Kawai T, Sakuramoto T, Kihara K
Hinyokika Kiyo. 1984 May;30(5):627-37.
The outcome of clinical therapy of adult nonseminomatous testis tumor presenting with negative human chorionic gonadotropin (hCG) at our hospital is reported. Of 45 nonseminoma, 28 cases showed negative hCG and they had no chorionic element. Embryonal carcinoma was found in 14 cases (50%), teratoma in 5 cases (17.9%), and teratomatous mixed tumor in 9 cases (32.1%). The 5 year actuarial survivals were 94% for stage I disease, 40% for stage II and 16.6% for stage III. Prophylactic irradiation was given to the patient with stage I disease and no relapse occurred in the irradiated area, but later, neoplasms had spread by vascular dissemination in 3 cases (17.6%). In the treatment of stage II disease, radiotherapy has proved unsatisfactory and retroperitoneal lymph nodes dissection was a choice of modality. Of 11 patients with lung metastasis including vascular dissemination from stage II and III disease, 3 cases (27.3%) were cured by localized radiotherapy and chemotherapy of the pre-VAB regimen era.
本文报告了我院成人非精原细胞瘤性睾丸肿瘤患者血清人绒毛膜促性腺激素(hCG)阴性时的临床治疗结果。45例非精原细胞瘤患者中,28例hCG阴性,无绒毛膜成分。其中14例(50%)为胚胎癌,5例(17.9%)为畸胎瘤,9例(32.1%)为畸胎瘤混合瘤。Ⅰ期患者5年实际生存率为94%,Ⅱ期为40%,Ⅲ期为16.6%。Ⅰ期患者接受了预防性放疗,放疗区域未出现复发,但后来有3例(17.6%)肿瘤通过血行转移。在Ⅱ期疾病的治疗中,放疗效果不理想,腹膜后淋巴结清扫是一种治疗方式。在11例包括Ⅱ期和Ⅲ期疾病血行转移至肺部的患者中,3例(27.3%)在VAB方案化疗前通过局部放疗和化疗治愈。