Abstract
Between 1991–96, 41 patients were treated in this unit for relapsed non-seminomatous germ cell tumours (NSGCT). Twenty-eight patients had raised markers at relapse: 17 required salvage chemotherapy and post-chemotherapy surgery, 11 only chemotherapy. In addition 9 patients received high dose chemotherapy. Overall 16/28 patients (57%) requiring chemotherapy remain alive, 14 (50%) disease free. Of the 17 patients treated with chemotherapy and surgery: 12 remain alive, 10 (59%) with no evaluable disease. Only 4/11 (36%) patients treated with chemotherapy alone remain alive, all in complete remission (CR). For relapse with raised markers, univariate analysis suggests that less than CR to induction therapy, resulting in the presence of residual disease is the most important predictor of poor outcome (P< 0.001). All of the 13 patients relapsing with normal markers remain alive, having been primarily treated surgically. Overall these results indicate an improving outlook for relapsed NSGCT. © 2000 Cancer Research Campaign
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References
Anthoney DA, Roberts J, Graham J, McKean MJ, Paul J and Kaye SB (1999) Alternating Bleomycin, Vincristine, Cisplatin (BOP)/Bleomycin, Etoposide, Cisplatin (BEP) chemotherapy as a dose intense regimen for intermediate and poor prognosis malignant germ cell tumours (MGCT). Proc Am Soc Clin Oncol,
Baniel J, Foster RS, Gonin R, Messemer JE, Donohue JP and Einhom LH (1995) Late relapse of testicular cancer. J Clin Oncol 13(5): 1170–1176
Bhatia S, Cornetta K, Broun R, Nichols C, Abonour R and Einhom LH (1998) High dose chemotherapy with peripheral stem cell or autologous bone marrow transplant as initial salvage chemotherapy for testicular cancer. Proc Am Soc Clin Oncol,
Bokemeyer C, Gerl A, Schoffski P, Harstrick A, Niederle N, Beyer J, Casper J, Schmoll HJ and Kanz L (1999) Gemcitabine in patients with relapsed or cisplatin-refractory testicular cancer. J Clin Oncol 17(2): 512–516
Bower M, Newlands ES, Holden L, Rustin GJ and Begent RH (1997) Treatment of men with metastatic non-seminomatous germ cell tumours with cyclical POMB/ACE chemotherapy. Ann Oncol 8(5): 477–483
Collette L, Sylvester RJ, Stenning SP, Fossa SD, Mead GM, de Wit R, de Mulder PH, Neymark N, Lallemand E and Kaye SB (1999) Impact of the treating institution on survival of patients with ‘poor-prognosis’ metastatic non-seminoma. European Organisation for Research and Treatment of Cancer Genito-Urinary Tract Cancer Collaborative Group and the Medical Research Council Testicular Cancer Working Party. J Natl Cancer Inst 91(10): 839–846
Fossa SD, Stenning S, Gerl A, Horwich A, Clark P, Wilkinson P, Jones WG, Williams M, Oliver T, Newlands E, Mead G, Cullen M, Kaye SB, Rustin G and Cook P (1999) Prognostic factors in patients with malignant non-seminomatous germ cell tumours relapsing after cisplatin based chemotherapy. Br J Cancer 80(9): 1392–1399
Harding MJ, Paul J, Gillis CR and Kaye SB (1993) Management of malignant teratoma: does referral to a specialist unit matter?. Lancet 341(8851): 999–1002
Horwich A, Sleijfer DT, Fossa SD, Kaye SB, Oliver RT, Cullen MH, Mead GM, de Wit R, de Mulder PH, Dearnaley DP, Cook PA, Sylvester RJ and Stenning SP (1997) Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic non-seminomatous germ cell cancer: a Multi-institutional Medical Research Council/European Organisation for Research and Treatment of Cancer Trial. J Clin Oncol 15(5): 1844–1852
International Germ Cell Cancer Collaborative Group (1997) International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 15(2): 594–603
Jansen RL, Sylvester R, Sleyfer DT, ten Bokkel Huinink WW, Kaye SB, Jones WG, Keizer J, van Oosterom AT, Meyer S, Vendrik CP, de Pauw M and Stoter G for the EORTC Genitourinary Tract Cancer Cooperative Group (1991) Long-term follow-up of non-seminomatous testicular cancer patients with mature teratoma or carcinoma at postchemotherapy surgery. Eur J Cancer 27(6): 695–698
Kaye SB, Mead GM, Fossa S, Cullen M, deWit R, Bodrogi I, van Groeningen C, Sylvester R, Collette L, Stenning S, De Prijck L, Lallemand E and deMulder P (1998) Intensive induction-sequential chemotherapy with BOP/VIP-B compared with treatment with BEP/EP for poor-prognosis metastatic non-seminomatous germ cell tumour: a Randomized Medical Research Council/European Organisation for Research and Treatment of Cancer study. J Clin Oncol 16(2): 692–701
Loehrer PJ, Gonin R, Nichols CR, Weathers T and Einhorn LH (1998) Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol 16: 2500–2504
Motzer RJ, Bajorin DF, Schwartz LH, Hutter HS, Bosl GJ, Scher HI, Lyn P and Fischer P (1994) Phase II trial of paclitaxel shows anti-tumour activity in patients with previously treated germ cell tumours. J Clin Oncol 12(11): 2277–2283
Motzer RJ, GA Green,, McCaffrey JA, Bajorin DF, Bosl GJ, Sheinfeld PC and Sogani, (1998) Paclitaxel (t), Ifosfamide (i), and Cisplatin (p) as first-line salvage therapy for relapsed germ cell tumour patients with favourable prognostic features. Proc Am Soc Clin Oncol,
Murphy BR, Breeden ES, Donohue JP, Messemer J, Walsh W, Roth BJ and Einhorn LH (1993) Surgical salvage of chemorefractory germ cell tumors. J Clin Oncol 11(2): 324–329
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de Bono, J., Paul, J., Simpson, A. et al. Improving the outcome of salvage treatment for non-seminomatous germ cell tumours (NSGCT). Br J Cancer 83, 426–430 (2000). https://doi.org/10.1054/bjoc.2000.1290
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DOI: https://doi.org/10.1054/bjoc.2000.1290