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Clinical Stage II Non‐seminomatous Germ Cell Testicular Tumours. Results of Management by Primary Chemotherapy
Author(s) -
PECKHAM M. J.,
HENDRY W. F.
Publication year - 1985
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.1985.tb07050.x
Subject(s) - etoposide , retroperitoneal lymph node dissection , bleomycin , medicine , chemotherapy , stage (stratigraphy) , embryonal carcinoma , surgery , cisplatin , seminoma , dissection (medical) , lymph node , germ cell tumors , testicular cancer , biology , paleontology , biochemistry , cellular differentiation , gene
Summary— Between 1977 and 1984, 92 patients with clinical Stage II non‐seminomatous germ‐cell testicular tumours were treated by primary chemotherapy, with surgery reserved for the excision of persisting masses. Eighty patients (87%) are alive and disease‐free: 96% for Stages IIA and IIB and 74% for Stage IIC. Of 43 Stage IIA, B and C patients treated with bleomycin. etoposideand cisplatin (BEP), 40 (93%) are disease‐free. For the whole group there was a significant difference between the outcome of treatment in patients with retroperitoneal masses > 8 cm in transverse diameter compared with those in whom masses were < 8 cm, the disease‐free rates being 54 and 97% respectively. Primary histology did not influence the outcome of treatment. However, whereas 51 % of patients with teratocarcinoma had masses resected after chemotherapy, only 26% of embryonal carcinoma patients came to surgery. The results obtained in this series are as good as those obtained when lymph node dissection is employed as the initial form of treatment. The avoidance of surgery with preservation of ejaculatory function in 78% of Stage IIA and IIB patients argues in favour of an initially non‐surgical approach to management.