Suzuki K, Orikasa S, Hoshi S, Yoshikawa K, Saito S, Ohyama C, Sato M, Kawamura S, Numahata K, Ito A, Tokuyama S
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Int J Urol. 1999 Jun;6(6):305-13. doi: 10.1046/j.1442-2042.1999.00062.x.
After chemotherapy for metastatic testicular tumors, masses may remain, often in the metastatic sites. This study analyses the role of resections for the residual masses.
Seventy-seven patients with advanced (stage II, III) testicular tumors were treated. Of these, 38 patients, including eight with seminoma and 30 patients with non-seminomatous germ cell tumors, underwent resection of residual masses after chemotherapy and have been followed for a median of 41.5 months (range 2-138) after the resection.
Residual masses were necrosis/fibrosis in 19 patients, mature teratoma in 11 and cancer in eight. The ratio of cancer in stage III (41.2%) was significantly higher than that in stage II (4.8%). Ten of 38 (26.3%) patients experienced recurrences in sites other than the resected sites, and five of 10 patients have died of cancer. Most recurrences (80%) occurred within two years. Recurrences after resection were detected in 4.8% of stage II patients, 52.9% of stage III, 16.7% of necrosis/fibrosis and mature teratoma, and 62.5% of cancer. The survival rate of patients with cancer was significantly lower in spite of adjuvant chemotherapy after surgery.
Resection for residual masses after chemotherapy in metastatic testicular tumors was useful in confirming the tissue and in controlling the metastatic sites. Recurrences were often found in patients with cancer in the residual mass and the prognosis of patients with cancer was poor, therefore the development of more effective therapy for patients with cancer is required to improve the prognosis.
转移性睾丸肿瘤化疗后，肿块可能残留，且常位于转移部位。本研究分析了对残留肿块进行切除的作用。
对77例晚期（II期、III期）睾丸肿瘤患者进行了治疗。其中，38例患者，包括8例精原细胞瘤患者和30例非精原细胞性生殖细胞肿瘤患者，在化疗后接受了残留肿块切除术，并在切除术后接受了中位时间为41.5个月（范围2 - 138个月）的随访。
残留肿块为坏死/纤维化的有19例，成熟畸胎瘤11例，癌8例。III期患者中癌的比例（41.2%）显著高于II期患者（4.8%）。38例患者中有10例（26.3%）在切除部位以外的部位复发，其中5例患者死于癌症。大多数复发（80%）发生在两年内。II期患者切除术后复发率为4.8%，III期为52.9%，坏死/纤维化和成熟畸胎瘤为16.7%，癌为62.5%。尽管术后进行了辅助化疗，但癌症患者的生存率仍显著较低。
转移性睾丸肿瘤化疗后对残留肿块进行切除有助于明确组织情况并控制转移部位。残留肿块为癌的患者常出现复发，且癌症患者预后较差，因此需要开发更有效的治疗方法来改善癌症患者的预后。
