title: Clinicopathological features predicting nodal metastasis of testicular seminoma: results from 100 cases in a single institute.
abstract: OBJECTIVE
  To investigate the clinical and pathological features which predict nodal metastasis and/or the prognosis of testicular seminoma and to evaluate the current treatment strategy in a single institute.
  
  
  METHODS
  We retrospectively analyzed 100 patients who had been pathologically diagnosed as having testicular seminoma in our institute. Ninety-one patients (91%) had stage I disease, 9 patients (9%) were stage II and none stage III. The median follow-up was 63.2 months (range 0.5-249).
  
  
  RESULTS
  The duration between the tumor recognition and the first outpatient visit ranged from 0 to 144 weeks, with a median of 5 weeks, which did not influence the clinical stage. The tumor diameter and the preoperative serum lactate dehydrogenase (LDH) level were the significant predictors of stage II disease. Following orchiectomy, 68 patients (74.7%) with stage I disease received radiotherapy. Only 1 patient who had not received adjuvant radiotherapy died from the recurrent disease. The 5-year survival was 100% for the irradiation group but 95% for the surveillance group, although the difference was not statistically significant. All the stage II patients were successfully treated with chemotherapy following orchiectomy.
  
  
  CONCLUSIONS
  The maximum tumor diameter and the preoperative serum LDH level were the significant predictors of nodal metastasis. Adjuvant radiotherapy in patients with stage I seminoma did not influence the survival. Systemic chemotherapy promised good survival for the seminoma, even with nodal metastasis, in this series. Our results support the good prognosis of testicular seminoma with the current treatment strategy.
authors.affiliation: Department of Urology, School of Medicine, Keio University, Tokyo, Japan. zenpaku@ndmc.ac.jp
authors.forename: Akinori
authors.initials: A
authors.lastname: Sato
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohigashi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
authors.forename: Jun
authors.initials: J
authors.lastname: Nakashima
authors.forename: Ken
authors.initials: K
authors.lastname: Marumo
authors.forename: Masaru
authors.initials: M
authors.lastname: Murai
mesh_terms: D000328:Adult; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018239:Seminoma / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery