Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2003
[Testicular germ cell tumors: prognosis].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Miladi Makram, Peyromaure Michaël, Remi Julien, Beuzeboc Philippe, Debre Bernard, Zerbib Marc
Аннотация
OBJECTIVES: To assess the prognosis of germ cell tumours of the testis based on a series of 60 patients.
MATERIAL AND METHODS: The files of 60 patients consecutively operated for germ cell tumour of the testis between February 1988 and January 2002 were reviewed. Tumours were classified as 35 seminomas (S) and 25 non-seminomatous germ cell tumours (NSGCT). In the S group, 32 patients received either prophylactic (28 pT1N0M0 tumours and 2 pT2N0M0 tumours) or therapeutic (1 pN2M0 tumour) adjuvant radiotherapy. The other 3 patients received BEP chemotherapy (1 pT3N0M0 tumour and 2 pN2M0 tumours). In the NSGCT group, 15 patients received adjuvant BEP chemotherapy (1 pT1N0M0 tumour, 5 pT2N0M0 tumours, and 7 pN2-3 and/or M+ tumours). Primary lymph node dissection was not performed in any patient, but 7 patients underwent lymph node dissection for residual masses after chemotherapy.
RESULTS: The mean follow-up after orchidectomy was 85.2 months. One patient in the S group developed left supraclavicular recurrence of a pT1N0M0 tumour, requiring 3 complementary cycles of BEP. All patients were in complete remission at the end of follow-up. In the NSGCT group, there was one recurrence after secondary lymph node dissection, requiring 3 complementary cycles of BEP. Only one death (4%) occurred after 18 months. All other patients were in complete remission at the end of follow-up.
CONCLUSIONS: The mortality rate of germ cell tumour of the testis was low in this series (0% for S and 4% for NSGCT at 7 years). These results are comparable to those reported in the literature. In our experience, stage pT1N0M0 NSGCT may be suitable for close surveillance, with no adjuvant therapy. It also does not appear justified to perform primary lymph node dissection in seminomas with lymph node involvement.
MATERIAL AND METHODS: The files of 60 patients consecutively operated for germ cell tumour of the testis between February 1988 and January 2002 were reviewed. Tumours were classified as 35 seminomas (S) and 25 non-seminomatous germ cell tumours (NSGCT). In the S group, 32 patients received either prophylactic (28 pT1N0M0 tumours and 2 pT2N0M0 tumours) or therapeutic (1 pN2M0 tumour) adjuvant radiotherapy. The other 3 patients received BEP chemotherapy (1 pT3N0M0 tumour and 2 pN2M0 tumours). In the NSGCT group, 15 patients received adjuvant BEP chemotherapy (1 pT1N0M0 tumour, 5 pT2N0M0 tumours, and 7 pN2-3 and/or M+ tumours). Primary lymph node dissection was not performed in any patient, but 7 patients underwent lymph node dissection for residual masses after chemotherapy.
RESULTS: The mean follow-up after orchidectomy was 85.2 months. One patient in the S group developed left supraclavicular recurrence of a pT1N0M0 tumour, requiring 3 complementary cycles of BEP. All patients were in complete remission at the end of follow-up. In the NSGCT group, there was one recurrence after secondary lymph node dissection, requiring 3 complementary cycles of BEP. Only one death (4%) occurred after 18 months. All other patients were in complete remission at the end of follow-up.
CONCLUSIONS: The mortality rate of germ cell tumour of the testis was low in this series (0% for S and 4% for NSGCT at 7 years). These results are comparable to those reported in the literature. In our experience, stage pT1N0M0 NSGCT may be suitable for close surveillance, with no adjuvant therapy. It also does not appear justified to perform primary lymph node dissection in seminomas with lymph node involvement.