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The Pattern of Spread and Treatment of Metastases in Testicular Seminoma
Author(s) -
PECKHAM M. J.,
HENDRY W. F.,
CALMAN F. M. B.
Publication year - 1979
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1979.tb02852.x
Subject(s) - seminoma , medicine , testicular cancer , oncology , cancer , chemotherapy
Summary— The results of treatment of 199 patients referred to the Royal Marsden Hospital with testicular seminoma from 1963 to 1975 are described. Of 190 previously untreated patients 16 (8.4%) have died of seminoma, 3 (1.5%) of teratoma and 9 (4.9%) of intercurrent disease. Of 121 Stage I patients the only death was due to a second testicular tumour. In Stage II (54 patients) there was a significant association between length of history before orchiectomy and volume of abdominal node metastases. This was not, however, prognostically significant. Death from seminoma occurred in 6 out of 38 patients (15.8%) with nodal metastases > 5 cm in diameter and 3 out of 16 patients (18.7%) with metastases > 5 cm in diameter; 2 of 8 Stage III patients died of seminoma. Thus radiation controlled nodal metastases in more than 80% of Stage I, II and III patients. In Stage IV patients and patients referred with disease relapse, 12 out of 16 patients died of seminoma. Chemotherapy experience is briefly reviewed. Cyclophosphamide as a single agent has produced a 50% response rate. There is no evidence to suggest a radiation‐related increase in mortality from the group of long‐term tumour‐free survivors.