Belvis Esclapés V, Merenciano Cortina F, Gassó Matoses M, Sánchez Marcos M, Torrús Tendero P, Fernández García J, Mira Llinares A
Servicio de Urología, Hospital de S.V.S. Alicante.
Actas Urol Esp. 1993 Jan;17(1):40-6.
This article reports our case series of testicle germinal cell tumours, consisting of 14 cases, between 1974-1991. 42.85% (6 cases) were seminomas, 4 (66.6%) in Stage I. There was one case (16.6%) in Stage III and another one in Stage IV. 14.29% (2 cases) were embryonic carcinomas, one in Stage I and one in Stage II. Teratomas represented 14.29% (2 cases), in Stages I and IV respectively. There were 4 cases of mixed tumours (2 cases) in which teratomatous components (3 out of 4) were predominant. 50% were in Stage I and 50% in Stage III. Inguinal orchiectomy was performed in all cases, and three received radiotherapy (seminomas in Stages I (2 cases) and III), with survival ranging from 1 to 7 years. Two cases (seminoma and embryonic carcinoma) received chemotherapy under different regimes depending on the time of diagnosis. One patient has survived 11 years following rescue lymphadenectomy while the other one died 14 months later from pulmonary metastasis. Among the mixed tumours, 50% (2 cases in Stages II and III) died 5 and 11 months afterwards without further treatment due to overall affectation at diagnosis. An abstentionist approach in Stage I (seminomas and non-seminomas), which was "strictly" applied in 5 cases showing disease-free survival ranging from 1 to 5 years, is defended. Follow-up was not feasible in 2 cases (14.2%). Both the diagnostic means and a review of treatment by Stages, reflecting the evolution of chemotherapy and the results obtained, are analyzed. Also the most widely accepted approaches in the management of these tumours.
本文报告了我们在1974年至1991年间收治的14例睾丸生殖细胞肿瘤病例系列。其中精原细胞瘤占42.85%(6例),I期4例(占66.6%)。III期1例(占16.6%),IV期1例。胚胎癌占14.29%(2例),分别为I期1例和II期1例。畸胎瘤占14.29%(2例),分别为I期和IV期。有4例混合性肿瘤(2例),其中畸胎瘤成分(4例中的3例)占主导。50%为I期,50%为III期。所有病例均行腹股沟睾丸切除术,3例接受放疗(I期(2例)和III期精原细胞瘤),生存时间为1至7年。2例(精原细胞瘤和胚胎癌)根据诊断时间接受不同方案的化疗。1例患者在挽救性淋巴结清扫术后存活了11年,另1例在14个月后死于肺转移。在混合性肿瘤中,50%(II期和III期各2例)因诊断时全身受累未进一步治疗,分别于5个月和11个月后死亡。对于I期(精原细胞瘤和非精原细胞瘤)采取保守治疗方法,在5例严格采用该方法的患者中,无病生存时间为1至5年。2例(占14.2%)无法进行随访。分析了诊断方法以及按分期回顾治疗情况,反映了化疗的进展和取得的结果。还分析了这些肿瘤治疗中最广泛接受的方法。