Pilichowska Małgorzata, Pęczkowski Piotr, Rosińska-Okrasa Dorota, Trzaska Barbara, Skowrońska-Gardas Anna, Demkow Tomasz
Urooncology Department, Maria Skłodowska-Curie, Memorial Cancer Hospital, Warsaw, Poland.
Contemp Oncol (Pozn). 2012;16(2):104-7. doi: 10.5114/wo.2012.28788. Epub 2012 May 29.
To review management and outcomes in patients with stage I seminoma after orchidectomy.
Between 1979 and 2004 a total 292 patients with stage I seminoma were treated with adjuvant chemotherapy or radiotherapy or were placed on surveillance. Median age at diagnosis was 36 years (range 20-69), with median follow-up 76.5 months (range 11-294). Of the patients, 200 (68.5%) were treated with adjuvant chemotherapy, 72 (24.6%) were irradiated and 20 (6.8%) were placed on surveillance.
The probability of 5-year overall survival and relapse-free survival for the entire group was 100% and 95.1% respectively. The 5-year relapse-free survival for adjuvant chemotherapy was 97.2%, for radiotherapy 94.6%, and 31.4% for the surveillance group. Of 24 (8.4%) patients who had relapse in lymph nodes and/or internal organs, 14/20 patients were in the surveillance group. All patients who had a relapse were salvaged successfully with chemotherapy. The toxicity of chemotherapy and radiotherapy was acceptable. No severe reactions were observed.
Our results confirm the excellent prognosis for patients with stage I seminoma after orchidectomy treated with adjuvant chemotherapy or radiotherapy. The high rate of relapse in our surveillance group suggests the necessity of adjuvant treatment.
回顾睾丸切除术后I期精原细胞瘤患者的治疗及预后情况。
1979年至2004年间，共有292例I期精原细胞瘤患者接受辅助化疗、放疗或接受观察。诊断时的中位年龄为36岁（范围20 - 69岁），中位随访时间为76.5个月（范围11 - 294个月）。其中，200例（68.5%）接受辅助化疗，72例（24.6%）接受放疗，20例（6.8%）接受观察。
整个组的5年总生存率和无复发生存率分别为100%和95.1%。辅助化疗的5年无复发生存率为97.2%，放疗为94.6%，观察组为31.4%。在24例（8.4%）出现淋巴结和/或内脏复发的患者中，20例中的14例在观察组。所有复发患者均通过化疗成功挽救。化疗和放疗的毒性是可接受的。未观察到严重反应。
我们的结果证实了睾丸切除术后接受辅助化疗或放疗的I期精原细胞瘤患者预后良好。我们观察组的高复发率表明辅助治疗的必要性。
