TESTICULAR GERM-CELL TUMORS AND HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION - A REPORT OF 26 CASES

Purpose: Besides tumors that are diagnostic of AIDS, such as non-Hodgk in's lymphoma, Kaposi's sarcoma, and invasive carcinoma of the cervix, other tumors have been described in the human immunodeficiency virus (HIV) setting. Some case reports on testicular cancer in HIV-infected patients have appeared in the literature. We present a retrospective s tudy on 26 cases of testicular germ cell tumors (TGCTs) observed withi n the Italian Cooperative Group on AIDS and Tumors (GICAT) between Nov ember 1986 and September 1994. Patients and Methods: Twenty-six patien ts with TGCT and HIV infection from the GICAT were retrospectively ana lysed. Results: Fourteen patients had seminoma and 12 had nonseminoma. Four patients underwent only orchidectomy, one patient received only chemotherapy, nine patients were treated with postsurgical chemotherap y, 10 patients (38%) received postsurgical radiotherapy, one patient r eceived postsurgical chemotherapy plus radiotherapy, and one patient w as lost for follow-up evaluation immediately after diagnosis. The comp lete response (CR) rate was 95%. Relapse occurred in 32% of patients. The median follow-up time was 33 months. The mortality rate was 37%. C auses of death were neoplasia in three of nine patients, AIDS in five of nine patients, and fortuitous event in one of nine patients. The ov erall 3-year survival rate was 65%, and the 3-year disease-free surviv al rate was 65%. Severe hematologic toxicity was observed in seven of 15 patients. Conclusion: HIV-infected patients with testicular cancer should be offered standard oncologic therapy, irrespective of their HI V status, since the majority can be cured of their tumor and have a go od quality of life. Use of concomitant prophylaxis for opportunistic i nfections is recommended. (C) 1995 by American Society of Clinical Onc ology.