Bianchi, Roberto

AU - Cozzi, Gabriele

AU - Bottero, Danilo

AU - Musi, Gennaro

AU - Mazzarol, Giovanni

AU - Ferro, Matteo

AU - de Cobelli, Ottavio

PY - 2017/8/1

Y1 - 2017/8/1

N2 - In this report, we assessed the reliability of frozen section examination of testicular masses in determining whether patients could receive surgery that would save their testicle or have surgery to remove the testicle and the mass. The results showed that the frozen section examination could greatly aid in making this decision. Background Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses. Patients and Methods From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors. Results Intraoperative FSE was conducted on 21% of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93% and 98%, respectively, for malignant tumors, and 90% and 99%, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40%) patients, including 6 of 23 monorchid patients. Conclusion FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes.

AB - In this report, we assessed the reliability of frozen section examination of testicular masses in determining whether patients could receive surgery that would save their testicle or have surgery to remove the testicle and the mass. The results showed that the frozen section examination could greatly aid in making this decision. Background Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses. Patients and Methods From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors. Results Intraoperative FSE was conducted on 21% of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93% and 98%, respectively, for malignant tumors, and 90% and 99%, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40%) patients, including 6 of 23 monorchid patients. Conclusion FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes.

KW - Frozen section

KW - Orchiectomy

KW - Small testicular masses

KW - Testicle

KW - Testis-sparing surgery

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