[Fertility after treatment for testicular tumor].
Thirty-four patients with stage 1 or stage 2A testicular tumor all survived 5 years after the treatment, whereas eighteen patients with stage 2B or 3 testicular tumor, including only nonseminomatous tumor, had a 5-year survival rate of less than 50%. Spermatogenesis returned to normal in 3 patients surviving 22 months after chemotherapy. Five patients who had undergone retroperitoneal lymph node dissection with division of the inferior mesenteric artery developed impaired ejaculation, whereas 3 patients who had undergone the operation without division of the inferior mesenteric artery had normal ejaculation. In 17 patients with right testicular tumor metastases were found in the para-aortic, paracaval and interaortocaval lymph nodes. On the other hand, in 4 patients with left testicular tumor metastases were limited to the para-aortic nodes. These results indicate that impaired spermatogenesis by conventional chemotherapy is reversible in patients with stage 1 or 2 testicular tumor, and patients with stage 1 tumor or stage 2 tumor with localized para-aortic metastases, not involving the inferior mesenteric artery, should undergo retroperitoneal lymph node dissection without division of the inferior mesenteric artery to preserve postoperative fertility.
Department of Urology, Shinshu University School of Medicine.
T
T
Okaneya
Y
Y
Kurizaki
K
K
Iwata
T
T
Tsuruta
M
M
Niwakawa
Y
Y
Murata
T
T
Nakagawa
A
A
Ogawa
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004407:Dysgerminoma / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D004542:Ejaculation; D005298:Fertility; D006801:Humans; D007223:Infant; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D013091:Spermatogenesis; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy
D000970:Antineoplastic Agents