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Non‐seminoma Germ Cell Tumours (Malignant Teratoma) of the Testis Results of Treatment and an Analysis of Prognostc Factors*
Author(s) -
PECKHAM M. J.,
BARRETT ANN,
McELWAIN T. J.,
HENDRY W. F.,
RAGHAVAN D.
Publication year - 1981
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1981.tb03160.x
Subject(s) - seminoma , germ cell , teratoma , germ , germ cell tumors , pathology , testicle , medicine , oncology , cancer research , biology , chemotherapy , microbiology and biotechnology , genetics , gene
SUMMARY— The results of treatment of 1 26 patients with non‐seminoma germ cell tumours (malignant teratoma) of the testis are presented. Of this group 81 % are alive and 70% disease‐free. Of 98 patients who had had no prior treatment 83% are alive and 76.5% disease free. Of 43 early‐stage patients 41 (95%) are alive and tumour‐free despite a 21 % relapse rate after radiotherapy. The disease‐free rate in patients with advanced disease treated with chemotherapy, and in some cases radiotherapy and/or surgery, ranged from 100 to 9% and was strongly dependent upon the volume of metastatic tumour and the histology. Patients with malignant teratoma undifferentiated (embryonal carcinoma) showed a significantly higher disease‐free survival rate than those with malignant teratoma intermediate (teratocarcinoma). Twenty‐six men with advanced disease received radiotherapy after chemotherapy and of these 23 (88%) are alive and 21 (81 %) are disease‐free. No difference in disease‐free survival rate was seen between advanced‐stage patients receiving vinblastine and bleomycin and those receiving, in addition, cis‐platinum. The overall drug‐related mortality was 4.5%. Serum alpha‐fetoprotein (AFP) and beta‐human chorionic gonadotrophin (β‐HCG) levels were valuable monitors in advanced disease but not prognostically significant if allowance was made for tumour volume. Fifteen patients had surgical resection of residual masses and one died post‐operatively.