Value of postoperative radiotherapy for patients with stage Ha and lib seminoma
Article published in Urologia Polska 2001/54/3.

authors

Wojciech Majewski ¹, Adam Maciejewski ², Stanisław Majewski ¹: ¹ Zakład Radioterapii Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie Oddział w Gliwicach Kierownik zakładu: prof, dr hab. n. med. Bogusław Maciejewski
² Klinika Chirurgii Onkologicznej Centrum Onkologii - instytut im. Marii Skłodowskiej-Curie Oddział w Gliwicach Kierownik kliniki: dr med. Jan Włoch

keywords

testis, testicular neoplasms, seminoma, radiotherapy

summary

Objective. To evaluate long-term results in patients with stage lla and lib seminoma treated with postoperative radiotherapy.

Material and methods. From 1974 to 1990, 61 patients with stage lla and lib seminoma (25 with stage lla and 36 with stage lib) underwent orchidectomy and postoperative irradiation. Patients received radiotherapy to para-aortic and bilateral iliac nodes, and 45 patients (74%) additionally received mediastinal and left supraclavicular irradiation. Median follow-up period was 130 months. Overall and relapse-free survival were evaluated as well as late toxicity after radiotherapy.

Results. Overall survival at 5 years was 92% and at 10 years 80%; in stage lla 100% and 96% respectively and in stage lib 86% and 70%. Five per cent of patients relapsed, they had distant metastases in lungs. No significantly better relapse-free survival was noted in patients who received mediastinal irradiation (relapse-free survival 95%; and in a group without mediastinal irradiation 94%). Radiotherapy was well tolerated. Overall late toxicity was observed in 7 patients (12%), and in 5 cases was related to mediastinal and supraclavicular irradiation. During follow-up five patients developed second malignancies.

Conclusion. Radiotherapy to infradiapliragmatic lymph nodes in stage lla and lib seminoma results in high (95%) 5-year overall survival and low frequency of late toxicity. Prophylactic mediastinal irradiation does not improve overall and disease-free survival, but results in increased frequency of late toxicity (11 %).

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