序贯治疗Ⅱ期睾丸非精原细胞瘤26例临床疗效观察

Efficacy of Combined Treatment for 26 Cases of Testicular Nonseminomatous Germ Cell Tumors in Clinical Stage-Ⅱ

目的探讨临床Ⅱ期睾丸非精原细胞瘤系统、合理、有效的治疗方法.方法采用术前化疗+腹膜后淋巴结清扫术+术后化疗的序贯疗法治疗26例临床Ⅱ期睾丸非精原细胞瘤并观察治疗效果.结果 26例患者术前化疗后腹膜后转移淋巴结均有缩小,行腹膜后淋巴结清扫术顺利,能完整清除腹膜后淋巴组织,减少了术中出血量及术后并发症,术后随访2～11 a,平均5 a,其中2例腹膜后转移淋巴结复发,经挽救性治疗后病情好转稳定,余24例无肿瘤复发及转移.结论本序贯疗法治疗临床Ⅱ期睾丸非精原细胞瘤效果良好.早期诊断、准确的临床分期以及合理的治疗对睾丸非精原细胞瘤的预后有重要影响.

Objective To explore the systemic,rational and effective treatment of clinical stage-Ⅱ testicular nonseminomatous germ cell tumors（NSGCT）.Methods The combined treatment including preoperation chemotherapy ＋ retroperitioneal lymph node dissection（RPLND）＋ postoperation chemotherapy was used to treat 26 patients with clinical stage-Ⅱ testicular nonseminomatous germ cell tumors and the efficacies were evaluated.Results The metastatic retroperitioneal lymph nodes of 26 cases became smaller after the preoperation chemotherapy.26 cases got successful retroperitioneal lymph node dissection and reduced the amount of surgical bleeding and the postoperation camplications.All of the patients were followed up for 5 years in average after treatment,in which 2 cases had recurrences of the metastatic retroperitioneal lymph nodes,improved after salvage therapy and the others survived without tumor.Conclusions The results of combined treatment for clinical stage-Ⅱ testicular nonseminomatous germ cell tumors are very perfect.Early diagnosis,accurate clinical staging and treatment have important influence on the prognosis of NSGCT.