Carcinoma of the testis

Abstract

Patients with Stage I or II malignant testis germ cell tumors underwent a randomized prospective study at Walter Reed Hospital, Washington, D.C., from 1968 to 1973. Pure cell lines of seminoma or choriocarcinoma were excluded. Forty patients had inguinal orchiectomy followed by irradiation to the inguinal, iliac, lumbar para-aortic, mediastinal and supraclavicular lymph nodes. Thirty-four patients (85%) in this group are alive and free of tumor a minimum of 3 years. Fifty-one patients received pre- and postoperative irradiation to primary lymphatic pathways in association with bilateral retroperitoneal lymphadenectomy as well as elective irradiation to the mediastinum and supraclavicular regions. Forty-six patients (90%) in this second group are alive and free of tumor a minimum of three years. Both treatment methods represent marked improvement in cure rates compared to lymphadenectomy and postoperative irradiation utilized prior to 1968, but no statistically significant difference from each other.

Second Cancers Among 40 576 Testicular Cancer Patients: Focus on Long-term Survivors

“…Standard management of testicular cancer includes orchiectomy, with adjuvant regional radiotherapy or retroperitoneal lymph node dissection used for early-stage seminomas or nonseminomatous germ cell tumors, respectively ( 16 ) . When adjuvant radiotherapy was given in the past, infradiaphragmatic fi elds included para-aortic and pelvic lymph node areas, with larger doses (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) given to treat nonseminomatous germ cell tumors than to treat seminomas (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) ( 17 , 18 ) . More recently, fi elds limited to the para-aortic lymph nodes have been used to treat seminomas, and radiation doses have been reduced to 20 Gy ( 10 , 11 , 19 ) .…”

Testicular Cancer: Risk Factors and the Role of Adjuvant Chemotherapy

“…The cytotoxic antibiotics were extensively 51 mostly in previously treated patients. Hematologic toxicity is moderate, but it is ototoxic and nephrotoxic.…”