Michael T. Kademian

The Management of Testicular Seminomas, 1979

The reported results from throughout the world of modern treatment of testicular seminoma are reviewed for the various clinical stages of disease. The three‐year survival rate for 1,346 patients with Stage 1 and 2 disease is 91%. Since the review reveals considerable differences in staging methods, a clinically useful staging system is proposed. Treatment methods are described and discussed. Recommendations are made assuming that patients so treated are clinically evaluated for extent of disease before treatment with currently available techniques, including lymphangiography, CT scanning, perhaps ultrasonography, and serum marker determinations. Although the role of cytoreductive surgery in patients with seminoma, even bulky seminoma, now is limited, occasionally when laparotomy is done, debulking may also be helpful. Effective combination chemotherapy regimens have not been identified. The 28% three‐year survival rate of patients with Stage 3 disease establishes the real need to identify such therapy. Finally, anaplastic seminoma is considered; a recent review by Percarpio indicates that this subtype perhaps is not unlike classical seminoma as far as stage distribution and prognosis is concerned.

Accuracy of bipedal lymphangiography in testicular tumors

The accuracy of bipedal lymphangiography to evaluate nodal metastases in patients with testicular malignancies is discussed. A total of 108 patients were evaluated. Histologic correlation was available in 45 cases. The over-all accuracy was 89% which compares favorably with other large series.

Testicular Seminoma: A Case Report of 2 Brothers with Seminoma and a Review of the Literature of Testicular Malignancies Occurring in Closely Related Family Members

AbstractTesticular malignancies in closely related family members rarely occur. This report describes 2 young adult brothers who had left testicular seminoma. Only 15 instances of testicular malignancies in closely related family members have been described previously.

Is staging laparotomy in cervical cancer justifiable

Abstract 1. (1) Surgical staging is more accurate than clinical staging in squamous cell carcinoma of the cervix. 2. (2) Conventional radiation therapy in cervical carcinoma routinely demands pelvic doses which are limited by normal tissues tolerance. 3. (3) The only information gained by exploratory laparotomy which might alter therapy significantly is the discovery of the periaortic nodal metastases, or other disease outside the pelvis. 4. (4) Because pelvic failure constitutes the overwhelming majority of treatment failures, control of periaortic disease, if possible, will not increase cure rate since failure will likely occur in the pelvis anyway. 5. (5) The chances of controlling periaortic metastases are small, and combined surgical exploration and radiation therapy will increase complications. 6. (6) Analysis of data previously reported in the literature indicates little benefit and suggests a detrimental effect from exploratory laparotomy. 7. (7) Preliminary reports of patients undergoing exploratory laparotomy show no increase in cure rate. 8. (8) Routine use of exploratory laparotomy in cervical cancer is not justifiable based on data about the disease which is already available.

Staging laparotomy and survival in carcinoma of the uterine cervix.

Pretreatment staging laparotomy in carcinoma of the uterine cervix has been advocated because surgical staging may detect disease not apparent clinically. An analysis of survival and local control data from previously reported large series of patients with carcinoma of the uterine cervix shows that surgical staging does not increase survival rates. It is likely that surgical staging may also increase morbidity from therapy.

Failures after irradiation in early vocal cord cancer.

Radiation therapy for early laryngeal cancer offers an excellent probability of cure as well as preservation of vocal function. Reported failure rates range from 9 to 21% in patients with T1 lesions, and from 28 to 44% in those with T2 lesions, the majority of whom are subsequently salvaged by surgery.

SEMINOMA: RESULTS OF TREATMENT WITH MEGAVOLTAGE IRRADIATION?

Abstract The results of megavoltage irradiation treatment of patients with the diagnosis of testicular seminoma are described. Treatment techniques are explained. Overall classical seminoma survival at 3 and 5 years was 9696 and 93% Analysis of results shows that elective irradiation to the mediastinum and supraclavicular areas is not necessary in Stage I disease. Doses required for elective treatment and treatment of massive disease are reviewed.

Low dose-rate irradiation of multicell spheroids☆

Abstract The effectiveness of irradiation at 88 rad/hr was studied in multicell spheroids of three sizes. Survival curves for all three spheroid populations (including a population initially containing a significant number of hypoxic cells) were nearly identical at this dose-rate. Attempts to determine the mechanism(s) responsible for the unexpected sensitivity of the large spheroids indicated that hypoxic cells were no longer detected after accumulation of 2130 rad. The possible role of an increased radiation killing of the hypoxic cells at the low dose-rate thus could not be evaluated.

Massive embryonal cell carcinoma of testes

Abstract A search of the literature failed to yield previous reports of malignant testicular tumors as large as the 2,730-Gm. embryonal cell testicular carcinoma reported here.