Tumors in undescended testis

Abstract

We herein report our experience in the management of 21 patients with tumors in undescended testis. The primary tumor was in the abdominal testis in six patients and in the inguinal testis in 15 patients. Seventeen patients had unilateral involvement and four had bilateral. Prior orchiopexy was reported in six (30%) patients, unilateral in three and bilateral in the other three, although tumors occurred in one side of three bilateral orchiopexy patients. Clinical staging showed five as stage I, six at stage IIb, two as stage IIc, seven as stage III, and in one no stage was possible. Microscopy showed seminoma, non-seminoma, and mixed tumors in 12, six, and three patients, respectively. As per protocol, stages I and IIb had either radiotherapy or retroperitoneal node dissection, giving three and five year survival of 11/11 (100%) and 7/7 (100%). All nine patients with stage IIc and stage III received induction chemotherapy (VAB-6) first and showed complete response (CR) in four (45%) and partial response (PR) in five (55%). Three and 5 year survival was 45% and 33%, respectively. Overall, 3 and 5 year survival was 70% and 69% respectively in all patients. Early stage disease (stages I, IIb) had excellent survivals, showing the adequacy of treatment, while patients with advanced tumor can still be salvaged with a combination of surgery, chemotherapy, and radiotherapy.