Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 2000 Jul 24;83(4):426–430. doi: 10.1054/bjoc.2000.1290

Improving the outcome of salvage treatment for non-seminomatous germ cell tumours (NSGCT)

J S de Bono 1, J Paul 1, A Simpson 1, A Anthoney 1, D Kirk 2, M Underwood 2, J Graham 2, S B Kaye 1
PMCID: PMC2374648  PMID: 10945485

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

Keywords: teratoma, relapse, salvage, prognosis

Full Text

The Full Text of this article is available as a PDF (50.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baniel J., Foster R. S., Gonin R., Messemer J. E., Donohue J. P., Einhorn L. H. Late relapse of testicular cancer. J Clin Oncol. 1995 May;13(5):1170–1176. doi: 10.1200/JCO.1995.13.5.1170. [DOI] [PubMed] [Google Scholar]
  2. Bokemeyer C., Gerl A., Schöffski P., Harstrick A., Niederle N., Beyer J., Casper J., Schmoll H. J., Kanz L. Gemcitabine in patients with relapsed or cisplatin-refractory testicular cancer. J Clin Oncol. 1999 Feb;17(2):512–516. doi: 10.1200/JCO.1999.17.2.512. [DOI] [PubMed] [Google Scholar]
  3. Bower M., Newlands E. S., Holden L., Rustin G. J., Begent R. H. Treatment of men with metastatic non-seminomatous germ cell tumours with cyclical POMB/ACE chemotherapy. Ann Oncol. 1997 May;8(5):477–483. doi: 10.1023/a:1008279222625. [DOI] [PubMed] [Google Scholar]
  4. Collette L., Sylvester R. J., Stenning S. P., Fossa S. D., Mead G. M., de Wit R., de Mulder P. H., Neymark N., Lallemand E., Kaye S. B. Impact of the treating institution on survival of patients with "poor-prognosis" metastatic nonseminoma. European Organization 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. 1999 May 19;91(10):839–846. doi: 10.1093/jnci/91.10.839. [DOI] [PubMed] [Google Scholar]
  5. Fosså S. D., Stenning S. P., Gerl A., Horwich A., Clark P. I., Wilkinson P. M., Jones W. G., Williams M. V., Oliver R. T., Newlands E. S. Prognostic factors in patients progressing after cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumours. Br J Cancer. 1999 Jul;80(9):1392–1399. doi: 10.1038/sj.bjc.6690534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harding M. J., Paul J., Gillis C. R., Kaye S. B. Management of malignant teratoma: does referral to a specialist unit matter? Lancet. 1993 Apr 17;341(8851):999–1002. doi: 10.1016/0140-6736(93)91082-w. [DOI] [PubMed] [Google Scholar]
  7. Horwich A., Sleijfer D. T., Fosså S. D., Kaye S. B., Oliver R. T., Cullen M. H., Mead G. M., de Wit R., de Mulder P. H., Dearnaley D. P. Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic nonseminomatous germ cell cancer: a Multiinstitutional Medical Research Council/European Organization for Research and Treatment of Cancer Trial. J Clin Oncol. 1997 May;15(5):1844–1852. doi: 10.1200/JCO.1997.15.5.1844. [DOI] [PubMed] [Google Scholar]
  8. Jansen R. L., Sylvester R., Sleyfer D. T., ten Bokkel Huinink W. W., Kaye S. B., Jones W. G., Keizer J., van Oosterom A. T., Meyer S., Vendrik C. P. Long-term follow-up of non-seminomatous testicular cancer patients with mature teratoma or carcinoma at postchemotherapy surgery. EORTC Genitourinary Tract Cancer Cooperative Group (EORTC GU Group) Eur J Cancer. 1991;27(6):695–698. doi: 10.1016/0277-5379(91)90168-d. [DOI] [PubMed] [Google Scholar]
  9. Kaye S. B., Mead G. M., Fossa S., Cullen M., deWit R., Bodrogi I., van Groeningen C., Sylvester R., Collette L., Stenning S. Intensive induction-sequential chemotherapy with BOP/VIP-B compared with treatment with BEP/EP for poor-prognosis metastatic nonseminomatous germ cell tumor: a Randomized Medical Research Council/European Organization for Research and Treatment of Cancer study. J Clin Oncol. 1998 Feb;16(2):692–701. doi: 10.1200/JCO.1998.16.2.692. [DOI] [PubMed] [Google Scholar]
  10. Loehrer P. J., Sr, Gonin R., Nichols C. R., Weathers T., Einhorn L. H. Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol. 1998 Jul;16(7):2500–2504. doi: 10.1200/JCO.1998.16.7.2500. [DOI] [PubMed] [Google Scholar]
  11. Motzer R. J., Bajorin D. F., Schwartz L. H., Hutter H. S., Bosl G. J., Scher H. I., Lyn P., Fischer P. Phase II trial of paclitaxel shows antitumor activity in patients with previously treated germ cell tumors. J Clin Oncol. 1994 Nov;12(11):2277–2283. doi: 10.1200/JCO.1994.12.11.2277. [DOI] [PubMed] [Google Scholar]
  12. Murphy B. R., Breeden E. S., Donohue J. P., Messemer J., Walsh W., Roth B. J., Einhorn L. H. Surgical salvage of chemorefractory germ cell tumors. J Clin Oncol. 1993 Feb;11(2):324–329. doi: 10.1200/JCO.1993.11.2.324. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES