Routine scrotal ultrasonography during the follow-up of patients with testicular cancer leads to earlier detection of asynchronous tumours and a high rate of organ preservation

Objective: To compare outcomes of patients with asynchronous tumours detected before and after the introduction of scrotal ultrasonography (SUS) during routine follow-up examinations.

Patients and methods: Since January 2001 SUS was also used during the follow-up of patients with testicular cancer. A series of 16 consecutive patients with asynchronous bilateral testicular tumours diagnosed while still complying with routine follow up investigations were identified and divided into two groups; group A was diagnosed by palpation only, before 2001, and group B was diagnosed after 2000. The groups were compared statistically for the interval between asynchronous tumours, clinical stage, tumour diameter at the time of diagnosis and rate of testis-sparing surgery.

Results: All tumours in group A were diagnosed by palpation, but only two in group B were palpable at the time of diagnosis. The mean tumour diameter was statistically significantly smaller in group B (1.2 cm) than in group A (2.68 cm); testis-sparing surgery was used in all of group B and only three patients in group A. After organ-sparing surgery all patients had normal testosterone levels. All patients after organ-sparing surgery had adjuvant scrotal radiotherapy because of germ cell tumour, and no patient had a local recurrence.

Conclusion: Our data indicate that using SUS for the remaining testicle in routine follow-up visits of patients with testicular cancer leads to the earlier detection of smaller tumours and, consequently, a higher rate of organ preservation. The maintenance of physiological endocrine function might finally result in a better quality of life.