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成人Ⅰ期原发睾丸畸胎瘤的治疗方法选择及复发因素

Stage I testis teratoma in adults: Treatment options and recurrence factors

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【作者】 朱识淼裴琼汤洋谢林国代晓飞孙光韩瑞发王建民

【Author】 ZHU Shi-miao1,PEI Qiong2,TANG Yang1,XIE Lin-guo1,DAI Xiao-fei1, SUN Guang1,HAN Rui-fa1,WANG Jian-min1 1.Department of Urology/Tianjin Institute of Urology,The Second Hospital of Tianjin Medical University,Tianjin 300211,China;2.Department of Urology,Tangshan Workers’ Hospital,Hebei Medical University,Tangshan,Hebei 063000,China)

【机构】 天津医科大学第二医院泌尿外科天津市泌尿外科研究所河北医科大学附属唐山工人医院泌尿外科

【摘要】 目的:回顾Ⅰ期睾丸畸胎瘤(包括纯畸胎瘤)的预后,并对其治疗提供建议。方法:回顾分析1993~2009年天津医科大学第二医院和唐山工人医院收治的27例Ⅰ期畸胎瘤患者(不包括表皮样囊肿),统计与治疗方法和临床病理相关的复发结果。结果:27例患者共4例复发,复发均发生在腹膜后,无死亡病例。手术组复发4例,3例伴复发危险因素,1例不伴危险因素;手术联合BEP化疗组未见复发病例。纯畸胎瘤睾丸根治性切除术后不予辅助化疗的复发率为11.1%。行辅助化疗的9例患者均能耐受,未见严重不良反应。结论:复发危险因素可以增加I期睾丸畸胎瘤的复发概率。尽管现在行根治性睾丸切除术后单纯监测的观念占据上峰,但术后予辅助化疗确实可以降低复发率,即使是单纯的畸胎瘤,也应行辅助化疗。

【Abstract】 Objective: To study the clinical outcomes of stage I testis teratoma,including pure teratoma,and to provide information on the treatment options for this disease.Methods: We retrospectively analyzed 27 cases of orchiectomy for stage I testis teratoma,excluding epidermoid cyst,and investigated its recurrence associated with treatment methods and clinicopathological factors.Results: Four of the 27 cases relapsed,all in the orchiectomy group and confined to the retroperitoneal region,3 with and the other 1 without risk factors,but with no death.No recurrence was found in those treated by orchiectomy followed by chemotherapy with bleomycin,etoposide and platinum(BEP).The total rate of recurrence was 15.8%.No severe side effects were observed in the 9 patients undergoing adjuvant BEP chemotherapy.Conclusion: Risk factors may increase the recurrence rate of stage I testis teratoma,while postoperative adjuvant chemotherapy can reduce it,including that of pure teratoma,though surveillance policy remains the most popular option after orchiectomy.

【关键词】 Ⅰ期畸胎瘤纯畸胎瘤监测化疗预后
【Key words】 stage I teratomapure teratomasurveillancechemotherapyoutcome
  • 【文献出处】 中华男科学杂志 ,National Journal of Andrology , 编辑部邮箱 ,2011年11期
  • 【分类号】R737.31
  • 【被引频次】9
  • 【下载频次】175
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