LONG-TERM RESULTS OF OPERATIVE THERAPY FO R METASTASIZED NONSEMINOMATOUS GERM-CELL TUMORS (NSGT) IN ADVANCED TUMOR STAGES

We present long-term results (minimum follow-up 5 years) in 145 patien ts with advanced non-seminomatous germ cell tumours, who underwent rad ical retroperitoneal lymphadenectomy (RPLA) after chemotherapy. We cor related patients' outcomes (death of disease) to different kinds of ch emotherapy and to intraoperative findings. We found that patients who were treated by a modified Einhorn scheme with cisplatin, etoposide an d bleomycin have a good prognosis. In all, 90 % showed no evidence of disease (NED). The NED rate was significantly lower in patients who we re treated by sequential alternative chemotherapy (DOD = 37 %). We det ermined the following prognostic factors which predict a poor outcome: salvage RPLA in the case of progressive disease or tumour marker incr ease during chemotherapy (DOD = 89 %, P < 0.0001) residual tumour in m ultiple-organ systems (DOD = 41 %, P = 0.0006) vital tumour in RPLA sp ecimen (DOD = 53 %, P < 0.0001) residual tumour mass > 5 cm (DOD = 41 %, P = 0.0188). We found that histopathological findings of the primar y tumour and tumour stage IIc-IIIc according to the lugano classificat ion have no prognostic significance for death of disease.