睾丸精原细胞瘤预后因素分析

An analysis of the prognosis factors in testicular seminoma

目的 :分析睾丸精原细胞瘤经综合治疗后的几个预后因素。材料与方法 :1975年 10月～ 1990年 12月间收治 133例睾丸精原细胞瘤。绝大部分病例行患侧睾丸附睾切除加精索高位结扎 ,小部分病例行腹腔探查 ,并行腹膜后淋巴结清扫。所有病人术后采用放疗 ,部分加用不规则化疗。结果 :5年生存率分别为 期 92 .6 % (6 5 / 70 )、 期 5 2 .6 % (10 / 19)、 期 2 5 % (4/ 16 )、 期 2 2 .2 % (2 / 9)。术后放疗剂量以 2 0～ 30 Gy者预后最好 ,5年生存率为 80 .0 % ,与 <2 0和 >30 Gy比较 (P<0 .0 5 )。结论 :术后放疗的时机应在 1个月之内。年龄、术后是否加用化疗、60 Co与加速器放疗 。

Purpose:To analyze the prognostic factors of testicular seminoma.Materials and Methods:133 patients with testicular seminoma histologically proved were treated from October, 1975 to December,1990. Most of them were firstly treated with orchiectomy and minority were treated with orchiectomy plus lymphadenectomy in abdomen cavity. All patients were treated with postoperative radiotherapy and a little part of them were combined with irregular chemotherapy. Results: The overall 5-year survival rates were:92.5(65/70) for stage Ⅰ, 52.6(10/19) for stageⅡ, 25%(4/16) for stage Ⅲ and 22.2%(2/9) for stage Ⅳ. Patients received radiation dose of 20～30Gy gave a five year survival rate of 80% which was much better than those who received radiation dose <20Gy or >30Gy(P<0.05). Conclusion: Radiotherapy is advised with the interval of less than one month after operation with a dose of 20～30Gy. Patient's age ,adjuvant chemotherapy and radiation source 60 Co or high energy X-ray) does not influence the prognosis.