腹股沟隐睾精原细胞瘤和阴囊睾丸精原细胞瘤预后的比较

目的分析腹股沟隐睾精原细胞瘤的预后,提出治疗方法。方法我们回顾性分析了１９５８～１９９１年治疗的４３例患者。根据我院精原细胞瘤分期标准,Ⅰ期３３例,Ⅱ期８例,Ⅲ、Ⅳ期各１例。所有患者均经腹股沟隐睾肿瘤切除术,Ⅰ、Ⅱ期以放射治疗为主,Ⅲ及Ⅳ期各１例分别行放疗或化疗。结果全组总的５年、１０年生存率分别为９３．０％和９０．３％,相应无病生存率分别为８８．１％和８５．３％。Ⅰ期５年、１０年总生存率均为１００％,Ⅱ期为７５．０％和６０．０％。２例复发,经放疗治愈。结论本组研究结果表明,腹股沟隐睾精原细胞瘤预后较好,和阴囊睾丸精原细胞瘤相似。建议对Ⅰ期、Ⅱ期早行术后腹主动脉旁和同侧盆腔淋巴结照射。当有腹股沟淋巴结转移或原发肿瘤明显侵及腹股沟周围组织时,再行腹股沟照射。

Comparison of prognosis between inguinal cryptorchic seminoma and scrotal seminoma

OBJECTIVE: To analyse the prognosis of patients with inguinal cryptorchic seminoma. METHODS: From 1985 through 1991, 43 patients with inguinal seminoma of undescended testis were treated and the therapeutic effect retrospectively reviewed. There were 33 patients in stage I, 8 in stage II, 1 in stage III, and 1 in stage IV. All patients had inguinal orchiectomy. Patients in stage I and II were primarily treated with radiotherapy, whereas one patient in stage III and another in stage IV were treated with radiotherapy or chemotherapy. RESULTS: The 5- and 10-year overall survival was 93.0% and 90.3%, respectively. The corresponding disease-free survival was 88.1% and 85.3%, respectively. The overall 5- and 10-year survival by stage was 100% and 100% for stage I, 75.0% and 60.0% for stage II, respectively. Two patients relapsed and were successfully treated with radiotherapy. CONCLUSION: Prognosis for inguinal cryptorchic seminoma is as good as that of scrotal testicular seminoma. Postorchiectomy radiotherapy encompassing para-aortic and ipsilateral iliac nodes is effective for stage I and early stage II inguinal crytorchic seminoma. The inguinal nodes should be included in the treatment ports only when they are involved or if there is obvious involvement of surrounding tissues by the primary tumor.