小児睾丸腫瘍の治療成績 : 主として胎児性癌について

概要

論文の詳細を見る
The statistics and therapy of testicular tumors, especially embryonal carcinoma, in children are reported with a comprehensive review from literatures. I. Statistical study 1. A total of 93 cases of testicular tumors were treated in our hospital from January 1964 to December 1973, of which 20 cases (21.5%) occurred in childhood. 2. The testicular tumors in our series consisted of 16 embryonal carcinomas, 2 mature teratomas, 1 myxosarcoma and 1 malignant lymphoma. The age distribution was less than 3 years and 4 months in germinal cell tumors, but 2 nongerminal cell tumors were seen at 6 and 9 years. The time interval between tumor detection and orchiectomy was less than 6 months, except one case of mature teratoma operated after 1 year and 10 months. They were all estimated to be in stage I by abdominal palpation, IVP or lymphography and chest X-ray. 3. Fifteen out of 16 cases of embryonal carcinoma are alive and well more than I year with an observed 5-year-survival rate of 92.3%. 4. Four cases of teratomas and nongerminal cell tumors are alive and well more than 8 years after the orchiectomy with or without post-operative irradiation to the retroperitoneal lymph nodes. II. Treatment and results of 16 cases of embryonal carcinoma 1 . Three cases receiving orchiectomy alone are living well more than 10 years. In one case, the recurrent residual spermatic cord was extirpated and irradiated at the age of 3. 2. Seven cases received orchiectomy and irradiation, six of which are alive and well more than 3 years. One case died of retroperitoneal lymph nodes metastasis 18 months later in spite of the prophylactic irradiation of 2,900 rad/25 fractions/48 days. 3. Two cases operated on for orchiectomy with retroperitoneal lymph nodes dissection and irradiation are alive and well more than 6 years. 4. Four cases received orchiectomy and dissection, 3 of which are alive and well more than I year. One case, developing 2 pulmonary metastatic lesions 6 months later, was cured by irradiation with bleomycin and alive well under the control of anticancer drugs for 2 years. 5. All lymph nodes disseced were found histologically negative in 6 cases. 6. No growth retardation of body length and weight was observed due to the prophylactic irradiation to retroperitoneal lymph nodes. Lameness was seen in one case 4 years after the irradiation to the metastatic lesions of spermatic cord at the left coxal region. III. Treatment planning according to stage 1 . Early histological diagnosis and accurate staging are important for treatment planning. Lymphogram or direct transperitoneal palpation of the retroperitoneal lymph nodes at orchiectomy are recommended. 2. High orchiectomy should be performed in all patients. 3. Orchiectomy alone might be enough in controlling children in stage I less than 2-year-old. For boys in stage I more than 2-year-old, the prophylactic irradiation of 3,000-4,000 rad/4-5 weeks to the retroperitoneal lymph nodes might be necessary. 4. For the cases in stage II, dissection of lymph nodes should be performed with or without postoperative irradiation and chemotherapy. IV. Other finding The activities of serum lactic dehydrogenase changed in parallel with growth or regression of tumor size. Values of LDH in cases of favorable course ranged between 300 and 600 units.
社団法人日本泌尿器科学会の論文
1975-07-20

小児睾丸腫瘍の治療成績 : 主として胎児性癌について

スポンサーリンク

概要

著者

関連論文

スポンサーリンク