[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.
Okaneya
T
T
Department of Urology, Shinshu University School of Medicine.
Kurizaki
Y
Y
Iwata
K
K
Tsuruta
T
T
Niwakawa
M
M
Murata
Y
Y
Nakagawa
T
T
Ogawa
A
A
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