Testicular seminoma: 20-year experience at the Northern Israel Oncology Center (1968–1988)

Abstract

Eighty-four patients with testicular seminoma were treated at the Northern Israel Oncology Center during the years 1968-1988. Using the staging classification of Hussey, 69 patients (82%) had Stage I, eight (10%) had Stage IIA, four (5%) had Stage IIB, one (1%) had Stage IIIA, and two (2%) had Stage IIIB disease. Sixty-nine patients (82%) had classic pure seminoma, nine (11%) had anaplastic seminoma and six (7%) had spermatocytic seminoma. Seventy-four patients (88%) underwent high inguinal orchiectomy and ten (12%) had a scrotal approach. Seventy-five patients (85%) were treated with postoperative irradiation. Stage I patients received 26-30 Gy to the paraaortic and ipsilateral pelvic lymph nodes. Stage IIA patients were treated in the same manner with a boost to the involved lymph nodes. With a mean follow-up of 97 months, 65 patients (77%) are alive and well with no evidence of disease, 7 patients (8%) are dead due to disease progression. The 5-, 10-, 15-, and 20-year actuarial survival for all patients was 90%, and for early stage patients 94%. Eight patients (14%) relapsed; 3 of them were salvaged by chemotherapy. Serious side effects of irradiation included lethal respiratory failure due to bleomycin-induced pulmonary fibrosis in one patient, peptic ulcer in three patients, hydronephrosis due to paraureteral fibrosis in one patient and recurrent paralytic ileus in one patient. Eight patients (10%) developed nine second cancers, three of them within the previous radiation field.(ABSTRACT TRUNCATED AT 250 WORDS)

Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma

“…Another important complication related to irradiation is a cardiac disease [15,22]. Gastrointestinal symptoms/peptic ulceration, impaired fertility and sexual problems are also associated with radiotherapy [23][24][25][26]. The results of M.D.…”

Radiation-induced tumors in irradiated stage I testicular seminoma: Results of a 25-year follow-up (1968–1993)

“…All patients were referred after orchiectomy and full pretreatment evaluation, including hematological and chemistry analyses, chest radiograph and bipedal lymphangiography; since 1980, tumor marker assessment (serum ␤-human choriogonadotrophin and ␣-fetoprotein) and computerized tomography of the upper/lower abdomen and lungs have become routine. Radiation techniques have been described in detail elsewhere [1].…”

“…Early testicular seminoma is a very radiosensitive tumor with survival rates of 90-98% with no apparent severe acute or late side effects [1]. Although extensive literature suggests increasing cancer induction following exposure to low-and moderate-dose radiation therapy, the real risk has been difficult to document.…”

Changing Management of Clinical Low-Stage Testicular Cancer

“…Radiation for seminoma has also been associated with peptic ulcer disease and infertility. Reported rates of peptic ulcers have ranged from 0-16% [4,39,40,41,42,43,44]. The MRC TE10 phase III study comparing para-aortic to dog-leg radiation fields collected toxicity data systematically and reported that, with a median follow-up of 4.5 years, 33 of 478 men (7%) were diagnosed with a peptic ulcer [42].…”