A clinical study of testicular tumors

北里大学病院泌尿器科にて経験した睾丸腫瘍について臨床的統計的観察を行った.1) 1972年7月より1984年12月までの12年5ヵ月間に58症例を経験したが, この間の外来患者は44, 698人であり睾丸腫瘍患者は0.13%を占めた.2)年齢は1歳から63歳の間に分布し, 平均28.6歳であった.初発年齢としては0～5歳と26～30歳の二峰性分布が認められた.3)主訴としては, 無痛性睾丸腫大が54例(93.1%)と大半を占めていた.4)患側は右28例(48.3%), 左が29例(50%), 両側性が1例(1.7%)であった.5)組織分類別ではセミノーマが30例(51.7%), 胎児性癌8例(13.8%), 奇形腫2例(3.5%), 複合型が18例(31.0%)であった.6)治療法としては, セミノーマに対してはそのほとんどに高位除睾術と放射線療法を施行した.非セミノーマに対しては, 高位除睾術と化学療法を組み合わせて施行したものが多数を占めた.7) Kaplan-Meier法による5年生存率は, stage 1.2のセミノーマは100%, 非セミノーマは62%であった
Fifty-eight of the 44, 698 patients seen at our Department, between 1972 and 1984 had a testicular tumor. The incidence rate was 0.13%. The mean age of these 58 cases was 28.6 years and two peak distributions, one in the 0 to 5 year and another in 26 to 30 year age group were observed. Among them, 54 patients (93.1%) had chief complaints of painless testicular swelling at initial examination. The vast majority of them had unilateral tumors; 28 in the right and 29 in the left. Only one patient had bilateral seminomas. Histologically, 30 of them (51.7%) were seminoma, 8 were embryonal carcinoma (13.8%), 2 were teratoma (3.5%) and the remaining 18 had tumors of double or multiple histological type. Most of the seminomas were treated by a combination of high orchiectomy and radiotherapy, and chemotherapy was done mainly for non-seminomatous cases. The 5-year survival rate calculated by the Kaplan-Meier method was 100% for patients with low stage (I, II) seminomas and 62% for those with non-seminomatous tumors.