Organ preservation for the treatment of contralateral testicular seminoma.

Abstract

Local excision of germ cell tumor in the remaining testicle followed by a modest dose of irradiation is an alternative to orchiectomy. This organ sparing technique provides superior quality of life and reduces the need for lifelong hormone replacement. We treated two patients with contralateral seminomas with organ preservation. Both patients received postoperative irradiation to the remaining testicle to a dose of 20 Gy in 10 fractions and 19.8 Gy in 11 fractions. Both patients are alive with no evidence of disease more than 3 years since the completion of their treatments. They both have reduced but preserved androgen production and retained their virility. They both are azospermic. We conclude that organ preservation for the treatment of contralateral testicular seminoma is a superior alternative to orchiectomy of the remaining testicle. It preserves male hormone production with equal survival outcome expectations.