Treatment results of testicular tumors retrospective study of 59 cases nemrock experience

ABSTRACT

The present study is a retrospective study of 59 patients with testicular germ cell tumors [30 cases of pure seminoma and 29 cases of non-seminoma]. The mean age for seminoma cases was 31.3 years +/- 4.46, while the mean age of non-seminoma cases was 28.5 years +/- 5.27. Testicular tumors were classified according to American Joint Committee on Cancer [AJCC], 1993. All cases were evaluated both clinically, laboratory and radiologically. All cases underwent high orchiectomy. Patients with early stage seminoma [stages I, IIa, b] 18 cases [60%] were treated postoperatively by radiotherapy to para-aortic and ipsilateral iliac lymph nodes. Combination chemotherapy was reserved for recurrent, refractory and progressive cases. Patients with bulky stage II seminoma 12 cases [40%] and all non-seminoma cases were treated by four courses of BEP. Cisplatinum 20 mg/m2 D1 Etoposide 100 mg/m2 D1 Bleomycin 30 IN i.v. push on day 2, 9, 16 every three weeks till maximum tolerable dose of bloodying is reached [300 IU]. Refractory and progressive cases were treated by second line chemotherapy in the form of Holoxan 1.2 mg/m2, D1 Mesna 400 mg/m2 h, 0, 4, 8 D1 Etoposide 75 mg/m2 D1 radiotherapy or surgery were used in cases refractory to salvage chemotherapy. In the present study the 5-year overall survival of seminoma cases was 87% for stages I-II [a,b] and 80% for stage II the 5-year overall survival of testicular non-seminoma was 75%, the 5-year DFS was 70% for early stage seminoma [I, IIa,b], 60% for stage II, bulky seminoma and 55% for testicular non-seminoma. The median time to disease progression was 26.3 months for early stage seminoma, 19.3 months for stage II seminoma and 18.3 months for testicular non-seminoma