Læknablaðið - 15.07.1997, Side 9

LÆKNABLAÐIÐ 1997; 83
477
Frjófrumuæxli í eistum önnur en
sáðkrabbamein. Gerbreyttar horfur
Afturskyggn rannsókn á íslandi 1971-1995
Reynir Bjömsson1’, Tómas Guðbjartsson2', Kjartan Magnússon31, Einar Guðlaugsson4’,
Sigurður Björnsson51, Guðmundur Vikar Einarsson121
Björnsson R, Guðbjartsson T, Magnússon K, Guð-
laugsson E, Björnsson S, Einarsson GV
A retrospective studv on Icclandic nien diagnosed
with non-seminomatous testicular cancer 1971-1995
Læknablaðið 1997; 83: 477-85
Introduction: Survival of patients witli testicular
cancer has changed dramatically over the last two
decades. This is mainly related to rnore successful
chemotherapy, using combinations of drugs includ-
ing cisplatinum. Therapy with cisplatinum was start-
ed in 1978 in Iceland. The survival of Icelandic men
with non-seminoma testicular cancer, before and
after this change in therapy, is not known.
Objective: Therefore a retrospective population-
based study was carried out on all Icelandic males
diagnosed with non-seminoma testicular cancer be-
tween 1971 and 1995.
Matcrial and methods: Fifty-seven males with an
average age of 29.1 years (range 17-52) were in-
cluded in the study. Clinical information was ob-
tained from the Icelandic Cancer Registry and hos-
pital records. AU specimens were reexamined by a
pathologist and the modified staging system of Bo-
den and Gibb was used for staging the disease.
Crude survival was evaluated with the Kaplan-
Meier method.
Frá 'læknadeild Háskóla (slands, Z|þvagfæraskurðdeild
Landspítalans, 3)krabbameinslækningadeild Landspítalans,
“’Rannsóknastofu Háskóla íslands í meinafræði, 5)lyflækn-
ingadeild Sjúkrahúss Reykjavíkur. Fyrirspurnir, bréfaskipti:
Reynir Björnsson, Furugrund 79, 200 Kópavogur. Bréfsími
564 1941. Netfang: reynir@vortex.is
Lykilorð: frjófrumuæxli í eistum önnur en sádkrabbamein,
lækning, horfur.
Results: Age standardized incidence for non-semi-
noma testicular cancer was 1.8 / 100,000 males per
year for the whole period. Among the 57 patients,
testicular swelling (93%) and pain (56%) were the
most common symptoms at diagnosis. AU 57 pa-
tients underwent orchiectomy, and 37 received che-
motherapy as well. The most common histological
type was embryonal carcinoma (44%) and average
tumor diameter was 4.3 cm with a range of 1-12 cm.
Tventy-six (51%) patients had stage I disease at
diagnosis but 10 (17%) had stage IV. Crude five and
10 year survival for the whole group was 85% and
83%. From 1971 to 1977 the crude five year survival
was 36% but 98% for the period 1978-1995. In De-
cember 1995 seven (64%) of 11 patients diagnosed
between 1971-1977 have died of the disease. On the
other hand only two patients (4%) diagnosed after
1977 have died as of december 1995. One because of
acute myelogenic leukemia, nearly seven years after
diagnosis of testis cancer. The other died of ter-
atocarcinoma 12 months after diagnosis despite in-
tensive chemotherapy including cisplatinum.
Conclusion: Surviva! of patients with non-seminoma
testicular cancer in Iceland has improved dramat-
ically after the introduction of cisplatinum based
chemotherapy in 1978. Of 46 patients diagnosed af-
ter 1977 only one (2%) has died because of the
disease and median follow up was eight years. The
incidence is low compared to other Western coun-
tries if Norway and Danmark are not included, were
the incidence is much higher. Clinical presentation
of the disease is similar between these countries.
Keywords: nonseminomatous testis cancer, therapy, re-
view, prognosis.
Ágrip
Inngangur: Langflest æxli í eistum eru upp-
runnin í frjófrumum (germ cells) eistans og eru
algengustu æxli sem greinast í ungum körlum.
Rúmlega helmingur þeirra eru sáðkrabbamein