Surgery for Undescended Testes and Risk for Testicular Cancer: Age Matters

Orchiopexy in the first few years of life means less risk for testicular cancer.
At 1 year of age, about 1% of boys have undescended testes (cryptorchidism). Most experts recommend that orchiopexy should be performed before the age of 2 years because some research has suggested a link between testicular cancer and older age at surgery.
Swedish investigators identified 16,983 men in a national registry who had received a diagnosis of cryptorchidism from 1964 through 1999 and who had undergone orchiopexy before age 20 (mean age at surgery, 8.6 years). During a mean follow-up of 12.4 years, 56 men developed testicular cancer. Compared with risk in the general population, the risk for testicular cancer among those who underwent surgery before age 13 was increased (relative risk, 2.2); this twofold increased risk was noted for patients treated at all ages before 13. Among those who underwent surgery after age 13, the risk increased significantly (RR, 5.4).
Comment: These data clearly support the current recommendation that orchiopexy for undescended testis should be performed during the first few years of life.
— Howard Bauchner, MD
Published in Journal Watch Pediatrics and Adolescent Medicine May 9, 2007
Pettersson A et al. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 2007 May 3; 356:1835-41.