[Good survival of Icelandic men diagnosed with testicular seminoma between 1971 and 1990 - A retrospective study.]

Testicular cancer is the most common cancer diagnosed in males aged 20 to 34 in Iceland. A retrospective population-based study was carried out on all Icelandic males diagnosed between 1971 and 1990 to evaluate presentation and survival of seminoma in Iceland. Fortyseven males with average age of 36 years (range 21-71) were included. Clinical informations were gained from the Icelandic Cancer Registry and hospital records. The staging system used was a modification of the system orginally proposed by Boden and Gibb and crude probability of survival was evaluated with the Kaplan-Meier method. Age standardized incidence for seminoma was 2.0/ 100,000 males per year for the whole period. Forty-five patients were diagnosed with symptoms where testicular swelling (98%) and pain (42%) were the most common symptoms. Two patients were diagnosed incidentally. All the patients except one underwent orchiectomy, 66% also received radiotherapy and 9% chemotherapy. Average tumor diameter was 8 cm before 1981 but 5.2 cm after 1981 (p=0.02). Most patients were diagnosed in stage I (73%), but 27% had disseminated disease at diagnosis (stage II-IV), most commonly retroperitoneal lymphnode metastases (85%). Crude five and 10 year survival was 89% and 84% respectively. Nine patients have died (August 1994) but none of seminoma. The incidence of seminoma is moderate in Iceland compared to the Nordic countries. Clinical symptoms and stage at diagnosis are similar. Survival is excellent for the group as a whole. For small localized tumors orchiectomy and surveillance seem to be an appropriate approach.