TESTICULAR GERM-CELL TUMORS - RESULTS OF THE GPO MAHO STUDY-82, STUDY-88, STUDY-92

The MAHO studies 82, 88 and 99 were cooperative studies for the treatm ent of testicular germ cell tumors in childhood. Between 1992 and 1993 137 Patients were registered: 76 suffered from yolk sac tumors (YST), 30 from differentiated teratomas (TD), 29 from malignant teratomas of either intermediate (MTI), undifferentiated (MTU) or trophoblastic ty pe (MTT) and 2 from seminoma. All patients received semicastratio. Che motherapy was administered to 53 patients based on stage and histology . Standard therapy consisted of four courses of vinblastine, bleomycin and cisplatinum. However, if viable tumor was suspected after two cou rses delayed laparotomy was performed (7 patients). If there was then complete tumor regression, standard therapy was continued (4 pts). If there was incomplete tumor response, the patients received a salvage t herapy with 3 courses of VP 16, ifosfamide and cisplatinum (3 pts). Re sults YST: 73 patients had stage I, 3 patients higher stages. 56 were followed according to ''watch and wait'' policy. 9 of these needed a d elayed standard chemotherapy, one died. The disease free survival of a ll 76 patients is 98%.TD: 30 patients had stage I. The disease free su rvival is 100%. Malignant teratomas (MTI, MTU, MTT): 13 patients had s tage I. 8 received adjuvant chemotherapy and 5 lymphadenectomy without chemotherapy. All patients survived disease free. 10 patients had sta ge II and received chemotherapy. All patients survived disease free. 6 patients had stage III. 3 died. Alltogether 26 of 29 patients survive d disease free. In summary, the probability of disease free survival o f all 137 patients suffering from testicular germ cell tumors is 97% a fter a median observation time of 60 months.