精巣腫瘍115例の臨床的検討

Abstract

1970～1989年に経験した精巣腫瘍115例について治療成績を中心に臨床的検討を行った.1)主訴は大部分, 陰嚢内容物の無痛性腫大であったが, 有痛性のものも20%見られた.2)患側は右側56例, 左側57例, 両側2例であった.また10例で停留精巣の合併を認めた.3)年齢は平均31.7歳で, 5歳以下と21～45歳に二峰性のピークを認めた.4)病理組織学的には, 単一組織型88例(セミノーマ68例, 胎児性癌10例, 奇形腫10例), 複合組織型22例, non-germinal tumor 5例であった.5)病期分類では, stage 1 69例, 2A 25例, 2B 8例, 3A 3例, 3B1 5例, 3B2 2例, 3C 3例であった.6)治療は全例に高位精巣摘除術を施行した.放射線療法, 化学療法, 後腹膜リンパ節郭清術を行ったのはそれぞれ77例, 42例, 16例であった.7)死亡例は17例で, Kaplan-Meier法による5年生存率はセミノーマで87.9%, 非セミノーマで66.9%であった.CDDP導入による治療成績の変化に統計学的有意差は認められなかった

One hundred and fifteen cases of testicular tumors treated at our Hospital between 1970 and 1989 were analyzed. The incidence of testicular tumors was 0.44% in the male outpatient department of our urological clinic. The age of these patients ranged from 6 months to 86 years (average: 31.7 years old) with two peaks in distribution; 0 to 5 and 21 to 45 years. Most of their chief complaints (77%) were painless swelling of scrotal contents. Location of the tumors included 56 in the right, 57 in the left and 2 on both sides. Histologically, there were 68 cases of seminoma, 10 cases each of embryonal carcinoma and teratoma, 22 cases of mixed type, 3 cases of malignant lymphoma and 2 cases of others. Stage of tumor was stage I in 69 cases, IIA in 25 cases, IIB in 8 cases and III in 13 cases. High orchiectomy was performed on all the patients. Radiotherapy, chemotherapy and retroperitoneal lymph node dissection were respectively done in 77, 42 and 16 cases. Seventeen patients died, and the 5-year survival rate calculated by the Kaplan-Meier method was 87.9% in seminoma and 68.9% in non-seminoma. The survival rate for the patients treated by chemotherapy including CDDP after 1983 was compared to those treated by other therapy before 1982. Between the two groups there was no significant difference.