Radiation therapy in malignant testis tumors.Part I: Seminoma; Part II: Carcinoma

Abstract

Specific treatment of malignant germ cell tumors of the testis following inguinal orchiectomy is predicated on histologic type and stage of involvement. A review of 839 patients treated at Walter Reed General Hospital has shown a 60% overall 10‐year survival. With seminomas, treatment by orchiectomy and irradiation to lymphatic drainage pathways can result in cure rates of 90‐95%. The proper treatment of testicular carcinoma is far from settled. The mainstay of such treatment in the U.S. has been retroperitoneal lymphadenectomy followed by irradiation for positive nodes. However, it is still not clear whether irradiation might not be equal or superior to lymphadenectomy in early disease. Bilateral lymphadenectomy has shown no advantage over unilateral lymphadenectomy with positive metastases when postoperative irradiation has been administered. Preoperative irradiation and lymphadenectomy show promise for testicular carcinoma, but investigation along such lines is limited thus far to small numbers of cases and a relatively short duration of followups. Prospective national studies for testis carcinoma are clearly needed.

The biological and clinical significance of HCG-containing cells in seminoma

“…This figure is within the range of published data based on morphological appearances or HCG production. Since, as shown in Table II (Javadpour et al, 1978;Hedinger et al, 1979;Mostofi, 1980;Bosman et al, 1980 (Dixon & Moore, 1952;Wilson & Woodhead, 1972;Maier & Sulak, 1973 (Cochran et al, 1975;Bartsch et al, 1979;Javadpour, 1980Javadpour, , 1983 but there is still no concensus as to its prognostic significance. Lange et al (1980) suggest that this finding in association with metastatic seminoma is a poor prognostic sign and indicates the use of chemotherapy.…”

Anaplastic Variant of Classical Seminoma of the Testis: Northern Israel Oncology Center Experience and Brief Review of Literature

“…They concluded that the treatment decision in AS patients should be based on stage and generally accepted adverse factors like size, lympho-vascular invasion, and rete testis involvement. Cockburn et al3 came to the same decision (25 patients), as did Maier and Sulak6 (39 patients).…”

“…While Kademian et al4 and Mostofi and Price5 demonstrated an aggressive clinical pattern, other authors6,7 demonstrated no difference in clinical behavior between AS and CS and suggested that treatment should be the same, stage for stage. There are very few studies and limited information about AS in recent years.…”

Le traitement du cancer du testicule

“…On avait depuis longtemps montré la radiosensibilité du séminome [12]. La radiothérapie a été intégrée à cette époque dans le traitement des stades II de TGNS associée au curage lomboaortique, principalement au Walter Reed Army Hospital [13]. Curieusement, la dernière étude de radiothérapie dans le cadre des TGNS, d'ailleurs randomisée, date de 1991 [14].…”