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KMID : 0857020050200010101
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Kosin Medical Journal
2005 Volume.20 No. 1 p.101 ~ p.109
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Testis Tumor; Analysis of Rik Factors and Survival Rate;Experience of 12 years
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Kim In-Keun
Rhew Hyun-Yul
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Abstract
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Backgroud: This study reviewed clinical characteristics and prognostic factors in testicular germ cell turmor in adults.
Materials and Methods: This investigation reviewed the records of 22 patients with testicular germ cell tumors managed at Kosin Hospital between July 1990 and June 2002. Patients were followed regularly to determine clinical outcome with tumor markers, chest X-ray and abdominal CT. mean follow-up was 5.65 years ranging from 5 months to 158 months.
Results: Painless testicular enlargements (91%) was the most common presenting symptom and histry of cryptorchidism was noted in 1 patient. Among 11 seminoma patients, 5 were stage Ⅰ, 5 were stage Ⅱ, and Ⅰ was Ⅲ, and among 11 nonseminomatous germ cell tumor (NSGCT) patients, 2 were stage Ⅰ, 6 were stage Ⅱ, 2 were stage Ⅲ and Ⅰ was Ⅳ, of the 5 patients with stange Ⅰ seminoma, there was no recurrance who recived retroperitoneal low dose radiation therapy after orchiectomy. And one patient had elevated level of serum β-hCG at initial presentation, but no relapse. Among 5 patients with stage Ⅰ and Ⅱ NSGCT under surveillance after radical orchiectomy, serum AFP or HCG elevations were observed in 1 seminoma and 4 NSGCT (2 mixed cell tumors and 2 yolk sac tumors), and one patient expired for brain metastasis despite of salvage chemotherapy. Five stage Ⅰ seminoma patients were treated radiotherapis and stage Ⅱ, Ⅲ, Ⅳ patients treated BEP (bleomycin and etoposide and cispatin) chemotherapies. One choricaricinoma patient expried in 5 months. The overall survival rate in total 22 patients was 86.4% at the median follow up of 5.65 years.
Conclusions: In this study, we had only 22 cases of testicular tumor, but could follow-up them up to 12 years. Most patients showed excellent survival, and it was not related with initial pathologic presentations or the clinical stage. So the authors suggest the need for further investigation about the new therapeutic modalities of more potent and less toxic.
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KEYWORD
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Testis tumor, Germ cell tumor, Survival rate, Risk factor
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