Post orchiectomy management in stage II testicular seminoma.
Twenty eight patients with stage II A and twenty patients with stage II B testicular seminoma were treated at this institute between January 1982 and December 1988. The three year crude survival observed in this retrospective analysis was 82% and 75% respectively. Post orchiectomy infradiaphragmatic radiotherapy was the mainstay of the treatment. In stage II A 4 patients were administered adjuvant chemotherapy as well. Prophylactic Mediastinal Irradiation (PMI) was not employed as a routine in this subgroup. Eight patients (28%) relapsed (Mediastinal Nodes--4, Pulmonary--3, Scrotal--1). In stage II B twelve patients were treated with primary abdominal radiotherapy and of them 4 were delivered PMI as well. Induction chemotherapy was administered in remaining 8 patients. Seven patients (35%) relapsed (Pulmonary-4, Mediastinal Nodes-3). Mediastinal recurrence was noted only in those who were treated with abdominal radiotherapy alone. Though salvage chemotherapy proved successful in 5 of the seven patients (70%) with nodal relapse, none of the patients with extranodal relapse responded to subsequent chemotherapy. For stage II A we recommend abdominal radiotherapy alone and for stage II B Induction chemotherapy is advised keeping radiotherapy reserved for residual mass. We do not advocate PMI as a routine in stage II testicular seminoma as no survival benefit is observed.
Singhal
S
S
Department of Radiation Oncology, Gujarat Cancer & Research Institute, Ahlmedabad, India.
Dixit
S
S
Murthy
R R
RR
Neema
J P
JP
Vyas
R K
RK
Baboo
H A
HA
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D011182:Postoperative Care; D011379:Prognosis; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D018239:Seminoma / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D014747:Vinblastine / Q000627:therapeutic use
D001761:Bleomycin; D014747:Vinblastine; D002945:Cisplatin