MANAGEMENT OF TESTICULAR SEMINOMA AT WESTMEAD HOSPITAL FROM 1980 to 87

Abstract

Testicular seminoma comprises fewer than 1% of male cancers but is a relatively common malignancy in young men. The management and outcome of 73 consecutive patients with testicular seminoma were reviewed. Median follow‐up was 51 months (range: 15–109 months). Their median age was 37 years (range: 21–67 years). There was a history of testicular maldescent in 5.5% of patients. Beta‐human chorionic gonadotropin was elevated in 22% of patients prior to orchidectomy and in 5% post‐surgery. The majority of patients had stage I (78%) or stage II (19%) seminoma after clinical staging. One patient (2%) with stage I seminoma relapsed, while two patients (14%) With stage II seminoma relapsed. The latter two were salvaged with further therapy. One of two patients treated for stage III seminoma died. A residual mass after radiotherapy was commonly observed in patients with stage II seminoma, but did not represent viable tumour. These results reflect the high cure rates that are achievable in seminoma with radiotherapy for early stage and non‐bulky abdominal disease and, more recently, with cisplatin‐based chemotherapy for bulky abdominal or disseminated disease.

Long‐term outcomes following post‐operative radiotherapy for Stage I/II testicular seminoma – an Australasian single‐institution experience

“…The excellent oncological outcomes reported in our study are consistent with those reported in the international [16][17][18] and Australian literature ( Table 3). [19][20][21][22][23] There is a worldwide trend towards decreased utilisation of PORT for Stage I seminoma. Data from the US National Cancer Database showed that the utilisation of PORT for Stage I seminoma dropped from 71% in 2000 to 47% in 2008, with a corresponding rise in the proportion of patients being put on surveillance from 30% in 2000 to 40% in 2008.…”

“…More than half of the patients (59%) had radiation to the PA plus ipsilateral common iliac lymph nodes (the classic [20][21][22][23][24][25][26][27][28]. There was no acute adverse reaction requiring hospital admission following radiation treatment.…”