Long-term follow-up of residual masses after chemotherapy in patients withnon-seminomatous germ cell tumours

This retrospective study was undertaken to determine the outcome of patient s with non-seminomatous germ cell tumour who achieved a serological complet e response but who had residual radiologic abnormalities upon completion of primary platinum-based chemotherapy. This was an analysis of 76 consecutiv e patients treated at Mount Vernon Hospital between 1983 and 1997. The pati ents were placed into two groups based upon whether they had surgical resec tion (surgery group, 48 patients) or observation (observation group, 28 pat ients) of residual radiologic masses on completion of initial chemotherapy (to enter the surgery group, complete surgical resection must have been ach ieved). The primary end-points were progression-free and overall survival. The percentage of patients alive with median follow up 66 months was 90% fo r the surgery group and 80% for the observation group (P = 0.53, not signif icant). The percentage of patients continuously disease-free was 70% in the surgery group and 80% in the observation group (P = 0.31, not significant) . In the small sub-group of patients with differentiated teratoma (TD) in t he primary lesion who were observed, there was no excess risk of relapse or death. Patients who achieve a serological complete response after primary chemotherapy, but are left with less than or equal to 2 cm radiological mas ses that are not cystic and have responded, can be safely observed with dil igent follow-up. (C) 2000 Cancer Research Campaign.