Khader J, Salem A, Abuodeh Y, Almousa A, Farah N, Abdelrahman F
Jamal Khader, MD, Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania Alabdulla Street, Amman, Jordan, Tel. +962788305344, Fax: +96265857323, Email:
Gulf J Oncolog. 2013 Jul;1(14):20-7.
The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a developing country with special reference to patients with history of surgical violation of the scrotum and the potential predictors of disease relapse.
Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan) between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months).
At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients were burdened by relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4cm upon pathological examination. Median time to relapse was 14 months (range, 8-25 months). None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy.
Our results confirm the excellent prognosis for patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients burdened by relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum is effective in preventing local failure.
Seminoma, stage I, radiotherapy, scrotal violation, developing country, management.
本报告旨在探讨发展中国家早期精原细胞瘤患者的治疗结果，特别提及有阴囊手术侵犯史的患者以及疾病复发的潜在预测因素。
2003年至2010年间，74例纯精原细胞瘤患者在侯赛因国王癌症中心（约旦安曼）接受治疗。所有患者均接受了睾丸切除术。除3例患者外，其余均接受了辅助放疗。转诊前有阴囊手术侵犯史的患者通过进一步切除或照射阴囊瘢痕进行处理。随访时间为1至200个月（平均33个月）。
随访时，除1例患者外，其余患者均存活。整个队列的3年无复发生存率为95.9%。3例患者出现复发，所有这些患者在腹股沟睾丸切除术后均接受了辅助放疗，且病理检查时最初肿瘤均大于4cm。复发的中位时间为14个月（范围8 - 25个月）。复发前均无肿瘤标志物升高。除1例患者外，其余患者均通过化疗成功挽救。
我们的结果证实了在发展中国家，早期精原细胞瘤患者经睾丸切除术和辅助放疗后的预后良好。尽管所有复发患者在初始评估时均显示出不良病理结果，但未发现一致的复发预测因素。有阴囊手术侵犯史的患者进行阴囊瘢痕再次切除或照射可有效预防局部失败。
精原细胞瘤；I期；放疗；阴囊侵犯；发展中国家；管理
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