[Radiotherapy of localized prostatic cancer: follow-up of 48 patients. G.C.C.P. (Cooperative Group for the Study of Prostatic Cancer)].

Objective: To evaluate the safety and long-term efficacy of curative-intent radiation therapy in patients with apparently localized prostate cancer.

Method: 48 patients with T < 3 M0 prostate cancer recruited between 1981 and 1985 received regular clinical follow-up for at least ten years or until their death. Radiation therapy was given according to the protocols established by Ray and Bagshaw.

[Advanced testicular seminoma: treatment of residual masses after chemotherapy. A review of 3 cases].

Based on 3 cases of advanced testicular seminoma classified as stage IIC, the treatment of residual masses after chemotherapy is discussed. The excellent therapeutic response confirmed by histological study of the residual masses, which show a fibrotic or necrotic appearance, allows the adoption of a strategy using imaging techniques: either there is persistence of a gland mass syndrome and resection needs to be carried our or retroperitoneal fibrosis is visualised and careful follow up would appear to be sufficient.

[Cancer of the testis, sarcoidosis and neurinoma].

The association of testicular cancer, sarcoidosis and neuroma is reported. Review of the literature revealed the rarity of the association of testicular cancer and sarcoidosis which is probably a chance association, but which is important in the context of staging, as overstaging may lead to useless or even dangerous treatment.

In vivo diffusion of enoxacin in healthy renal and adenomatous prostate tissue in man.

Enoxacin is a new quinolone derivative that is well absorbed after oral administration and shows good efficacy against the pathogenic bacteria usually isolated in urinary infections. We studied the diffusion of enoxacin in healthy renal tissue (13 patients) and adenomatous prostate tissue (16 patients) in surgical patients dosed with enoxacin preoperatively. The plasma and parenchymal concentrations were measured by high-performance liquid chromatography after 5 successive oral doses of 400 mg given at 12-hour intervals.

[Hydronephrosis and ureteropelvic junction syndrome. Apropos of 93 cases].

So called "congenital" hydronephrosis, a relatively frequent condition, is increasingly benefiting from modern investigative techniques such as ultrasound. This should enable a reduction in the time interval between clinical symptomatology and treatment. In a series of 93 cases, the authors demonstrate that pathological anatomy is of little value as regards etiology, while plastic surgery of the pyelo-ureteral junction still remains the most simple and reliable treatment with a low associated morbidity.

[Testicular prosthesis. Study of complications, apropos of 63 cases].

The authors report 63 cases of insertion of testicular prostheses (Lattimer model in Silastic, manufactured by Dow Corning) in patients who had undergone castration for testicular cancer. A study of the early and late post-operative complications, which were relatively rare and always benign, allows several simple rules to be proposed regarding this surgical procedure. There does not seem to be any problem with long term tolerance to medical silicones, after a ten year follow up period for the earliest cases.

[A rare cause of hematuria: vesical nephrogenic adenoma].

The authors report a case of a 20 year old patient with macroscopic hematuria due to a rare bladder tumor: a nephrogenic adenoma. Although a benign condition, its tendency to recurrence often means that aggressive therapy is required. Bladder ultrasonography is the principal examination for surveillance of these patients.

[Exeresis of residual masses of germinal tumors of the testis after chemotherapy].

Between 1978 and 1988, amongst the 184 patients treated at the Hôpital du Val de Grâce for a testicular germ cell tumour, 47 patients underwent resection of residual masses after chemotherapy: 27 patients were classified as stage II and 20 were classified as stage III. The chemotherapy, administered for 3 to 6 cycles, used three types of protocols: VAB 6, PVeBV or BEP. Resection of residual masses was only undertaken after return to normal of the biological markers with persistently abnormal medical imaging.

[A rare diagnosis of an intrascrotal tumor: polyorchidism].

The authors report a new case of polyorchidism and review the literature. They discuss the different anatomo-clinical forms and the therapy of this rare anomaly.

[2 cases of carcinoid tumor of the testis].

The authors report two cases of carcinoid tumour of the testis in young subjects. One case was isolated and the other was associated with a teratoma. The authors attempt to define this disease on the basis of a review of the literature.

[Biological markers and germinal tumors of the testis. Value and limitations of the assay of chorionic gonadotrophin hormone and alpha-fetoprotein].

Between 1978 and 1985, 128 patients with germinal tumors of the testes were treated at the Val-de-Grâce Hospital; biological market levels--beta HCG and AFP--were determined before and after orchidectomy in the peripheral blood and during orchidectomy in testicular blood in 76 patients. HCG levels were elevated in 13% of seminomas and HCG and/or AFP levels were elevated in 76% of non seminomas; the sensitivity of the determination was greater in testicular blood. However, in our study, there was no parallelism between marker levels before orchidectomy and tumor stage or prognosis.

[Assay of chorionic gonadotrophin, follicle-stimulating hormone and alpha-fetoprotein in the efferent blood in germinal tumors of the testis].

Assays of human chorionic gonadotrophin (hCG), follicle-stimulating hormone (FSH) and alpha-foetoprotein were performed in peripheral blood and spermatic vein in 73 cases of testicular germ cell tumors. This study showed that the detection sensitivity of hCG is up to 40 times higher in the efferent blood of the tumor than in peripheral blood and that the drop in FSH concentrations often precedes a trophoblastic transformation. These results are of particular interest in the search for a minor trophoblastic or embryonic component.

[Do inguinal lymph node metastases of germinal tumors of the testis exist?].

Abdomino-aortic glands are usually involved by regional extension of germinal tumors of testis. Inguinal gland extension may occur from alteration of lymphatic circulation due to inguinoscrotal surgery and post-orchidectomy scrotal contamination. Among 140 patients treated in Val-de-Grâce Army Hospital between 1978 and 1985, only one patient with a pure non-seminoma germinal tumor developed inguinal gland metastases.

[Apropos of a case of renal oncocytoma with hepatic localization].

A renal oncocytoma was treated by radical nephrectomy. Although it was considered benign, hepatic localizations were discovered seven years later. The authors discuss the problems of whether these were secondary metastatic lesions or a new development in the evolution of the disease.

[Bilateral testicular cancer of different histological types].

Four cases are presented. The first cancer was in a non-seminomatous location while the second tumor was a seminoma in all four patients, one being of mixed origin. A literature review demonstrated reports on 30 similar cases.