Chraibi Y, Culine S, Terrier-Lacombe M J, Kramar A, Kattan J, Droz J P
Département de médecine, institut Gustave-Roussy, Villejuif, France.
Bull Cancer. 1994 Apr;81(4):311-7.
To assess prognostic factors for extratesticular involvement in patients with testicular stage I non seminomatous germ cell tumors, we retrospectively studied the clinical and histological features of 58 patients treated at Institut Gustave-Roussy. Twenty-four patients were followed after orchiectomy alone, and 34 patients underwent an initial subsequent retroperitoneal lymphadenectomy. Nineteen patients (33%) experienced an extratesticular involvement after a mean follow-up period of 40 months. All relapses occurred during the first year of follow-up. Disease-free survival at one year was 64% and overall survival was 100%. The clinical and histological features studied were: age, AFP and HCG serum levels before orchiectomy, tumor size, TNM stage, histologic type with the corresponding percentage, venous and lymphatic involvement. The detection of metastasis at lymphadenectomy or during the follow-up after orchiectomy was the single criteria for prognostic factor research. Venous and/or lymphatic involvement as well as a high percentage of embryonal carcinoma component turned out to be the two independent significant prognostic factors which predict extratesticular involvement.
为评估睾丸I期非精原细胞瘤患者睾丸外受累的预后因素，我们回顾性研究了古斯塔夫 - 鲁西研究所治疗的58例患者的临床和组织学特征。24例患者仅接受睾丸切除术后随访，34例患者最初接受了腹膜后淋巴结清扫术。平均随访40个月后，19例患者（33%）出现睾丸外受累。所有复发均发生在随访的第一年。一年无病生存率为64%，总生存率为100%。所研究的临床和组织学特征包括：年龄、睾丸切除术前的甲胎蛋白（AFP）和人绒毛膜促性腺激素（HCG）血清水平、肿瘤大小、TNM分期、组织学类型及相应百分比、静脉和淋巴管受累情况。淋巴结清扫术时或睾丸切除术后随访期间转移的检测是预后因素研究的唯一标准。静脉和/或淋巴管受累以及胚胎癌成分的高比例被证明是预测睾丸外受累的两个独立显著预后因素。
