Adjuvant chemotherapy in resected nonseminomatous germ cell tumors of testis: stages I and II.

Abstract

T ESTICULAR CARCINOMAS constitute only 1% of malignant tumors in males yet are the second most common cause of death from malignancy in the 15-34-yr-old age group.’ In the United States, it was estimated for 1977 that 3600 men would develop malignant germ cell tumors of the testis: 1750 seminomatous and 1850 nonseminomatous germ cell tumors (NSGCT). At the time of diagnosis, approximately 44% of patients with NSGCT have localized disease (Stage I), 23% have regional disease (Stage II), and 33% have distant metastases (Stages 111 and IV).2.3 Thus, 1240 patients with NSGCT were estimated to have localized tumor or regional metastases and 610 distant metastases. The 5-yr survival rate for patients with distant metastases was 12% in the years 19501954 and probably most of these survivors were patients with pure seminomas. Presently, chemotherapy has been found capable of inducing significant tumor regression in 80%-100% of patients with disseminated NSGCT and complete remission in 50%-70%.4.m6 Traditionally, Stages I and II NSGCT have been treated with surgery and/or irradiation. However, a certain proportion of patients will recur with distant metastases and the established efficacy of chemotherapy in advanced disease makes it attractive for use in an adjuvant setting.