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This study was performed to explore pathological risk factors for post-orchiectomy relapse in patients with stage I seminoma and nonseminoma, and to assess oncological outcomes in those managed with surveillance. Methods: In this single institution study, 118 and 40 consecutive patients with stage I seminoma and nonseminoma were reviewed, respectively. Of the 118 patients with stage I seminoma, 56 and one received adjuvant radiotherapy and chemotherapy, respectively, and 61 were managed with surveillance. Of the 40 men with stage I nonseminoma, 4 underwent adjuvant chemotherapy and 36 were managed with surveillance. Results: No patient had cause-specific death during the mean observation period of 104 and 99 months in men with seminoma and nonseminoma, respectively. In men with stage I seminoma, 1 (1.7%) receiving radiotherapy and 4 (6.6%) men managed with surveillance had disease relapse; the 10-year relapse-free survival (RFS) rate was 93.4% in men managed with surveillance, and their RFS was not different from that in patients receiving adjuvant radiotherapy (logrank P=0.15). Patients with tunica albuginea involvement showed a poorer RFS than those without (10-year RFS rate 80.0% vs. 94.1%), although the difference was of borderline significance (P=0.09). In men with stage I nonseminoma, 9 (22.5%) patients experienced relapse. Patients with lymphovascular invasion seemingly had a poorer RFS than those without; 40.0% and 18.7% of the patients with and without lymphovascular invasion had disease relapse, respectively, although the difference was not significant (logrank P=0.17). Conclusion: In both men with stage I seminoma and nonseminoma, surveillance after orchiectomy is a feasible option. 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Oncological outcomes in patients with stage I testicular seminoma and nonseminoma : pathological risk factors for relapse and feasibility of surveillance after orchiectomy
http://hdl.handle.net/10191/24542
http://hdl.handle.net/10191/24542dcb9a1fb-9934-4a72-a5c1-53a093129904
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要旨 (210.7 kB)
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2014-05-28 | |||||
タイトル | ||||||
タイトル | Oncological outcomes in patients with stage I testicular seminoma and nonseminoma : pathological risk factors for relapse and feasibility of surveillance after orchiectomy | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Oncological outcomes in patients with stage I testicular seminoma and nonseminoma : pathological risk factors for relapse and feasibility of surveillance after orchiectomy | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Stage I seminoma | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Stage I nonseminoma | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Surveillance | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Outcome | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_46ec | |||||
タイプ | thesis | |||||
その他のタイトル | ||||||
その他のタイトル | 精巣腫瘍病期Iにおける治療成績 : 病理組織学的リスク因子および術後無治療経過観察の妥当性についての検討 | |||||
著者 |
Kobayashi, Kazuhiro
× Kobayashi, Kazuhiro |
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著者別名 | ||||||
識別子 | 50186 | |||||
識別子Scheme | WEKO | |||||
姓名 | 小林, 和博 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Surveillance after orchiectomy has recently been a management option in patients with stage I seminoma, while it remains controversial in those with stage I nonseminoma, and the risk factor associated with relapse is still a matter of concern in both entities. This study was performed to explore pathological risk factors for post-orchiectomy relapse in patients with stage I seminoma and nonseminoma, and to assess oncological outcomes in those managed with surveillance. Methods: In this single institution study, 118 and 40 consecutive patients with stage I seminoma and nonseminoma were reviewed, respectively. Of the 118 patients with stage I seminoma, 56 and one received adjuvant radiotherapy and chemotherapy, respectively, and 61 were managed with surveillance. Of the 40 men with stage I nonseminoma, 4 underwent adjuvant chemotherapy and 36 were managed with surveillance. Results: No patient had cause-specific death during the mean observation period of 104 and 99 months in men with seminoma and nonseminoma, respectively. In men with stage I seminoma, 1 (1.7%) receiving radiotherapy and 4 (6.6%) men managed with surveillance had disease relapse; the 10-year relapse-free survival (RFS) rate was 93.4% in men managed with surveillance, and their RFS was not different from that in patients receiving adjuvant radiotherapy (logrank P=0.15). Patients with tunica albuginea involvement showed a poorer RFS than those without (10-year RFS rate 80.0% vs. 94.1%), although the difference was of borderline significance (P=0.09). In men with stage I nonseminoma, 9 (22.5%) patients experienced relapse. Patients with lymphovascular invasion seemingly had a poorer RFS than those without; 40.0% and 18.7% of the patients with and without lymphovascular invasion had disease relapse, respectively, although the difference was not significant (logrank P=0.17). Conclusion: In both men with stage I seminoma and nonseminoma, surveillance after orchiectomy is a feasible option. However, disease extension through tunica albuginea might be a factor associated with disease relapse in patients with organ-confined seminoma, and those with stage I nonseminoma showing lymphovascular invasion may possibly be at high risk for disease relapse. | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 学位の種類: 博士(医学). 報告番号: 乙第2174号. 学位記番号: 新大博(医)乙第1770号. 学位授与年月日: 平成25年9月20日 | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Diagnostic Pathology. 2013, 8:57 | |||||
書誌情報 | 発行日 2013-09-20 | |||||
出版者 | ||||||
出版者 | 新潟大学 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | info:doi/10.1186/1746-1596-8-57 | |||||
著者版フラグ | ||||||
値 | ETD | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関名 | 新潟大学 | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2013-09-20 | |||||
学位授与番号 | ||||||
学位授与番号 | 13101B2174 | |||||
学位記番号 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 新大博(医)乙第1770号 |