治疗小儿睾丸卵黄囊瘤25年的临床回顾

目的 回顾２５年治疗小儿睾丸卵黄囊瘤的疗效，以探讨睾丸卵黄囊瘤的合理治疗方案。方法 ４３例小儿睾丸卵黄囊瘤均施和根治性高位精索睾丸切除术。２７例同时或分期施行腹膜后淋巴结清扫术。１７例甲胎蛋白（ＡＦＰ）升高。随访３２例，存活２９例，其中淋巴结清扫１６例，未清扫１３例。结果 腹膜后洒巴结清扫组存活率与未清扫组差异无显著性意义，术前ＡＦＰ阳性的存活率与ＡＦＰ阴性者也差异无显著性意义。结论 对Ⅰ期小儿睾

Retrospective review of testical yolk sac tumors during 25 years' period

Objective To discuss a proper treatment protocol for testicle yolk sac tumors. Methods The outcomes of 43 children with testicle Yolk sac tumors of the past 25 years were reviewed. All cases were underwent radical high level spermatectomy and orchiectomy, and 27 of them were performed on retroperitoneal lymphadenectomy simultaneously or in stage. The AFP was increased in 16 cases. The follow up results showed that 29 were still alive. There were no difference among patients with retroperitoneal lymphadenectomy or without. Conclusions Patients with testicle yolk sac tumors in stage I needn't retroperitoneal lymphadenectomy. It is indicated in cases with a sustained elevation of AFP, and confirmation of retroperitoneal lymph node metastasis by ultrasound or CT. For chemotherapy, AD protocol is used in stage 1 of yolk sac tumors, and PVB protocol is adopted in stage II or stage III.