[Treatment and prognosis of stage II testicular seminoma]

Sixty-five patients with stage II testicular seminoma treated from 1960 through 1990 were reviewed. According to Royal Marsden Hospital staging, there were 11 stage IIA, 13 stage IIB, and 41 stage IIC. Thirty Patients were treated with combination of radiotherapy and chemotherapy, 11 chemotherapy alone, 24 rediotherapy alone. The overall 5-year survival rate was 75.6%, with 100% for stage IIA, 92.3% for stage IIB and 62.9% for stage IIC. The differences were statistically significant. In stage IIC patients, there was no significant difference between those tumors > 10cm and < 10cm in diameter. Of the 41 IIC cases, 4 were treated with chemotherapy, 15 were treated with whole abdominal rediation, 22 with paraaortic and ipsilateral pelvic radiation. The 5-year survival rate was 91.7% and 51.2%, respectively. These differences was statistically significant. We recommand that stage IIC disease should be treated primarily with whole abdominal radiation. Regardless of the stage of the disease, prophylactic mediastinal irradiation did not influence the survival nor the relapse rate and may therefore be omitted.