Opot E N, Magoha G A
Department of Surgery, College of Health Sciences, University of Nairobi.
East Afr Med J. 2000 Feb;77(2):80-5. doi: 10.4314/eamj.v77i2.46402.
To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital.
Retrospective case study of testicular cancer patients over a fifteen year period.
Kenyatta National Hospital, a referral and teaching hospital.
All histologically confirmed testicular cancer patients recorded at the Histopathology Department of Kenyatta National Hospital between 1983 and 1997.
The mean age was 34.8 years with a peak incidence in the 30-44 year age group. History of cryptochirdism was obtained in 10.26% of the patients. Thirty one patients (79.49%) presented with painless testicular swellings, eleven (28.08%) with pain, nine (23.08%) with scrotal heaviness, six (15.38%) with abdominal swellings and one (2.56%) each with gynaecomastia and eye swelling. On examination 32 patients (82.05%) had testicular masses, ten (25.64%) had abdominal masses, seven (17.91%) had supraclavicular and cervical lymphadenopathy, and one each (2.56%) had gynaecomastia and eye mass respectively. More than eighty nine per cent had germ cell cancers with seminoma accounting for 67.35%, teratoma 12.24%, embroyonal carcinoma 8.16%, rhabdomyosarcoma 6.12% and malignant germ cell tumour, orchioblastoma and dysgerminoma each accounted for 2.04%. Three patients (7.7%) had orchidectomy and radiotherapy and chemotherapy, sixteen (41.03%) had orchidectomy and radiotherapy, six (15.38%) had orchidectomy and chemotherapy, ten (25.64%) had radiotherapy and chemotherapy, three (7.7%) and two (5.13%) had only chemotherapy and radiotherapy respectively. No cisplastin based chemotherapy regime was used. Follow up was effected for eighteen patients (46.15%) and seven patients (38.89%) were alive after five years.
Prognosis with current regimes was poor with survival of only 38.89% after five years. Cisplastin based chemotherapy with up to 90% cure rates should be included as a component of testicular cancer management at Kenyatta National Hospital.
确定肯雅塔国家医院睾丸癌的患病率、临床特征、治疗方法及预后。
对15年间睾丸癌患者进行回顾性病例研究。
肯雅塔国家医院，一家转诊和教学医院。
1983年至1997年间在肯雅塔国家医院组织病理学部门记录的所有经组织学确诊的睾丸癌患者。
平均年龄为34.8岁，发病高峰在30 - 44岁年龄组。10.26%的患者有隐睾病史。31例患者（79.49%）表现为无痛性睾丸肿大，11例（28.08%）有疼痛，9例（23.08%）有阴囊沉重感，6例（15.38%）有腹部肿块，1例（2.56%）有男子女性型乳房和眼部肿胀。检查发现32例患者（82.05%）有睾丸肿块，10例（25.64%）有腹部肿块，7例（17.91%）有锁骨上和颈部淋巴结病，各有1例（2.56%）分别有男子女性型乳房和眼部肿块。超过89%为生殖细胞癌，其中精原细胞瘤占67.35%，畸胎瘤占12.24%，胚胎癌占8.16%，横纹肌肉瘤占6.12%，恶性生殖细胞瘤、成睾细胞瘤和无性细胞瘤各占2.04%。3例患者（7.7%）接受了睾丸切除术及放疗和化疗，16例（41.03%）接受了睾丸切除术及放疗，6例（15.38%）接受了睾丸切除术及化疗，10例（25.64%）接受了放疗和化疗，3例（7.7%）和2例（5.13%）分别仅接受了化疗和放疗。未使用基于顺铂的化疗方案。对18例患者（46.15%）进行了随访，5年后7例患者（38.89%）存活。
目前治疗方案的预后较差，5年后生存率仅为38.89%。基于顺铂的化疗治愈率高达90%，应纳入肯雅塔国家医院睾丸癌治疗方案。
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