[非精原细胞瘤性睾丸生殖细胞肿瘤的临床评估]

[Clinical evaluation of nonseminomatous testicular germ cell tumors].

作者信息

Nukui M, Nakao M, Nakagawa S, Takada H, Ebisui K, Sugimoto K, Watanabe H, Maekawa M

机构信息

Department of Urology, Kyoto Prefectural University of Medicine.

出版信息

Hinyokika Kiyo. 1991 Oct;37(10):1281-5.

PMID:1721771

Abstract

We treated 26 patients with nonseminomatous germ cell tumors (NSGCT) between January 1976 and March 1989. Histologically, 7 were embryonal carcinoma (27%), 4 were teratoma (15%), 2 were yolk sac tumor (8%), 10 were teratocarcinoma (38%) and 3 were other mixed tumors. As regards staging, 18 belonged to stage I (69%), 1 to stage II A (4%), 1 to stage IIB (4%), 1 to stage IIIA, 2 to stage III B1 (8%) and 3 to stage III B2 (12%). Patients in stage I were treated by orchidectomy with lymphadenectomy and occasionally chemotherapy before 1984, resulting in a 100% 5-year survival. However, after 1985, 5 cases in stage I were treated by orchidectomy alone according to a watch-and-see policy. Two cases among them relapsed within two years and both of them contained immature teratoma elements. Six patients with metastatic tumor were treated with PVB therapy of which response rate was 66.7%. The total 5-year survival rate of patients in stage I, II and III was 100%, 50%, 50%, respectively and that in overall cases was 84.6%.

摘要

1976年1月至1989年3月期间，我们共治疗了26例非精原细胞性生殖细胞肿瘤（NSGCT）患者。组织学检查显示，7例为胚胎癌（27%），4例为畸胎瘤（15%），2例为卵黄囊瘤（8%），10例为畸胎癌（38%），3例为其他混合性肿瘤。在分期方面，18例属于Ⅰ期（69%），1例属于ⅡA期（4%），1例属于ⅡB期（4%），1例属于ⅢA期，2例属于ⅢB1期（8%），3例属于ⅢB2期（12%）。1984年前，Ⅰ期患者接受睾丸切除术及淋巴结清扫术治疗，偶尔术前进行化疗，5年生存率为100%。然而，1985年后，根据观察等待策略，5例Ⅰ期患者仅接受了睾丸切除术。其中2例在两年内复发，且均含有未成熟畸胎瘤成分。6例转移性肿瘤患者接受了顺铂-长春新碱-博来霉素（PVB）治疗，有效率为66.7%。Ⅰ期、Ⅱ期和Ⅲ期患者的5年总生存率分别为100%、50%、50%，总体病例的5年总生存率为84.6%。