Clinical characteristics, prognosis and treatment for pelvic cryptorchid seminoma
Elsevier Science, 1997
Online
academicJournal
Zugriff:
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 ChineseAcademy of Medical Sciences, Beijing. They presented with a lower abdominal mass and showed a predominancefor the right side. A high proportion of patients with PCS [ 26 of 60 (43% )] had metastatic disease, compared to20% 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 60patients, 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 furthertreated with radiotherapy, chemotherapy, or a combination of both. Patients with Stage I and II disease receivedradiotherapy, 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 lo-year survivals were 100% for Stage I, 94% and 87% for Stage II, and 56% and 42%for Stage III/IV, respectively @ < 0.05). Volume of irradiation, i.e., whole abdominal-pelvic radiotherapy ( 10patients), versus hockey-stick encompassing paraaortic, ipsilateral iliac nodes and the primary tumor or tumorbed (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 anddied.Conclusion: Stage I and II PCS can he 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 theparaaortic, ipsilateral iliac nodes and primary tumor or tumor bed. We recommend platinum-based chemotherapyfor Stage IIB-IV PCS. 0 1997 Elsevier Science Inc.
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Clinical characteristics, prognosis and treatment for pelvic cryptorchid seminoma
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Autor/in / Beteiligte Person: | Li ; COUCKE, Philippe ; Qian ; Huang, Yi-Rong ; Gu, Da-Zhong ; Mirimanoff, René-Olivier ; Yu, Zi-Hao |
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Veröffentlichung: | Elsevier Science, 1997 |
Medientyp: | academicJournal |
DOI: | 10.1016/S0360-3016(97)00052-7 |
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