Germ cell tumors in undecided testis-prognostic factors and treatment outcome

Abstract EN

The medical records of 270 patients with germ cell tumors of the testis (147 seminoma and 123 non-seminoma) seen at our institute between 1975-1997 were reviewed.

Thirty-five (13 %) patients had tumors in undescended tes-tis ; seminoma in 28 and 7 patients had non-seminoma.

The mean age at diagnosis was 34 years.

Orchiopexy was performed in only 4 patients.

The involved testis was in the scrotum in the 4 patients who had orchiopexy, in the inguinal canal in 15 and in the lower abdomen in 16.

Pain and palpable mass were the most common presenting symptoms.

Using the modified Royal Marsden Hospital staging system, the stage at diagnosis was I in 14 patients, II in 18 and IV in 3.

Orchiectomy was carried out in 26 patients, open biopsy in 3 and fine needle aspiration in 6.

For patients with seminoma, 14 patients received external radiation (XRT) only, 7 chemotherapy, and combined XRT and chemotherapy in 6 patients.

One patient had orchiectomy only.

Patients with non-seminoma were treated with chemotherapy.

Complete response was achieved in 84 % of the seminoma cases.

At a median follow up of 52 months (range 2 months-19.5 years), the 5-year overall actuarial survival rate for patients with seminoma was 85 % compared to 68 % in patients with non-seminoma.

Univariate and multivariate analyses for survival were done for the 28 patients with seminoma.

Early stage and complete response to treatment were associated with significant high survival rate in univariate analysis.

None of the above were significant on multivariate analysis.

Conclusion : patients with undescended testes have a higher risk for developing seminoma than non-seminoma.

Treatment results of germ cell tumors in undescended tes-tis are equivalent to those in normally located testis.