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The long‐term outcome of patients who relapse after chemotherapy for non‐seminomatous germ cell tumours
Author(s) -
LEDERMANN J.A.,
HOLDEN L.,
NEWLANDS E.S.,
BEGENT R.H.J.,
RUSTIN G.J.S.,
BAGSHAWE K.D.,
BRAMPTON M.
Publication year - 1994
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.1994.tb16591.x
Subject(s) - medicine , etoposide , chemotherapy , regimen , surgery , cisplatin , germ cell tumors , ifosfamide , oncology
Objective To examine the long‐term survival of a group of patients with non‐seminomatous germ cell tumours, who relapse after chemotherapy and are retreated with a cisplatin and etoposide‐based regimen. Patients and methods At the Charing Cross Hospital between 1979 and 1988 38 patients in relapse were seen. The median interval after primary therapy was 8 months. They were treated with an intensive cisplatin and etoposide‐based regimen with cycles repeated at 7–10 day intervals, and with surgery in 22 patients. Results Forty‐seven per cent of patients entered a second complete remission and 88% of these remain disease free. The overall survival was 46% with a median follow‐up of more than 4.3 years. Surgery was performed in 14 of 18 patients who entered a second complete remission. Adverse risk factors before initial chemotherapy and the time to relapse did not predict outcome but patients with unresectable radiological masses after relapse therapy had a poor outcome despite normalization of serum tumour markers. The tumours of 68% of patients initially treated with cisplatin‐based regimens and 62% of patients who also received etoposide remained responsive to conventional doses of these drugs at relapse. Conclusions This study demonstrates that there is a group of patients with relapsed teratoma who can be cured without the need for very high dose chemotherapy and autologous bone marrow rescue.