Therapy in Stage I Non-Seminomatous Testicular Tumor

Weißbach, L.; Ea, Boedefeld; W, Oberdörster; Vahlensieck, W

doi:10.1159/000463502

Cited by 15 publications

(6 citation statements)

References 29 publications

(34 reference statements)

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“…The morbidity of this invasive investigation, in this case the frequency of 'dry ejaculation', should be minimal. Other authors have also found that unilateral RLND leads to preserva tion of ejaculation in 80-100% of the patients [19,20,23], However, not all investigators [19,20] have ob served a difference between patients with right-sided and left-sided RLND as in the present study: none of our patients undergoing right-sided unilateral RLND had 'dry ejaculation'.…”

Section: Discussioncontrasting

confidence: 59%

“…Nevertheless, the authors feel that the presented findings may represent the basis for future treatment policy in patients with NSGT in CSI, where limited RLND is applied more often. tumor-free patients and/or nerve-sparing techniques are used [19][20][21][22][23]. RLND in patients in CSI is predominantly a diagnostic procedure, identifying the tumor-free pa tients who do not need further treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Distribution of Retroperitoneal Lymph Node Metastases in Patients with Non-Seminomatous Testicular Cancer in Clinical Stage I

Fosså

Ous²,

Stenwig³

et al. 1990

Eur Urol

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Distribution of Retroperitoneal Lymph Node Metastases in Patients with Non-Seminomatous Testicular Cancer in Clinical Stage I

Fosså

Ous²,

Stenwig³

et al. 1990

Eur Urol

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“…Since this procedure included resection of the sympathetic ganglia from T12 to L3 and of a number of preganglionic nerves responsible for ejaculation, ejaculatory disorders frequently developed [7-91. The introduction of the PVB combination chemotherapy and the wait-and-see approach adopted since 1981 for patients with a stage 1 tumor put an end to "prophylactic" RLND [ 101. To prevent ejaculatory problems, homolateral lymph node dissection or lymph node dissection leaving the hypogastric plexus intact has been advocated [11][12][13]. In patients with bulky disease, however, anatomical boundaries are more often than not difficult to recognize.…”

Section: Discussionmentioning

confidence: 99%

Sexual function after surgery and combination chemotherapy in men with disseminated nonseminomatous testicular cancer

Nijman¹,

Koops²,

Oldhoff³

et al. 1988

Journal of Surgical Oncology

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Between 1978 and 1982 the sexual functions of 54 patients with a nonseminomatous testicular tumor stage II or III were assessed before and after treatment with surgery and combination chemotherapy. Two years after completing therapy 54% of the patients experienced sexual functional disorders. Greatly reduced or absent antegrade ejaculation was reported by 26 patients; 18 of them had been treated with more or less extensive retroperitoneal lymph node dissection, whereas 8 had not. This means that the chemotherapy might be responsible for ejaculatory disorders in 30% of the patients. Only two patients reported a change in the quality of erection; seven patients experienced a decidedly diminished libido, and five patients noticed their orgasm had changed in a negative sense. The appearance of the contralateral testis changed in 21 patients, who showed "atrophy" of this testis. The findings of this study indicate that sexual and ejaculatory disorders in particular are quite common in men treated for a disseminated nonseminomatous testicular tumor. Many of these disorders seem to be owing to causes other than surgical intervention.

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“…Today most patients with early nonseminoma undergo retroperitoneal surgery for staging to define the patients in PSI and early PSII 137-391. Without adjuvant chemotherapy 10-15% of the patients with PSI and about 50% of the patients with PSII develop distant metastases during follow-up, most often beyond the retroperitoneal space [40][41][42]. The majority of these patients can be cured by cisplatin-containing Chemotherapy if the relapse is diagnosed at an early stage.…”

Section: Early Nonseminomamentioning

confidence: 99%

Testicular cancer in young norwegians

Fosså

Aass

Kaalhus

1988

Journal of Surgical Oncology

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The clinical experience is reviewed in 597 Norwegian testicular cancer patients (age range: 15-45 years) treated from 1979 to 1986. During this period, computer tomography, determination of serum AFP/HCG, and cisplatin-based chemotherapy represented the modern diagnostic and therapeutic modalities. Before orchiectomy 67% of the patients had elevated AFP/HCG. An abnormal postorchiectomy serum tumour marker decrease and the presence of small vessel infiltration in the histological sections of the primary tumour significantly predicted microscopic retroperitoneal metastases in patients with clinical stage I (CSI) nonseminoma. One-third of these patients had a pathological stage II (PSII). After radiotherapy 99% of 90 seminoma patients (CSI/IIa) survived for 5 years. After cisplatin-based chemotherapy (+radiotherapy/surgery) the 5-year survival rate in 25 patients with advanced seminoma was 81%. The survival rate in 148 nonseminoma patients PSI/IIa was 100% and 87% in 94 patients with advanced nonseminoma (greater than or equal to CSIIb). Nausea, general exhaustion, myelosuppression, peripheral neuropathy, and Raynaud-like phenomena were the main acute treatment-related side effects. Slight gastrointestinal problems, slight peripheral neuropathy, Raynaud-like phenomena, and fertility disturbances were frequent late side effects. The sexual life in testicular cancer patients did not seem to be significantly impaired as compared to the normal population. Most of the patients reported no or only slight emotional problems during and after treatment. The need of thorough information at the time of diagnosis was stressed by most of them. Secondary cancer was diagnosed in 27 of 795 patients (1970-1982) (Testicular: 15; pulmonary: 4; sarcoma: 2; others: 6). Testicular cancer is today a curable malignancy. Future clinical research has to concentrate on the identification of high-risk and low-risk patients, the avoidance of overtreatment, and the reduction of toxicity (especially of long-term side effects).

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Therapy in Stage I Non-Seminomatous Testicular Tumor

Cited by 15 publications

References 29 publications

Distribution of Retroperitoneal Lymph Node Metastases in Patients with Non-Seminomatous Testicular Cancer in Clinical Stage I

Distribution of Retroperitoneal Lymph Node Metastases in Patients with Non-Seminomatous Testicular Cancer in Clinical Stage I

Sexual function after surgery and combination chemotherapy in men with disseminated nonseminomatous testicular cancer

Testicular cancer in young norwegians

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