Risk adapted management with adjuvant chemotherapy in patients with high risk clinical stage I nonseminomatous germ cell tumor

Purpose: We propose that patients with high risk, clinical stage I nonsemin omatous germ cell tumors receive 2 cycles of chemotherapy initially, instea d of undergoing surgery or observation. Materials and Methods: A total of 59 patients with high risk, clinical stag e I nonseminomatous germ cell tumor received risk adapted adjuvant chemothe rapy. Until June 1987, 20 patients were treated with 2 courses of adjuvant cisplatin, vinblastine and bleomycin at 3-week intervals. After June 1987 a nother 39 patients were treated with 2 cycles of bleomycin, etoposide and c isplatin. Results: Long-term results with this treatment strategy have been excellent with limited morbidity. Conclusions: Adjuvant chemotherapy may be of parti cular value in patients with compromised followup.