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

作　　者：朱识淼[1] 裴琼[2] 汤洋[1] 谢林国[1] 代晓飞[1] 孙光[1] 韩瑞发[1] 王建民[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津300211 [2]河北医科大学附属唐山工人医院泌尿外科,唐山063000

出　　处：《中华男科学杂志》2011年第11期1007-1010,共4页National Journal of Andrology

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。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 

分 类 号：R737.31[医药卫生—肿瘤]