Testicular seminoma: A study of 103 patients treated at UCLA

The records of all patients treated at UCLA with stage I through stage III testicular seminoma, diagnosed in 1956-1983, were reviewed. Histologic subtype, therapeutic protocol, survival, early and late sequelae, and the incidence of subsequent primary malignancies are examined in this presentation. Of the four patients initially seen with stage III disease, three have achieved long-term disease-free survival after combined irradiation and chemotherapy. The only patient with stage III disease initially treated with irradiation alone relapsed and failed to respond to salvage chemotherapy. Previous pelvic surgery did not affect relapse rate. Irradiation of the whole pelvis was not associated with improved control. Four patients complained of gynecomastia after therapy, and as none of these patients had elevated human chorionic gonadotropin levels, the gynecomastia was attributed to gonadal failure. There was a 6% incidence of late gastrointestinal problems, possibly attributable to the para-aortic irradiation