The management of testicular seminoma: Edinburgh 1970-1981.

One hundred and fifty two patients with seminoma of the testis presenting to a regional centre between 1970 and 1981 have been reviewed. One hundred and forty three of these patients were treated primarily with radiotherapy. The actuarial survival of all 152 patients was 84.4% at 5 years and 83.3% at 10 years. The following factors significantly influenced survival: clinical stage; T-stage of the primary tumour; date of first treatment. Patients treated after 1979 had a better prognosis than patients treated before 1973. A group of patients with an actuarial survival of 100% at 5 years could be identified: they were in clinical stage I after lymphography and had T1 primary tumours. We could find no clear relationship between tumour size, duration of symptoms and clinical stage at presentation. We conclude that radiation therapy still has an important role to play in the management of seminoma of the testis. We recommend prophylactic retroperitoneal irradiation for patients in clinical stage I, primary treatment with radiotherapy for patients in clinical stages IIA and IIB, and primary treatment with chemotherapy for patients in clinical stages IIC, III and IV.