Testicular seminoma: 20-year experience at the Northern Israel Oncology Center (1968-1988).
Eighty-four patients with testicular seminoma were treated at the Northern Israel Oncology Center during the years 1968-1988. Using the staging classification of Hussey, 69 patients (82%) had Stage I, eight (10%) had Stage IIA, four (5%) had Stage IIB, one (1%) had Stage IIIA, and two (2%) had Stage IIIB disease. Sixty-nine patients (82%) had classic pure seminoma, nine (11%) had anaplastic seminoma and six (7%) had spermatocytic seminoma. Seventy-four patients (88%) underwent high inguinal orchiectomy and ten (12%) had a scrotal approach. Seventy-five patients (85%) were treated with postoperative irradiation. Stage I patients received 26-30 Gy to the paraaortic and ipsilateral pelvic lymph nodes. Stage IIA patients were treated in the same manner with a boost to the involved lymph nodes. With a mean follow-up of 97 months, 65 patients (77%) are alive and well with no evidence of disease, 7 patients (8%) are dead due to disease progression. The 5-, 10-, 15-, and 20-year actuarial survival for all patients was 90%, and for early stage patients 94%. Eight patients (14%) relapsed; 3 of them were salvaged by chemotherapy. Serious side effects of irradiation included lethal respiratory failure due to bleomycin-induced pulmonary fibrosis in one patient, peptic ulcer in three patients, hydronephrosis due to paraureteral fibrosis in one patient and recurrent paralytic ileus in one patient. Eight patients (10%) developed nine second cancers, three of them within the previous radiation field.(ABSTRACT TRUNCATED AT 250 WORDS)
Stein
M
M
Northern Israel Oncology Center, Rambam Medical Center, Haifa.
Steiner
M
M
Moshkowitz
B
B
Sapir
D
D
Kessel
I
I
Kuten
A
A
D000328:Adult; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D009919:Orchiectomy; D011867:Radioisotope Teletherapy; D018714:Radiotherapy, Adjuvant; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D018239:Seminoma / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D013997:Time Factors
D003037:Cobalt Radioisotopes