Testicular seminoma

20-year experience at the Northern Israel Oncology Center (1968-1988)

M. Stein, M. Steiner, B. Moshkowitz, D. Sapir, I. Kessel, A. Kuten

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Eighty-four patients with testicular seminoma were treated at the Northern Israel Oncology Center during the years 1968-1988. Using the staging classification of Hussey, 69 patients (82%) had Stage I, eight (10%) had Stage IIA, four (5%) had Stage IIB, one (1%) had Stage IIIA, and two (2%) had Stage IIIB disease. Sixtynine patients (82%) had classic pure seminoma, nine (11%) had anaplastic seminoma and six (7%) had spermatocytic seminoma. Seventy-four patients (88%) underwent high inguinal orchiectomy and ten (12%) had a scrotal approach. Seventy-five patients (85%) were treated with postoperative irradiation. Stage I patients received 26-30 Gy to the paraaortic and ipsilateral pelvic lymph nodes. Stage IIA patients were treated in the same manner with a boost to the involved lymph nodes. With a mean follow-up of 97 months, 65 patients (77%) are alive and well with no evidence of disease, 7 patients (8%) are dead due to disease progression. The 5-, 10-, 15-, and 20-year actuarial survival for all patients was 90%, and for early stage patients 94%. Eight patients (14%) relapsed; 3 of them were salvaged by chemotherapy. Serious side effects of irradiation included lethal respiratory failure due to bleomycin-induced pulmonary fibrosis in one patient, peptic ulcer in three patients, hydronephrosis due to paraureteral fibrosis in one patient and recurrent paralytic ileus in one patient. Eight patients (10%) developed nine second cancers, three of them within the previous radiation field. It is concluded that appropriate planning and adequate radiation dose can yield a 20-year disease-free survival rate for more than 90% of patients with early stage testicular seminoma. Accurate staging may prevent overtreatment, thus reducting long-term toxicity. Because of the risk of developing a second primary cancer, careful follow-up monitoring with a high index of suspicion for such disorders is warranted.

Original languageEnglish (US)
Pages (from-to)461-469
Number of pages9
JournalInternational Urology and Nephrology
Volume26
Issue number4
DOIs
StatePublished - Dec 1994
Externally publishedYes

Fingerprint

Seminoma
Israel
Second Primary Neoplasms
Lymph Nodes
Radiation
Intestinal Pseudo-Obstruction
Orchiectomy
Groin
Hydronephrosis
Pulmonary Fibrosis

ASJC Scopus subject areas

  • Urology
  • Nephrology
  • Geriatrics and Gerontology

Cite this

Testicular seminoma : 20-year experience at the Northern Israel Oncology Center (1968-1988). / Stein, M.; Steiner, M.; Moshkowitz, B.; Sapir, D.; Kessel, I.; Kuten, A.

In: International Urology and Nephrology, Vol. 26, No. 4, 12.1994, p. 461-469.

Research output: Contribution to journalArticle

Stein, M, Steiner, M, Moshkowitz, B, Sapir, D, Kessel, I & Kuten, A 1994, 'Testicular seminoma: 20-year experience at the Northern Israel Oncology Center (1968-1988)', International Urology and Nephrology, vol. 26, no. 4, pp. 461-469. https://doi.org/10.1007/BF02768019
Stein, M. ; Steiner, M. ; Moshkowitz, B. ; Sapir, D. ; Kessel, I. ; Kuten, A. / Testicular seminoma : 20-year experience at the Northern Israel Oncology Center (1968-1988). In: International Urology and Nephrology. 1994 ; Vol. 26, No. 4. pp. 461-469.
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