Purpose : We reviewed clinical features and survival rates of nonseminomatous germ
cell testicular tumors(NSGCTs) and analyzed pathological risk factors of relapse in stage
1 group under surveillance program.
Materials and Methods : Forty one patients were treated for primary NSGCTs from
February 1983 to April 1998. 20(48.8%) patients were stage Ⅰ and 19 of them were
followed up under surveillance program after orchiectomy and 1 underwent orchiectomy
and adjuvant therapy(RPLND and PVB chemotherapy). 11(26.8%) were stage Ⅱ and
10(24.4%) stage Ⅲ and all stage Ⅱ and Ⅲ patients underwent orchiectomy and adjuvant
therapy. Statistical analysis with Fisher's exact test was performed to identify that
pathological risk factors affected relapse rate.
Results : Mean age at diagnosis was 26 year(range 16-47) and mean follow-up period
was 58 month(range 5-163). According to histopathological types, embryonal carcinoma,
teratoma, teratocarcinoma and mixed type represented 19.5%, 26.8%, 7.3% and 46.3%,
respectively. Among 41 patients, 33 showed significant elevation of tumor markers at
diagnosis. The 5-year survival rates of stage Ⅰ, Ⅱ and Ⅲ were 95%, 80% and 56%,
respectively and overall 5-year survival rate was 82%. Among stage Ⅰ patients under
surveillance program, there was statistically significant increase of relapse rate in the
patients with pathological risk factors(presence of embryonal elements, local stage
T2 or higher, presence of lymphovascular invasion) as compared to those
without.
Conclusions : In stage Ⅰ NSGCT patients, if there are pathological risk factors after
orchiectomy, aggressive therapy such as early retroperitoneal lymph node dissection or
chemotherapy is selectively needed.