Long-term follow-up of non-seminomatous testicular cancer patients with mature teratoma or carcinoma at postchemotherapy surgery

Jansen, R. L. H.; Sylvester, Richard; Sleyfer, D. T.; Huinink, W.W. ten Bokkel; Kaye, Stan B.; Jones, William G.; Keizer, J.; Oosterom, A.T. van; Meyer, S.; Vendrik, C. P. J.; Pauw, M. De; Stoter, G.

doi:10.1016/0277-5379(91)90168-d

Cited by 41 publications

(18 citation statements)

References 17 publications

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“…Viable cancer cells were found in 16 patients (19%). A recent review (Fossa et al, 1992) showed that the percentage of resected specimens containing viable cancer cells is around 20%, and this percentage was also found in some other recent publications (Dearnaley et al, 1991;Jansen et al, 1991;Mead et al, 1992) and in our series. However, the fraction of resected patients varies widely between these studies, e.g.…”

Section: Discussionsupporting

confidence: 88%

“…Incompletely resected patients had a poor prognosis (5y-RF%:50%), as was found in other studies (Tait et al, 1984;Harding et al, 1989;Jansen et al, 1991). (Harding et al, 1989), but in contrast with the observations in several other studies (Tait et al, 1984;Geller et al, 1989;Jansen et al, 1991;Mead et al, 1992). The observation in our study may be explained by lack of power to detect an existing difference due to the relatively low number of relapses.…”

Section: Discussionmentioning

confidence: 46%

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Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis

Steyerberg

Keizer²,

Zwartendijk³

et al. 1993

Br J Cancer

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Cisplatin combination chemotherapy yields a 60-80% cure rate in metastatic nonseminomatous germ cell tumours (NSGCT) of the testis (Peckham, 1988;Stoter et al., 1989;Einhorn, 1990 (Peckham 1988;Einhorn, 1990). After completion of induction chemotherapy, the size of metastases was determined on CT scan. If residual masses were detected (> 1 cm). resection was planned, provided that tumour markers were normal. If tumour markers remained elevated, additional chemotherapy was usually given until normalisation of tumour markers, and subsequent resection was performed of residual masses (n = 5). In 99 patients residual masses were resected. Excluded were the following patients to prevent prognostic inhomogeneity: patients not treated according to standard protocol (e.g. treated with radiotherapy before induction chemotherapy) (n = 7); patients with extragonadal tumours (n = 3); patients who were operated while tumour markers were above normal (n = 3). After this selection 86 patients were studied. Patient dataAll patient data were updated until October 1991. The histological diagnosis of the original testicular cancer was made in the participating hospitals and was reviewed for patients in EORTC trials. In the analysis, the British classification (Pugh, 1976), was used. The disease was staged according to the Royal Marsden Hospital classification (Peckham, 1988). Further, the maximum transverse diameter of abdominal masses, the maximum transverse diameter of pulmonary tumour nodules, and the number of lung metastases were determined on computed tomographic (CT) scan before and after chemotherapy. The highest serum levels of AFP (ng ml-I) and HCG (IU 1') prior to chemotherapy were recorded. The type and number of chemotherapy regimens were registered, before and after resection, as well as the completeness of resection as noted by the surgeon, and the type of histology in the resected material. The data were divided in three groups of potential prognostic facors:factors known at the start of cytostatic treatment ('prechemotherapy factors'), factors known after chemotherapy but before resection ('postchemotherapy fac-

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 46%

Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis

Steyerberg

Keizer²,

Zwartendijk³

et al. 1993

Br J Cancer

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“…In patients with marker negative relapses surgery should be the first salvage procedure to recognise regrowth with mature teratoma which is adequately treated by surgery alone (Jansen et al, 1991). Differential diagnosis of marker negative relapse also includes second malignancy as observed in one of our patients who developed a glioblastoma more than 9 years after whole-brain irradiation for cerebral metastases.…”

Section: Survivalmentioning

confidence: 74%

Prognosis after salvage treatment for unselected male patients with germ cell tumours

Gerl¹,

Clemm²,

Schmeller³

et al. 1995

Br J Cancer

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“…In such cases histology often will reveal mature teratoma or even completely necrotic tumour tissue, as in one of our patients relapsing after 8 years. The growing teratoma syndrome after chemotherapy has been described by several authors (Basheda et al, 1991, Jansen et al, 1991 and represents a condition which has to be treated surgically. Late re-growth of residual completely necrotic metastasis has not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Salvage treatment in male patients with germ cell tumours

Josefsen

Ous²,

Høie³

et al. 1993

Br J Cancer

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Summary The outcome of salvage treatment was reviewed in 55 patients relapsing during or after their primary chemotherapy for advanced malignant germ cell tumours. Fifty-two patients had been given cisplatinbased chemotherapy as their primary treatment, whereas three patients had received carboplatin-based chemotherapy. The median time to relapse was 2 months (range: 0-96 months) from discontinuation of the primary treatment. Two patients underwent radical surgery only, and one patient had radiotherapy to a brain metastasis as his only curatively intended salvage treatment. Six patients did not receive any treatment for their recurrent malignancy (refusal, terminal condition) except for purely palliative measures. The disease-free survival for the total group was 27% at 5 years. Complete response to primary treatment lasting for > 6 months was the only parameter which significantly predicted a favourable outcome (45% 5 year disease-free survival in 12 eligible patients).

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Long-term follow-up of non-seminomatous testicular cancer patients with mature teratoma or carcinoma at postchemotherapy surgery

Cited by 41 publications

References 17 publications

Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis

Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis

Prognosis after salvage treatment for unselected male patients with germ cell tumours

Salvage treatment in male patients with germ cell tumours

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