Halme A, Kellokumpu-Lehtinen P, Lehtonen T
Department of Surgery, Deaconess Institute Hospital, Helsinki, Finland.
Acta Oncol. 1989;28(6):777-83. doi: 10.3109/02841868909092307.
A nationwide series of 422 patients with testicular germ cell cancer diagnosed in Finland in 1972-1983 was analysed. The age-adjusted incidence rate, although very low (1.6 per 10(5) male population per year), has increased compared to that in previous decades. The 3-year survival rate has improved markedly and was during the last part of the period high in patients with local (stage I) and regional (stages IIA-B) disease (100% for seminoma and over 90% for non-seminoma patients) but still fairly poor in advanced stages (stages IIC-IV) (58% for seminoma and 26% for non-seminoma patients). The improvement of the survival rate was most marked in non-seminoma patients below the median age (28.5 years). Cisplatin based chemotherapy was one of the major reasons for the improved prognosis, not only in non-seminoma patients but also in those with seminoma. There was no trend with time concerning the stage distribution of the disease. On the basis of relapse rates in stage I non-seminoma and seminoma patients staged surgically and clinically respectively, accuracy of clinical staging but not of surgical staging seemed to have improved. During the early period surgically staged stage I-II non-seminoma patients had a slightly better prognosis than clinical stage I-II patients but a similar difference was not observed during the cisplatin era.
对1972年至1983年在芬兰诊断出的422例睾丸生殖细胞癌患者进行了一项全国性分析。年龄调整发病率虽非常低（每年每10万男性人口中1.6例），但与前几十年相比有所上升。3年生存率有显著提高，在该时期后期，局部（I期）和区域（IIA - B期）疾病患者的生存率较高（精原细胞瘤患者为100%，非精原细胞瘤患者超过90%），但晚期（IIC - IV期）患者的生存率仍相当低（精原细胞瘤患者为58%，非精原细胞瘤患者为26%）。生存率的提高在年龄中位数（28.5岁）以下的非精原细胞瘤患者中最为显著。以顺铂为基础的化疗是预后改善的主要原因之一，不仅对非精原细胞瘤患者，对精原细胞瘤患者也是如此。疾病的分期分布没有随时间变化的趋势。根据分别通过手术分期和临床分期的I期非精原细胞瘤和精原细胞瘤患者的复发率，临床分期而非手术分期的准确性似乎有所提高。在早期，手术分期的I - II期非精原细胞瘤患者的预后略好于临床分期的I - II期患者，但在顺铂时代未观察到类似差异。
