Results of treatment of non seminomatous germ cell tumours; 122 consecutive cases in the West of Scotland, 1981-1985

Graham, Janet; Harding, M.; Mill, L.; Kerr, D. J.; Rankin, Elaine M.; Calman, Kenneth C.; Kaye, SB

doi:10.1038/bjc.1988.38

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…Im Rahmen der Kooperativen Therapiestudie MAKEl 83/86 wurden 205 Patienten erfaßt und folgenden Diagnosen zugeordnet: 97 Teratome, 66 Dottersacktumoren, 22 Dysgerminome, 17 embryonale Karzinome und 3 Choriokarzinome; 20% der Tumoren bestanden aus mehr als einem histologischen Typ. Die Hauptlokalisation waren Ovar (91 mal), Steißbeinregion (74mal), mediastinal (zwölfmal), intraperitoneal (zehnmal) und 18mal an anderen Orten.…”

Section: Zusammenfassungunclassified

“…Die präoperative Chemotherapie war wesentlich für die hohe Remissionsrate fortgeschrittener Tumoren, die der von Ovarialtumoren im Stadium I entspricht. Die Toxizität war vornehmlich durch eine starke Myelosuppres- 22 dysgerminomas, 17 embryonal carcinomas and three choriocarcinomas; 20% of all tumors were c1assified as mixed histology. Predominant primary sites were the ovaries (91 pts), the saccrococcygeal region (74 pts), the mediastinum (12 pts), the peritoneal cavity (10 pts) and other sites (18 pts).…”

Section: Zusammenfassungunclassified

“…Möglicherweise ist dieser ungünstige Prognosefaktor für das embryonale Karzinom nur von zufälligem Charakter, da die Lokalisationen für Dottersacktumoren und embryonale Karzinome sehr unterschiedlich gewichtet sind (Tabelle 4) und in anderen Therapiestudien maligne extragonadale Keimzelltumoren eine signifikant schlechtere Prognose als metastasierte testikuläre Keimzelltumoren hatten (1, 4,11,22,28,31).…”

Section: Histologieunclassified

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Nichttestikuläre Keimzelltumoren: Analyse der Therapiestudie MAKEI 83/86 und Protokolländerungen für die Nachfolgestudie

Göbel

Bamberg²,

Haas³

et al. 1989

Klin Padiatr

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205 patients with germ cell tumors were entered into the GPO Cooperative Study MAKEI 83/86 and classified as follows: 97 teratomas, 66 yolk sac tumors, 22 dysgerminomas, 17 embryonal carcinomas and three choriocarcinomas; 20% of all tumors were classified as mixed histology. Predominant primary sites were the ovaries (91 pts), the saccrococcygeal region (74 pts), the mediastinum (12 pts), the peritoneal cavity (10 pts) and other sites (18 pts). The treatment of teratomas was primarily surgery. Localised dysgerminomas received radiotherapy following surgery, in advanced stages (III, IV) four courses of chemotherapy vinblastine 3 mg/m2/day (days 1 + 2), bleomycin 15 mg/m2/day (days 1-3) and cisplatinum 20 mg/m2/day (days 4-8) (VBC) were applied. The other fully malignant tumors received four courses of VBC chemotherapy, in extragonadal primary tumors and advanced stages of all sites additional four courses of VP16 100 mg/m2/day (days 1-3), ifosfamide 1500 mg/m2/day (days 1-5) and cisplatin 20 mg/m2/day (days 1-5) (VPIC) were administered. To avoid mutilating surgery in advanced disease, four courses of VBC chemotherapy were administered prior to resection. The relapse-free survival according to Kaplan-Meier for protocol patients with teratomas is 0.97 +/- 0.01, for dysgerminomas 0.73 +/- 0.09 and for other fully malignant histologic entities 0.81 +/- 0.02 with a median period of observation of 31 months. The toxicity mainly consisted of myelosuppression during VPIC chemotherapy in 39 of 62 pts resulting in twelve incidents of sepsis with lethal outcome in two pts. Impaired renal function was reported in 14 pts, the incidence of neuropathy, ototoxicity and pulmonary toxicity was negligible. For the follow-up study a reduction in chemotherapy seems justified in patients with favourable prognosis. The substitution of VP16 for vinblastine may result in reduced toxicity.

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Section: Zusammenfassungunclassified

Section: Histologieunclassified

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Nichttestikuläre Keimzelltumoren: Analyse der Therapiestudie MAKEI 83/86 und Protokolländerungen für die Nachfolgestudie

Göbel

Bamberg²,

Haas³

et al. 1989

Klin Padiatr

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“…Over the past 20 years there has been a dramatic change in both the incidence of germ cell malignancy -this has risen three-fold to the current figure of 3-4 per 100,000 males per annum (Boyle et al, 1987) -and its long-term survival, which currently stands at about 85% (Graham et al, 1988). The combination of cisplatin, vinblastine and bleomycin was introduced in the 1970s for disseminated testicular teratoma, and in the 1980s etoposide was shown to be superior to vinblastine in this combination (Williams et al, 1987).…”

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confidence: 99%

Long-term sequelae of treatment for testicular germ cell tumours

Bissett

Kunkeler²,

Zwanenburg³

et al. 1990

Br J Cancer

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Summary Seventy-four patients previously treated in our department for germ cell tumour of the testis underwent a series of tests to determine the frequency of long-term therapeutic complications. All had received cisplatin-based chemotherapy as part of their treatment. There was a significant deterioration in renal function throughout the group. Eighteen (24%) had supine blood pressure greater than systolic 140 mmHg or diastolic 90 mmHg after treatment but hypertension did not correlate with renal impairment. Raynaud's phenomenon was common after chemotherapy (26/74) as was persistent sensory neuropathy (23/74). Although 34% had testosterone levels below the normal range, only six patients had a low free testosterone index with one testis still in situ; 18 patients have fathered children after chemotherapy. Approximately half of the patients completed a psychosexual questionnaire and some 30% of them admitted to sexual problems which they attributed to their treatment. Long-term sequelae of cisplatin-based chemotherapy for testicular malignancy are frequent and persistent, and follow-up of these patients should include prospective measurement of changes in blood pressure.

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“…In nonseminomatous EGCT, the long-term disease free survival of patients receiving standard cisplatin containing combination chemotherapy averages 30--40% [1,4,5,14,17]; in nonseminomatous testicular GCT, the 5 yr disease free survival ranges from 60-100% depending on the tumour volume [17]. In the absence of signs of progressive disease, all residual tumour after chemo therapy comple tion should be managed by surgery.…”

Section: Discussionmentioning

confidence: 99%