Lymphadenectomy and radiation therapy in malignant tumors of the testicle other than pure seminoma

✍ Scribed by Joseph R. Castro

• Publisher: John Wiley and Sons
• Year: 1969
• Tongue: English
• Weight: 355 KB
• Volume: 24
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(196907)24:1<87::aid-cncr2820240112>3.0.co;2-3

✦ Synopsis

The treatment techniques and results in a group of 127 patients with malignant tumors of the testicle, other than pure seminoma, seen from 1946 to 1964 at the M. D. Anderson Hospital and Tumor Institute at Houston are discussed. An 82% 3-year NED rate has been obtained in Stage I disease whether lymphadenectomy or radical radiotherapy alone followed orchiectomy. In a small group of patients with Stage I1 disease, a 57% 3-year NED rate has been obtained by utilizing lymphadenectomy and radiation therapy. Local control and survival rates appear markedly improved by adding radiotherapy to lymphadenectomy when lymph nodes are positive in the surgical specimen. Failures appear to be due to distant metastases; supporting evidence for prophylactic irradiation of the mediastinum and supraclavicular area was not found. URING THE PERIOD OF 1946 TO 1964 IN-D clusive, 218 patients with malignant testicular tumors received all, or a significant part, of their treatment at the M. D. Anderson Hospital and Tumor Institute at Hous- ton. Of this number, there were 127 cases of histology other than pure seminoma with greater than 3-year follow-up, all in the carcinoma or teratoma histologic Groups I1 through V according to the Dixon-Moore classification* which is as follows:

Group I: seminoma, pure; Group 11: embryonal carcinoma, pure or with seminoma; Group 111: teratoma, pure or with seminoma; Group IV: teratoma with either embryonal carcinoma, choricarcinoma, or both, and with or without seminoma; and Group V: choriocarcinoma, pure or with either seminoma or embryonal carcinoma, or both.

All pathological material was reviewed by the Department of Pathology.

Of these patients, 37 were treated by radical orchiectomy and paraaortic lymphadenectomy alone, 22 patients were treated by radical orchiectomy, paraaortic lymphadenec-Supported in part by US. Public Health Service Research Grants CA-06294 and CA-05654.