Guideline of guidelines: management of small testicular masses
Bibliographic record
Abstract
OBJECTIVE: To compare and summarise the most up to date international guidelines and major recommendations for the management of small testicular masses (STMs). METHODS: A systematic search was conducted in PubMed, EMBASE, Scopus, Google Scholar, and the Cochrane Library up to 1 November 2024. The latest editions of five international guidelines were included in the review: the European Association of Urology 2025; the National Comprehensive Cancer Network 2024; the American Urological Association 2023; the Canadian Urological Association 2022; and the European Society for Medical Oncology 2018. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was applied by two authors (M.T. and G.F.) to assess the quality of these guidelines. RESULTS: Emerging evidence supports testis-sparing surgery (TSS) as a viable option for managing STMs, showing acceptable oncological outcomes and preservation of gonadal function in select patients. The shared indications for TSS include indeterminate STMs identified on ultrasonography with negative tumour markers, particularly in the case of a solitary testis or of bilateral tumours. Where intra-operative frozen section analysis is available, and confirms a benign lesion, a radical orchidectomy could be avoided. CONCLUSION: Consensus across guidelines favours TSS in suitable cases, balancing oncological control with functional outcomes and informed patient decisions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.075 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.006 |
| Bibliometrics | 0.011 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.006 | 0.003 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.006 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".