Assuntos
Bleomicina/administração & dosagem , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Hidroxiureia/administração & dosagem , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/cirurgia , Esquema de Medicação , Quimioterapia Combinada , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Pessoa de Meia-Idade , Esvaziamento Cervical , Estadiamento de Neoplasias , Projetos Piloto , Radiografia , Dosagem RadioterapêuticaRESUMO
Over a 28 year period, 77 patients with early stage anaplastic seminoma of the testis were treated by orchiectomy and lymphatic irradiation at three Army medical centers. With a median follow-up of 97 months, the 10 year actuarial survival is 96% of Stage I patients and 87% for Stage II patients. For patients with Stage I anaplastic seminoma no survival advantage can be demonstrated for adding mediastinal and supraclavicular irradiation versus para-aortic and pelvic irradiation alone. The addition of retroperitoneal lymphadenectomy to lymphatic irradiation increased the frequency of major gastrointestinal complications without significantly improving survival. Patients with anaplastic seminoma and elevated serum beta-subunit human chorionic gonadotrophin levels have a poor prognosis and should be considered for adjuvant combination chemotherapy. Anaplastic seminoma of the testis has a similar clinical presentation, response to therapy and prognosis compared to typical seminoma and should be managed in the same way.
