Peckham M J, Hendry W F
Br J Urol. 1985 Dec;57(6):763-8. doi: 10.1111/j.1464-410x.1985.tb07050.x.
Between 1977 and 1984, 92 patients with clinical Stage II non-seminomatous germ-cell testicular tumours were treated by primary chemotherapy, with surgery reserved for the excision of persisting masses. Eighty patients (87%) are alive and disease-free: 96% for Stages IIA and IIB and 74% for Stage IIC. Of 43 Stage IIA, B and C patients treated with bleomycin, etoposide and cisplatin (BEP), 40 (93%) are disease-free. For the whole group there was a significant difference between the outcome of treatment in patients with retroperitoneal masses greater than 8 cm in transverse diameter compared with those in whom masses were less than 8 cm, the disease-free rates being 54 and 97% respectively. Primary histology did not influence the outcome of treatment. However, whereas 51% of patients with teratocarcinoma had masses resected after chemotherapy, only 26% of embryonal carcinoma patients came to surgery. The results obtained in this series are as good as those obtained when lymph node dissection is employed as the initial form of treatment. The avoidance of surgery with preservation of ejaculatory function in 78% of Stage IIA and IIB patients argues in favour, of an initially non-surgical approach to management.
1977年至1984年间，92例临床II期非精原细胞性生殖细胞睾丸肿瘤患者接受了一线化疗，手术仅用于切除残留肿块。80例患者（87%）存活且无疾病：IIA期和IIB期患者为96%，IIC期患者为74%。在43例接受博来霉素、依托泊苷和顺铂（BEP）治疗的IIA、B和C期患者中，40例（93%）无疾病。对于整个组而言，横径大于8 cm的腹膜后肿块患者与肿块小于8 cm的患者相比，治疗结果存在显著差异，无病生存率分别为54%和97%。原发组织学不影响治疗结果。然而，51%的畸胎癌患者在化疗后进行了肿块切除，而只有26%的胚胎癌患者接受了手术。该系列研究所得结果与采用淋巴结清扫作为初始治疗方式时的结果相当。在IIA期和IIB期患者中，78%的患者避免了手术并保留了射精功能，这支持了最初采用非手术治疗方法的观点。
