精巣腫瘍109例の臨床的検討

Abstract

1970～1994年に経験した精巣腫瘍109例について臨床的検討を行った. 1)組織分類では, 単一組織型75例, 複合組織型31例, 非胚細胞腫瘍3例であった. 2)セミノーマに比べて, 非セミノーマは進行度が高い傾向にあり, 特に絨毛癌, 未熟奇形腫は初診時high stageが多かった. 3)セミノーマ例, 非セミノーマ例ともhCG陽性群の5年生存率は悪かったが, 有意差はなかった.又, 非セミノーマ例では, AFP陽性例の5年生存率は陰性例に比べ有意に悪かった.これはAFP陽性例にhigh stageが多い為であった. 4)予後(5年生存率)は1981年以降の症例(89.4%)は1980年以前の症例(69.9%)に比較して有意に良かった

One hundred and nine patients with testicular tumors were treated in our hospital between 1970 and 1994. The patients ranged in age from 4 months to 73 years with an average of 35.3 years. The most frequent chief complaint was painless swelling of the scrotal contents. Of 106 germinal tumors, 61 cases were of pure seminomas, and the other 45 cases contained non-seminomatous elements. The remaining 3 cases were non-germinal tumors; 2 malignant lymphomas and one rhabdomyosarcoma. Clinical staging classified them into 80 cases of stage I, 21 cases of stage II, and 8 cases of stage III. The five-year survival rate calculated by the Kaplan-Meier method was 79.6% in total, and 85.0, 91.7, 66.7 and 50.0% in stage I, IIA, IIB, and III, respectively. A comparison with the 5-year survival rate before 1980 (69.9%) when computed tomographic (CT) equipment and chemotherapy including cisplatin were introduced in our hospital, showed significant improvement after 1981 (89.4%).