Orchidopexy for congenital cryptorchidism in childhood and adolescence and testicular cancer in adults: an updated systematic review and meta-analysis of observational studies.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies (cohort and case-control)
PubMed 36988678 · doi:10.1007/s00431-023-04947-9
What was done
The authors conducted a systematic review and meta-analysis according to PRISMA guidelines to determine the risk of testicular cancer in adults with a history of orchidopexy for congenital cryptorchidism before adulthood. PubMed and Scopus were searched from inception through February 2023. Included studies were evaluated using the Newcastle-Ottawa Scale (NOS), and pooled odds ratios (OR) were calculated using a random-effects model.
What was found
Six observational studies (3 case-control, 3 cohort) involving 371,681 patients and 1,786 testicular cancer cases were included. The pooled OR for testicular cancer after orchidopexy was 3.99 (95% CI: 2.80–5.71) with moderate heterogeneity (I² = 51%). The mean NOS quality score across all studies was 8/9.
Why it matters
This meta-analysis updates the quantified risk of adult testicular cancer in patients surgically treated for congenital cryptorchidism, confirming a nearly fourfold increased risk persists into adulthood despite early surgical correction.
Limits
The review included only 6 observational studies, inheriting the inherent confounding and bias risks of cohort and case-control designs. Moderate statistical heterogeneity (I² = 51%) was present. Specific subgroup numerical estimates regarding timing of surgery or contralateral testicular risk were not provided in the abstract.
Cited by
- supports Cryptorchidism (undescended testicles) is associated with increased risks of male infertility and testicular cancer.