Auld R B
Can Fam Physician. 1985 Jun;31:1281-4.
Testis cancer is most commonly discovered because of painless testicular enlargement. Careful examination remains the best non-invasive diagnostic procedure. Accurate definition of pathological type and clinical stage determines management and defines prognosis. Surgical removal of the testis by an inguinal incision after spermatic cord occlusion is mandatory, and scrotal needling or biopsy must be avoided. Seminomas are the most common. When confined to the testis or when spread is limited to a few small retroperitoneal nodes, cure rates of 90% or more are produced by orchiectomy and radiation. Non-seminomatous germinal tumors should be staged surgically using retroperitoneal lymphadenectomy if clinical staging implies minimal tumor spread. Where tumor spread is found, aggressive chemotherapy produces a cure rate of greater than 95%. For advanced disease, chemotherapy is the primary treatment post-orchiectomy.
睾丸癌最常因无痛性睾丸肿大而被发现。仔细检查仍然是最佳的非侵入性诊断方法。准确界定病理类型和临床分期决定治疗方案并明确预后。在精索闭塞后经腹股沟切口手术切除睾丸是必要的，必须避免阴囊穿刺或活检。精原细胞瘤最为常见。当局限于睾丸或扩散仅限于少数小的腹膜后淋巴结时，睾丸切除术和放疗的治愈率可达90%或更高。如果临床分期提示肿瘤扩散极小，非精原性生殖细胞瘤应通过腹膜后淋巴结清扫术进行手术分期。若发现肿瘤扩散，积极化疗的治愈率大于95%。对于晚期疾病，化疗是睾丸切除术后的主要治疗方法。
