Summary
A retrospective survival analysis was performed on 287 patients treated with chemotherapy following orchidectomy for stage II testicular non-seminoma between 1982 and 1986 at a number of centres in the United Kingdom and 1 centre in Norway. A total of 80 patients had lymphadenectomy for a residual mass after chemotherapy. In 17 of these cases the histology was undifferentiated malignancy, in 44 it was differentiated teratoma, in 18 there was necrosis only and in 1 case histology was unknown. The overall survival in 47 patients with initial stage IIA disease (nodes measuring <2 cm in transverse diameter) was 98% [95% confidence interval (CI), 96%–100%] at 3 years. In 175 patients with stage IIB disease (nodal diameter, 2–5 cm) the 3-year survival was 96% (95% CI, 93%–99%) and in 65 patients with stage IIC disease (nodal diameter, >5 cm) it was 84% (95% CI, 75%–93%). In stage IIA and stage IIB disease this approach leads to survival equivalent to that obtained with the approach of initial retroperitoneal lymph-node dissection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bosl GJ, Geller N, Bajorin D, Leitner SP, Yagoda A, Golbey RB, Scher H, Vogelzang NJ, Auman J (1988) A randomized trial of etoposide + cisplatin versus VAB-6 (vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin) in patients with good prognosis germ cell tumor. J Clin Oncol 6:1231–1238
Donohue JP, Thornhill JA (1991) Retroperitoneal lymphadenectomy in staging and treatment: the development of nerve-sparing techniques. In: Horwich A (ed) Testicular cancer — clinical investigation and management. Chapman and Hall, London New York Tokyo Melbourne Madras, pp 175–203
Donohue JP, Rowland RG, Kopecky K, Steidle CP, Geier G, Ney KG, Williams ES (1987) Correlation of computerized tomographic changes and histological findings in 80 patients having radical retroperitoneal lymph node dissection after chemotherapy for testis cancer. J Urol 137:1176–1179
Einhorn LH, Williams SD, Loehrer PJ, Birch R, Drasga R, Omura G, Greco FA (1989) Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a Southeastern Cancer Study Group protocol. J Clin Oncol 7:387–391
Horwich A, Wilson C, Cornes P, Gildersleve J, Dearnaley DP (1993) Increasing the dose intensity of chemotherapy in poor-prognosis metastatic non-seminoma. Eur Urol 23:219–222
Jewett MAS, Kong YS, Goldberg SD, Sturgeon JFG, Thomas GM, Alison RE, Gospodarowicz MK (1988) Retroperitoneal lymphadenectomy for testis tumor with nerve sparing for ejaculation. J Urol 139:1220–1224
Logothetis CJ, Swanson DA, Dexeus F, Chong C, Ogden S, Ayala AG, Von Eschenbach AC, Johnson DE, Samuels M (1987) Primary chemotherapy for clinical stage II nonseminomatous germ cell tumors of the testis: a follow-up of 50 patients. J Clin Oncol 5:906–911
Mead GM, Stenning SP, Parkinson MC, Horwich A, Fossa SD, Wilkinson PM, Kaye SB, Newlands ES, Cook PA (1992) The second Medical Research Council study of prognostic factors in nonseminomatous germ cell tumours. J Clin Oncol 10:85–94
Peckham MJ, Hamilton CR, Horwich A, Hendry WF (1987) Surveillance after orchidectomy for stage I seminoma of the testis. Br J Urol 59:343–347
Pizzocaro G (1987) Retroperitoneal lymph node dissection in clinical stage IIA and IIB nonseminomatous germ cell tumours of the testis. Int J Androl 10:269–275
Pizzocaro G, Nicolai N, Salvioni R, Piva L, Faustini M, Zanoni F, Milani A (1992) Comparison between clinical and pathological staging in low stage nonseminomatous germ cell testicular tumors. J Urol 148:76–79
Richie JP, Kantoff PW (1991) Is adjuvant chemotherapy necessary for patients with stage B1 testicular cancer? J Clin Oncol 9:1393–1396
Stoter G, Kaye S, Jones W, Ten Bokkel Huinink W, Sleyfer D, Splinter T, Van Oosterom A, Harris A, Boven E, De Pauw M, Sylvester R (1987) Cisplatin (P) and VP16 (E) ± bleomycin (B) (BEP vs EP) in good risk patients with disseminated nonseminomatous testicular cancer; a randomized EORTC GU Group study. Proc Am Soc Clin Oncol 6:110
Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ (1987) Disseminated germ cell tumors: chemotherapy with cisplatin plus bleomycin plus either vinblastine or etoposide. N Engl J Med 316:1435–1440
Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP, Paulson DF, Brunner KW, Jacobs EM, Spaulding JT, DeWys WD, Crawford ED (1987) Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med 317:1433–1438
Author information
Authors and Affiliations
Additional information
Supported by grants from the Medical Research Council, Cancer Research Campaign and the Bob Champion Cancer Trust
On behalf of the MRC Testicular Tumor Working Party
Rights and permissions
About this article
Cite this article
Horwich, A., Stenning, S. Initial chemotherapy for stage II testicular non-seminoma. World J Urol 12, 148–150 (1994). https://doi.org/10.1007/BF00192276
Issue Date:
DOI: https://doi.org/10.1007/BF00192276