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題 名 | Observations after Orchiectomy in Clinical Stage Ⅰ Nonseminomatous Germ Cell Tumors of the Testis=睪丸切除術後以監視的方法追蹤臨床病期Ⅰ睪丸非精原細胞瘤 |
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作 者 | 郭俊逸; 錢大維; 謝玉林; 林登龍; 張延驊; 魏拙夫; 陳光國; 張心湜; | 書刊名 | 中華醫學雜誌 |
卷 期 | 62:6 1999.06[民88.06] |
頁 次 | 頁356-366 |
分類號 | 416.275 |
關鍵詞 | 臨床病期Ⅰ睪丸非精原細胞瘤; 睪丸; 監視; Clinical stage Ⅰ nonseminomatous germ cell tumor; Testis; Observation; |
語 文 | 英文(English) |
英文摘要 | BACKGROUND: The optimal management of clinical stage I nonseminomatous germ cell tumor (NSGCT) of the testis remains controversial. For years, retroperitoneal lymph node dissection in combination with orchiectomy, has been the standard treatment in patients with clinical stage I NSGCT. Recently, with advancement of effective cisplatin-based chemotherapy and clinical staging procedures, a new approach of observation after orchiectomy is being evaluated. We reviewed cases of orchiectomy and observation for clinical stage I NSGCT of the testis in order to evaluate the treatment outcome. METHODS: We retrospectively reviewed the records of 13 patients with clinical stage I NSGCT of the testis treated at our hospital from February, 1981 to August, 1996. The patient age at diagnosis ranged from 0.6 to 44 years. Nine patients had yolk sac tumors, and four had mixed germ cell tumors. Median follow-up was 42 months (range, 20-132 months). RESULTS: Prior to orchiectomy, serum beta-human chorionic gonadotropin and alpha-fetoprotein (AFP) were raised to abnormal concentrations in four and in 13 patients, respectively. With a median follow-up of 42 months, three of 13 patients relapsed at a median of three months after orchiectomy. Two patients showed elevated AFP and radiographically identifiable tumors simultaneously, and one patient showed elevated AFP as the only evidence of relapse. Following treatment with cisplatin- based chemotherapy, the three patients who relapsed responded successfully and the elevated AFP returned to normal. The patients are currently alive and disease free. CONCLUSIONS: Observation after orchiectomy is a reasonable approach for patients with clinical stage I NSGCT of the testis. |
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