ADJUVANT CHEMOTHERAPY FOR STAGE-I NONSEMINOMATOUS TESTICULAR CANCER

Developments in the treatment of stage I testicular nonseminomatous ge rm cell tumours have aimed primarily at reducing morbidity since the i ntroduction of retroperitoneal lymph node dissection. Surveillance aft er orchidectomy, i.e. follow-up alone with chemotherapy only for relap sed disease, was found to be logistically and psychologically taxing f or patients. Risk factors for relapse were, however, identified from a nalyses of tumour histology of the orchidectomy specimen. Between Sept ember 1988 and April 1992, 20 patients with clinical stage I testicula r non-seminomatous germ cell tumours and a relatively high risk of rel apse were entered into a prospective study of adjuvant chemotherapy. T he chemotherapy regimen consisted of 2 cycles of cisplatin, etoposide and bleomycin. Each cycle of chemotherapy lasted 3 days. There have be en no relapses at;a median follow-up of 31 months (range 12 - 53 month s). Acute and late toxicity have been modest. We have found adjuvant c hemotherapy to be effective after orchidectomy in patients with stage I disease with adverse prognostic factors for relapse.