Retroperitoneal lymphadenectomy and aggressive chemotherapy in nonbulky clinical stage II nonseminomatous germinal testis tumors

摘要: In a former series of 60 resected Stage II nonseminomatous germinal testis tumors the authors succeeded in demonstrating that adjuvant cisplatin, vinblastine, and bleomycin (PVB) was able to significantly improve survival (100% 11 treated versus 28.5% 7 historical controls, P less than 0.01) only patients with retroperitoneal metastases greater 5 cm, macroscopic extranodal spread, tumor invasion into veins (pathologic II-C). Forty-eight evaluable clinical nonbulky cancer underwent lymphadenectomy as primary treatment. Four courses postoperative PVB were administered 18 clinically understaged (14 pathologic II-C, 4 postoperatively reclassified III). The remaining 30 followed at monthly intervals. After median follow-up 25 months, relapses were: 1 (10%) 10 I patients; 8 (40%) 20 II-A II-B; null treated. Eight nine (89%) who had relapse entered continuous complete remission following salvage therapy. overall 2-year disease-free this case is 98%. Retroperitoneal by compulsive selective use aggressive chemotherapy an alternative induction treatment cancer, immediate all disease.