Non-seminoma germ cell tumours (malignant teratoma) of the testis. Results of treatment and an analysis of prognostic factors.
The results of treatment of 126 patients with non-seminoma germ cell tumours (malignant teratoma) of the testis are presented. Of this group 81% are alive and 70% disease-free. Of 98 patients who had had no prior treatment 83% are alive and 76.5% disease-free. Of 43 early-stage patients 41 (95%) are alive and tumour-free despite a 21% relapse rate after radiotherapy. The disease-free rate in patients with advanced disease treated with chemotherapy, and in some cases radiotherapy and/or surgery, ranged from 100 to 9% and was strongly dependent upon the volume of metastatic tumour and the histology. Patients with malignant teratoma undifferentiated (embryonal carcinoma) showed a significantly higher disease-free survival rate than those with malignant teratoma intermediate (teratocarcinoma). Twenty-six men with advanced disease received radiotherapy after chemotherapy and of these 23 (88%) are alive and 21 (81%) are disease-free. No difference in disease-free survival rate was seen between advanced-stage patients receiving vinblastine and bleomycin and those receiving, in addition, cis-platinum. The overall drug-related mortality was 4.5%. Serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (beta-HCG) levels were valuable monitors in advanced disease but not prognostically significant if allowance was made for tumour volume. Fifteen patients had surgical resection of residual masses and one died post-operatively.
D002369:Castration; D006063:Chorionic Gonadotropin / Q000097:blood; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D013724:Teratoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000509:alpha-Fetoproteins / Q000032:analysis
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins