[Clinical management of testicular tumors]

Testicular tumor is a rare diseases in Japan. The incidence, histology, staging, tumor markers, treatment, and prognosis of this diseases are reviewed. Recently dramatic changes have occurred in the management of the disease, resulting in substantial improvement in ultimate survival. Many developments in chemotherapy, particularly the introduction of cis-platinum, have been largely responsible for this dramatic improvements in treatment and prognosis. Therapy depends a large extent upon the histological type and stage of the tumors, including tumor markers. Surgical excision of primary tumors followed by combination chemotherapy is primary mode of treatment in advanced testicular tumor cases. Standard chemotherapy for advanced tumors involves either cis-platinum, vinblastine, and bleomycin (PVB), or the above 3 drugs combined with actinomycin-D and cyclophosphamide (VAB-6). These regimens have produced complete remission rates of 50%-77% and improved the frequency of long-term survival. The treatment goal for this disease is cure. The achievement of disease free status, with aggressive combined chemotherapy and surgery or radiation is essential for reaching this goal.