EVALUATION OF PRIMARY STANDARD CISPLATIN-BASED CHEMOTHERAPY FOR CLINICAL STAGE-II NONSEMINOMATOUS GERM-CELL TUMORS OF THE TESTIS

Objective To evaluate the use of primary cisplatin-based chemotherapy before retroperitoneal lymph node dissection (RPLND) in patients with clinical stage II non-seminomatous germ cell tumours of the testis. Pa tients and methods Between 1984 and 1992, 55 patients with clinical st age II testicular cancer (12 with stage IIA, 33 stage IIB and 10 stage IIC disease) were treated at Institut Gustave Roussy with primary che motherapy using three conventional regimens including cisplatin, Patie nts were assessed 4 weeks after the end of chemotherapy and, depending on the response, underwent RPLND; the overall survival and disease pr ogression were monitored. Results Sixteen (29%) patients achieved a su stained complete remission after chemotherapy only, while 30 (55%) pat ients required subsequent RPLND for persistent residual tumour masses: nine other patients obtained a clinical partial remission. Six patien ts who initially had achieved either a clinical complete response (thr ee) or a surgical complete response (one) or a clinical partial respon se (two) subsequently relapsed. Overall, 52 of 55 (95%) patients remai ned free of disease 33 to 111 months after the end of treatment. Concl usion These results show that primary cisplatin-based chemotherapy can effect a cure of the tumour in all subgroups of patients with stage I I disease.