Pizzocaro G, Pasi M, Zanoni F, Salvioni R, Milani A, Pilotti S
Eur Urol. 1985;11(2):79-82. doi: 10.1159/000472460.
A retrospective analysis of patients with pathologic stage I nonseminomatous germinal testis tumors treated with orchidectomy and retroperitoneal lymphadenectomy was done in an attempt to define the relapse pattern and to eventually identify risk factors predisposing to tumor recurrence. Of 102 patients, 91 (89.2%) remain disease free with a median follow-up of greater than 5 years (range 3-10 years), and 11 (10.8%) suffered relapse 3-35 months after lymphadenectomy (median free interval 6 months). 9 of 11 patients developed primarily intrathoracic recurrences. The tumor was so rapidly progressing at relapse, that it was diagnosed when clinically advanced in 7 of 11 cases. Nevertheless, 8 of 11 patients were salvaged with effective available chemotherapy and resection of residual disease. Only scrotal violation showed a significant increased risk of tumor recurrence (5 of 24 cases, versus 6 of 78 who had inguinal orchidectomy, p less than 0.05). We recommend a very close follow-up for all patients with pathologically assessed stage I nonseminomatous germinal testis tumors during the first 3 years following orchidectomy and retroperitoneal lymphadenectomy. With early recognition of relapse, an approximately 100% cure rate will be achieved with effective available chemotherapy.
对接受睾丸切除术和腹膜后淋巴结清扫术治疗的病理分期为I期非精原性生精细胞瘤患者进行了回顾性分析，以确定复发模式并最终确定易导致肿瘤复发的危险因素。在102例患者中，91例（89.2%）在中位随访时间超过5年（范围3 - 10年）后仍无疾病，11例（10.8%）在淋巴结清扫术后3 - 35个月复发（中位无病间隔6个月）。11例患者中有9例主要发生胸腔内复发。肿瘤在复发时进展迅速，11例中有7例在临床晚期时才被诊断出来。尽管如此，11例患者中有8例通过有效的现有化疗和残留病灶切除术得以挽救。仅阴囊侵犯显示肿瘤复发风险显著增加（24例中有5例，而腹股沟睾丸切除术的78例中有6例，p < 0.05）。我们建议对所有经病理评估为I期非精原性生精细胞瘤的患者在睾丸切除术和腹膜后淋巴结清扫术后的前3年进行密切随访。通过早期识别复发，采用有效的现有化疗可实现约100%的治愈率。
