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Management of testicular tumors- SGPGIMS experience

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Author(s): Singh Vishwajeet | Srivastava Aneesh | Srivastava Avinash | Kumar Anant | Kapoor Rakesh | Mandhani Anil

Journal: Indian Journal of Urology
ISSN 0970-1591

Volume: 20;
Issue: 2;
Start page: 160;
Date: 2004;
Original page

Keywords: Germ cell | multimodality | radiotherapy | chemotherapy.

ABSTRACT
Objectives : To assess the single centre experience of multimodality treatment approaches and overall outcome in testicular tumor patients. Methods : In a retrospective study, records of 70 pa-tients were analysed. Seminoma was present in 21 cases, non seminomatous germ cell tumour (NSGCT) in 48 pa-tients and Leydig cell tumor in 1 patient. The clinical stag-ing in seminoma of the testis were stage I in 6 cases, stage IIA in 4 cases, the stage JIB in 2 cases, stage HC in 2 cases and stage III in 7 cases. In the NSGCT group stage I tumor was present in 3 cases, stage IIA in I case, stage IIB in 4 cases, stage IIC in 4 cases and stage III in 36 cases. Adjuvant radiotherapy to retroperitoneum was given in stage I and IIA of seminoma. Primary retroperitoneal lympho node dissection (RPLND) was done in 4 cases of NSGCT and biopsy of lymph nodes was positive for ma-lignant cells in one case. Cisplatinum based chemotherapy was given in stage IIB, JIC and stage III of seminoma and NSGCT Secondary RPLND was done in 2 cases and ex-cision of postchemotherapy residual masses in 14 cases. Results : The patients of stage I NSGCT tumors had recurrence free mean follow-up of 9 years while 1 case of stage IIA was disease free at 1 year of follow-up. All cases of stage IIA, IIB,IIC seminoma and NSGCT patients were alive and doing well on follow-up. In advanced and meta-static tumors, 75% of seminoma and 60% of NSGCT pa-tients were alive and disease free with mean follow-up period of 5 years and 4 years respectively. Conclusions: Excellent prognosis was seen in early stages of testicular germ cell tumors. Advanced and metastatic seminoma showed good prognosis whereas only 60% of such NSGCT are disease free and alive on long-term follow-up.
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