Clinical characteristics, prognosis, and treatment of pelvic cryptorchid seminoma.

Details

Serval ID
serval:BIB_3428899F699E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical characteristics, prognosis, and treatment of pelvic cryptorchid seminoma.
Journal
International journal of radiation oncology, biology, physics
Author(s)
Li Y.X., Coucke P.A., Qian T.N., Huang Y.R., Gu D.Z., Mirimanoff R.O., Yu Z.H.
ISSN
0360-3016
Publication state
Published
Issued date
1997
Peer-reviewed
Oui
Volume
38
Number
2
Pages
351-7
Language
english
Notes
Publication types: Journal Article - Publication Status: ppublish
Abstract
PURPOSE: To analyze the clinical characteristics, prognosis, and treatment outcome of pelvic cryptorchid seminoma (PCS), and to determine whether whole abdominal-pelvic irradiation for Stage I disease is necessary. METHODS AND MATERIALS: From 1958 to 1991, 60 patients with PCS were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing. They presented with a lower abdominal mass and showed a predominance for the right side. A high proportion of patients with PCS [26 of 60 (43%)] had metastatic disease, compared to 20% of those with scrotal seminoma, and there was a tendency toward a higher frequency of pelvic nodal metastases. There were 34 Stage I, 6 Stage IIA, 11 Stage IIB, 5 Stage III, and 4 Stage IV patients. Of these 60 patients, 56 underwent laparotomy with or without cryptorchiectomy (37 radical orchiectomy, 7 partial orchiectomy, and 12 biopsy of the primary or cervical node), and 4 cervical node biopsy only. All patients were further treated with radiotherapy, chemotherapy, or a combination of both. Patients with Stage I and II disease received radiotherapy, whereas patients with Stage III and IV were treated with chemotherapy. RESULTS: The overall and disease-free survivals at 5 and 10 years were 92% and 87%, and 88% and 84%, respectively. The 5- and 10-year survivals were 100% for Stage I, 94% and 87% for Stage II, and 56% and 42% for Stage III/IV, respectively (p < 0.05). Volume of irradiation, i.e., whole abdominal-pelvic radiotherapy (10 patients), versus hockey-stick encompassing paraaortic, ipsilateral iliac nodes and the primary tumor or tumor bed (17) did not influence outcome in Stage I patients. Five patients relapsed within 2-12 years after treatment, and four of these patients were successfully salvaged. Four patients developed a second malignant tumor and died. CONCLUSION: Stage I and II PCS can be adequately controlled by radiotherapy regardless of the surgical procedure. Whole abdominal-pelvic irradiation for Stage I and IIA disease is not required, and fields can be limited to the paraaortic, ipsilateral iliac nodes and primary tumor or tumor bed. We recommend platinum-based chemotherapy for Stage IIB-IV PCS.
Keywords
Adolescent, Adult, Aged, Cryptorchidism, Humans, Lymphatic Metastasis, Male, Middle Aged, Pelvis, Seminoma, Survival Analysis, Testicular Neoplasms
Pubmed
Web of science
Create date
24/01/2008 17:12
Last modification date
20/08/2019 13:20
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