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Results of retroperitoneal lymph node dissection and postoperative adjuvant chemotherapy with dactinomycin in the treatment of retroperitoneal metastases of nonseminomatous testicular germ cell tumors
Author(s) -
Wobbes Th.,
Eibergen R.,
Oldhoff J.,
Koops H. Schraffordt
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19830315)51:6<1076::aid-cncr2820510617>3.0.co;2-k
Subject(s) - medicine , retroperitoneal lymph node dissection , chemotherapy , radiation therapy , mediastinum , dissection (medical) , stage (stratigraphy) , surgery , dactinomycin , lymph node , adjuvant , adjuvant therapy , germ cell tumors , lymph , urology , oncology , testicular cancer , pathology , biology , paleontology , cycloheximide , microbiology and biotechnology , protein biosynthesis
This article discusses 103 patients with a nonseminomatous testicular germ cell tumor. Treatment of 87 patients in clinical Stages I, II‐A, and II‐B consisted of bilateral retroperitoneal lymph node dissection. In Stage I (54 patients), no further treatment was given. The three‐year survival was 96%, while recurrence‐free survival was 98%. Of 33 patients in Stages II‐A and II‐B, 26 received adjuvant chemotherapy with dactinomycin, and ten of these were given radiotherapy (peritoneum/mediastinum) as well. The three‐year survival was 88% and recurrence‐free survival was 85%. Seven patients in Stages II‐A and II‐B received no adjuvant chemotherapy; four of them died. Treatment of 14 patients in Stage II‐C primarily consisted of dactinomycin therapy, subsequently combined with surgery and radiotherapy. The three‐year survival was 28.5%. These findings raise the question whether adjuvant single‐agent chemotherapy with dactinomycin for patients with a nonseminomatous testicular germ cell tumor should not be re‐evaluated.