Seminoma of the testis at Groote Schuur Hospital, 1973-1984

The clinical records of 47 patients with testicular seminoma treated between 1973 and 1984 were reviewed. The mean age was 41 years. There were relatively few blacks and patients of mixed race--4% and 17% respectively. The incidence of associated testicular maldescent was statistically significantly higher among the black and mixed-race patients (40%) than among the white patients (8%). Forty-three patients underwent retroperitoneal irradiation after orchidectomy, with a 5-year survival rate of 87% at a median follow-up of 52 months. There were no relapses at follow-up in 27 stage I patients; 1 of 8 patients with stage IIA and B (non-bulky) disease relapsed after 12 years, and relapses occurred in all 5 patients with stage IIC (bulky) seminoma. Retroperitoneal and mediastinal irradiation has controlled disease in 2 patients with stage III disease without bulky metastases. One patient with stage IV seminoma treated with irradiation relapsed. One of the patients with stage I disease has developed a major bowel complication following 3,000 cGy fractionated irradiation. Our experience with cis-platinum-based chemotherapy includes noting its effectiveness in a patient with unresectable locally advanced testicular seminoma. We recommend retroperitoneal irradiation after orchidectomy for patients with stage I and IIA/B disease and cis-platinum combination chemotherapy after orchidectomy for those with more advanced disease.