Management consideration in nonpulmonary visceral metastatic seminoma of testis

To develop a more appropriate therapeutic strategy for treatment of nonpulm onary visceral metastatic testicular seminoma based on the International Ge rm Cell Consensus Classification, we reviewed the medical records of patien ts with nonpulmonary visceral metastatic testicular seminoma who were treat ed over a 20-year period, Only 15 (2.2%) of the 686 cases of testicular sem inoma were nonpulmonary visceral metastatic seminoma. The median age of pat ients was 38 years (range, 22-53 years), Ten (67%) of the patients had an i nitial diagnosis of supradiaphragmatic or visceral metastatic disease. In a ddition to nonpulmonary visceral metastasis, ail patients had lymph node me tastasis as well, the majority of which involved the retroperitoneal lymph nodes. The median and mean progression-free survival durations after chemot herapy for advanced disease were 19 months and 63.7 months, respectively. S ix patients (40%) survived, five relapsed after radiation therapy and four died of chemorefractory disease not dependent on the specific regimen, Alth ough the number of cases reviewed in this study was small, we conclude that the choice of chemotherapeutic regimen among the current treatments for no npulmonary visceral metastatic seminoma of testis primary does not present a different outcome. Therefore, multimodality therapies using new strategie s or new agents are well indicated.