Article (Scientific journals)
Clinical characteristics, prognosis and treatment for pelvic cryptorchid seminoma
Li; COUCKE, Philippe; Qian et al.
1997In International Journal of Radiation, Oncology, Biology, Physics, 38 (2), p. 351-357
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Keywords :
seminoma; cryptorchidism; radiotherapy
Abstract :
[en] Purpose: To analyze the clinical characteristics, prognosis, and treatment outcome of pelvic cryptorchid seminoma (PCS), and to determine whether whole abdominal-pelvic irradiation for Stage I disease is necessary. Methods and Materials: From 1958 to 1991,60 patients with PCS were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing. They presented with a lower abdominal mass and showed a predominance for the right side. A high proportion of patients with PCS [ 26 of 60 (43% )] had metastatic disease, compared to 20% of those with scrotal seminoma, and there was a tendency toward a higher frequency of pelvic nodal metastases. There were 34 Stage I, 6 Stage IIA, 11 Stage IIB, 5 Stage III, and 4 Stage IV patients. Of these 60 patients, 56 underwent laparotomy with or without cryptorchiectomy (37 radical orchiectomy, 7 partial orchiectomy, and 12 biopsy of the primary or cervical node), and 4 cervical node biopsy only. All patients were further treated with radiotherapy, chemotherapy, or a combination of both. Patients with Stage I and II disease received radiotherapy, whereas patients with Stage III and IV were treated with chemotherapy. Results: The overall and disease-free survivals at 5 and 10 years were 92% and 87%, and 88% and 84%, respectively. The 5- and lo-year survivals were 100% for Stage I, 94% and 87% for Stage II, and 56% and 42% for Stage III/IV, respectively @ < 0.05). Volume of irradiation, i.e., whole abdominal-pelvic radiotherapy ( 10 patients), versus hockey-stick encompassing paraaortic, ipsilateral iliac nodes and the primary tumor or tumor bed (17) did not influence outcome in Stage I patients. Five patients relapsed within 2-12 years after treatment, and four of these patients were successfully salvaged. Four patients developed a second malignant tumor and died. Conclusion: Stage I and II PCS can he adequately controlled by radiotherapy regardless of the surgical procedure. Whole abdominal-pelvic irradiation for Stage I and IIA disease is not required, and fields can be limited to the paraaortic, ipsilateral iliac nodes and primary tumor or tumor bed. We recommend platinum-based chemotherapy for Stage IIB-IV PCS. 0 1997 Elsevier Science Inc.
Disciplines :
Oncology
Hematology
Author, co-author :
Li
COUCKE, Philippe  ;  Centre Hospitalier Universitaire Vaudois (CHUV) > Radiothérapie
Qian
Huang, Yi-Rong;  Chinese Academy of Medical Sciences > Radiation Oncology > Beijing, P.R. China
Gu, Da-Zhong;  Chinese Academy of Medical Sciences > Radiation Oncology > Beijing, P.R. China
Mirimanoff, René-Olivier;  Centre Hospitalier Universitaire Vaudois (CHUV) > Radiation Oncology > Lausanne, Switzerland
Yu, Zi-Hao;  Chinese Academy of Medical Sciences > Radiation Oncology > Beijing, P.R. China
Language :
English
Title :
Clinical characteristics, prognosis and treatment for pelvic cryptorchid seminoma
Publication date :
1997
Journal title :
International Journal of Radiation, Oncology, Biology, Physics
ISSN :
0360-3016
eISSN :
1879-355X
Publisher :
Elsevier Science, Tarrytown, United States - New York
Volume :
38
Issue :
2
Pages :
351-357
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 15 July 2009

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