Between August 1983 and April 1996, 53 testicular
germ cell tumors in 52 patients were treated at Toranomon Hospital. The average age of the patients was 36.1 years (range 21-89). The affected side was the right side in 24, left in 27 and bilateral in 1 case. Of the 53
tumors 34 (64.2%) were
seminoma and 19 (35.8%) were non-seminomatous
germ cell tumor (NSGCT). High
ligation orchiectomy was performed in all cases. Of 29 stage I
seminomas, post-operative
adjuvant radiotherapy was performed in 6 cases prior to 1991. None of these
tumors recurred. Two cases of relapses (8.7%) were found among the 23 stage I
seminomas followed by surveillance. Of 8 stage I NSGCTs followed by surveillance, 4 (50.0%)
tumors which contained
embryonal carcinoma element and vascular invasion relapsed within 12 months after
orchiectomy. A case of stage IIA
seminoma was treated successfully by irradiation. Seven cases of stage II (3
seminomas and 4 NSGCTs) and 8 cases of stage III (1
seminoma and 7 NSGCTs) as well as cases of 6 stage I patients who developed relapse during surveillance were treated by
VAB-6 chemotherapy. Of these 21 cases, 11 (52.4%) achieved complete response (CR) and 10 (47.6%) partial response (PR). Salvage surgery and/or additional
chemotherapy was successful to bring the 10 PR cases into CR condition. One NSGCT patient, however, died of
electrolyte imbalance during the
maintenance chemotherapy for
disease progression after achieving CR. All 34 patients with
seminomas and 18 of the 19 with NSGCTs were alive without evidence of disease after a mean follow up period of 61.1 months (range 4-150 months).