International Urology and Nephrology 33: 529–531, 2001.
© 2002 Kluwer Academic Publishers. Printed in the Netherlands.
529
Analyses of 98 seminoma cases: A review article
Metin Güden, Cüneyt Ulutin & Serdar Göktas
.
Department of Radiation Oncology and Urology Gülhane Military Medical Academy and School of Medicine,
Ankara, Turkey
Abstract. 98 Patients with seminoma were treated at Clinic of Radiation Oncology of Gülhane Military Medicine
Academy between the years 1974–1995. All cases were undergone orchiectomy. The median age of the patients
whom were staged respectively 76%, 17%, 7% according to AJCC system, stage I, stage II and stage III was 28 (20–
58). While 87 patients were undergone only radiotherapy, 11 patients with advanced stage had taken chemotherapy
with radiotherapy. In 52 months of median follow up duration, 5 year disease free survival rates were 98.6%,
93.3%, 25% and 94.5% for stage I, stage II, stage III and all stages respectively. As a result, we can propose that
the seminoma is a disease with good results in oncology. In our view detailed staging and new treatment approaches
in advanced disease will achieve better results in the future.
Key words: Radiotherapy, Seminoma
Introduction
Germ cell tumours of the testes have been seen very
rarely and they appeared to be at the rate of 1% of
neoplasms in men [1, 2, 3]. About 5500–6000 new
cases are detected in the U.S. every year [1, 2, 4].
Occurrence rate in the society is 0.04% [2, 4, 5]. It
occurs in the white population at the rate of 0.037%
and in the black 0.009% whom live in U.S. [7]. Due
to its seldom appearance, this tumour becomes a very
important oncologic disease. It is the mostly seen
carcinoma of the young male between the age of 15–
35 [1, 6]. Bilateral occurrence rate is 2–3% for the
germ cell tumours of the testes and if it occurs, it
is usually seminoma [4, 5]. Cryptorchidism is one
of the most important etiologic factors [1, 8, 9].
Males with cryptorchidism have 10–40 times higher
risk of getting tumour than the normal population [1,
2]. A history of undescending testes can be detected
at about 10% in testicular neoplasm [7]. Testicular
feminization syndrome increases the risk of involve-
ment 40 times as much the normal population [1]. The
other etiologic factors are orchitis, testicular trauma,
irradiation, genetic mutations respectively.
Seminoma makes up 40–50% percent of the testic-
ular cancers [2]. Subtypes of seminoma are classified
as classic, anaplastic, and spermatic at the occurrence
rate of 85%, 10%, 5% respectively. Most presenting
symptoms of the patients are listed according to their
frequency: mass, testicular pain, epididimitis, gyneco-
mastia, infertility and back pain.
Material and methods
This evaluation of the patients with histologically
proven pure seminoma includes 98 cases who were
staged according to the Royal Mardsen staging system
between 1974 and 1995 in the Department of Radi-
ation Oncology, Gülhane Military Medicine Academy.
74 cases out of 98 were Stage I (76%), 17 Stage II
(17%), and 7 Stage III (7%). At the beginning of the
treatment mean age of the patients was 28 (ranged
20 to 58). All 98 cases were undergone transinguinal
orchiectomy. After the operation, patients were
evaluated again by history, clinical examination,
biochemistry, lung x-ray, abdominal ultrasonography,
computerised thorax and abdominal tomogrophy. The
four of the cases had histories of undescending testicle.
In 55 cases localisation of the tumour was on the right
side while forty cases was on the left side. However, in
three cases there were bilateral tumours unfortunately.