精巣腫瘍78例の臨床的検討

Abstract

74例の胚細胞腫瘍のうち, 47例がセミノーマ, 27例が非セミノーマであった。4例の非胚細胞腫瘍があった。セミノーマでは非セミノーマに対して高齢発生, 低ステージであった。病期1では経過観察した1歳の卵黄嚢腫瘍の1例が再発したが, 化学療法にて救命可能であった。病期2では初回に照射療法を施行した3例のセミノーマ, および非セミノーマで再発が認められた。1例のみ救命可能であった。病期3では1例が再発, 5例が初回治療より抵抗性を示した。前例死亡した

Seventy eight patients with testicular tumor were treated in our hospital between 1982 and 1992. Of 78 patients, 74 had germinal cell tumor (seminoma in 47 patients and non-seminoma in 27), and the other 4 had 3 malignant lymphoma and 1 rhabdomyosarcoma. Ages ranged from 1 to 67 years with the average of 36.1. The age of the patients with seminoma was significantly higher than that of patients with non-seminoma. Most patients complained of painless swelling of the scrotal content, but some patients complained of testicular pain, fever, and so on. Those who complained of such symptoms had significantly worse prognosis than those who had only painless scrotal swelling. Patients with non-seminoma visited us about 4.9 months after the onset of their symptoms and 12.1 months in seminoma. Clinical stages were more progressive in non-seminoma than in seminoma. Inguinal orchiectomy was performed followed by irradiation, chemotherapy, retroperitoneal lymph node dissection or thoracotomy. Recurrence developed in 6 patients and the other 7 patients died of progressive disease within 2 years from the first attendance. The 2-year survival rate calculated by the Kaplan-Meier method was 81 and 70% in seminoma and non-seminoma, respectively, and 100, 88, 63, 75, and 22% in stage I, IIA, IIB, IIIO and IIIA, B, C, respectively.