This study included 265 consecutive Japanese men undergoing
orchiectomy for stage I testicular GCT, and a retrospective review of their records was performed.
RESULTS: Of these 265 patients, 192 and 73 were pathologically classified with
seminoma and nonseminoma, respectively. Prophylactic radiation and
chemotherapy were performed in 62 patients with
seminoma and 6 with nonseminoma, respectively. Disease recurrence occurred in 12
seminoma patients, of whom 11 had not received prophylactic
radiation therapy; however, all 12 achieved a complete response to
bleomycin,
etoposide and
cisplatin therapy. Of the nonseminoma patients, 19 experienced disease recurrence and were then treated with
bleomycin,
etoposide and
cisplatin followed additionally by the surgical resection of
residual tumors and salvage
chemotherapy in 7 and 4, respectively. There was no
cancer-specific death in the 265 patients, and 5-year recurrence-free survival rates in patients with
seminoma and nonseminoma were 92.6 and 72.8%, respectively. Furthermore, following factors appeared to be significantly associated with recurrence-free survival in these patients: age, T classification, microvascular invasion and adjuvant
therapy for those with
seminoma, and microvascular invasion for those with nonseminoma.
CONCLUSIONS: Despite a generally favorable prognosis in Japanese men with stage I testicular GCT, intensive follow-up or prophylactic
therapy should be considered for men with possible risk factors of disease recurrence.