[Pure testicular seminoma. Experience in treatment of 44 patients]

The records of 44 patients with pure testicular seminoma treated from 1981 to 1989 were reviewed. Twenty-one patients (48%) had stage I disease; 16 patients (36%) stage IIA; 4 patients (9%) stage IIB and 3 patients (7%) stage III. A previous history of cryptorchism was present in 7 patients (16%); testicular trauma in 9 patients (20%); orchiepididymits in 1 patient (2%) and genitourinary malformation in 1 patient (2%). Typical seminoma was observed in 43 patients (98%) and anaplastic seminoma in the remaining one (2%). There were no patients with spermatocytic seminoma. An elevated level of beta-human chorionic gonadotropin persisting after orchiectomy was found in 6 patients (14%). Syncytiotrophoblastic giant cells were identified after serial sections of the surgically resected tissue in two patients. Levels of this serum marker returned to normal values after primary treatment in all patients. Overall survival for all patients is 96% at 8 years. This corresponds to 100% for stages I, IIA and IIB and to 33% (1/3) for state III. Two patients (5%) presented recurrent disease in extralymphatic territories. Both of them were successfully rescued with proper therapy. Treatment was generally well tolerated and toxicity was mild to moderate.