Prognosis in patients with metastatic non-seminomatous testicular cancer.
155 patients with metastatic non-seminomatous testicular cancer were treated with cisplatin-based chemotherapy which in most cases was combined with surgery. The 5 year crude survival was 90% for all patients (98 patients with small volume disease: 97%; 32 patients with large volume disease: 91%; 25 patients with very large volume disease: 64%). High pre-chemotherapy serum tumour marker levels (AFP greater than 500 micrograms/l; and/or HCG greater than 1000 U/l) decreased the survival rates in all groups. Only 4 of 17 relapsing patients were rendered tumour-free by salvage chemotherapy. In a multivariate analysis, a pre-chemotherapy alpha-foetoprotein (AFP) level greater than 500 micrograms/l was associated with poor survival as was the presence of a retroperitoneal tumour greater than 10 cm, lung metastases greater than 3 cm and/or extrapulmonary hematogenous metastases. It is concluded that easily assessable clinical pre-treatment variables can be used to define high risk or low risk patients with metastatic testicular cancer. Treatment intensity should be adjusted in accordance to such prognostic factors.
Department of Medical Oncology, Norwegian Radium Hospital, Oslo.
N
N
Aass
S D
SD
Fosså
S
S
Ous
A E
AE
Stenwig
H H
HH
Lien
E
E
Paus
O
O
Kaalhus
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000628:therapy; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000628:therapy; D013223:Statistics as Topic; D015996:Survival Rate; D013724:Teratoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D002945:Cisplatin