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Treatment of Disseminated Germ Cell Tumours of the Testis
Author(s) -
ATHANASSIOU A.,
PECTASIDES D.,
BAFALOUKOS D.,
BARBOUNIS V.,
DIMITRIADIS M.,
CHRISTODOULOU K.
Publication year - 1989
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.1989.tb05950.x
Subject(s) - germ cell , germ , germ cell tumors , biology , medicine , cancer research , microbiology and biotechnology , genetics , chemotherapy , gene
Summary— Between 1979 and 1987 64 men with non‐seminomatous germ cell tumours of the testis were treated with chemotherapy. Nearly half of these patients had large volume disease. The most frequently used combinations were VAB‐6 and POMB/ACE. Chemotherapy lasted 3.9 months for small volume disease and 5.5 months for large volume disease. Seven patients (11%) underwent resection of residual masses; viable malignancy was found in only 1 of these. Relapse occurred in 6 complete responders, 3 of whom were salvaged with further chemotherapy. Fifty‐three patients are presently alive and have received no treatment for periods of 5 to 86 months. Life table analysis forecasts a survival of 81%. Adverse prognostic factors have been recognised and include high initial serum concentrations of β‐human chorionic gonadotrophin (β‐HCG) and alpha fetoprotein (AFP), large volume disease and prior irradiation. Although the survival time of patients with advanced disease has improved in recent years, it remains considerably below that of patients who present with less advanced disease. Such patients should be treated aggressively from the outset in order to obtain maximum benefit from chemotherapy. Selected cases also require adjunctive surgery.