Residual mass following chemotherapy of seminoma.
BACKGROUND
The residual mass so frequently found after chemotherapy of advanced seminoma may consist entirely of benign tissue or may contain residual disease amenable to adjuvant therapy.


METHODS
A detailed retrospective analysis was performed on 45 patients treated with cisplatin based chemotherapy for advanced seminoma between 1978 and 1994.


RESULTS
The probability of a residual mass after chemotherapy was higher if the pre-treatment mass diameter was > 5 cm (78% versus 15%, P = 0.0009). Of 33 patients with residual masses following cisplatin chemotherapy, 4 were explored surgically showing fibrosis only, 15 were treated by adjuvant radiotherapy and 14 were managed by observation alone. Recurrence occurred in 2 of 14 patients managed by observation and in 2 of 15 managed by radiotherapy. There was no evidence that risk of recurrence was related to diameter of residual mass.


CONCLUSIONS
Residual masses persisted following cisplatin based combination chemotherapy for seminoma in 73% of cases. In our study, recurrence was rare and there was no evidence that this was influenced by either the size of the residual mass or the use of adjuvant therapy.
Horwich
A
A
Department of Clinical Oncology, Royal Marsden NHS Trust, Institute of Cancer Research, Sutton, Surrey, UK.
Paluchowska
B
B
Norman
A
A
Huddart
R
R
Nicholls
J
J
Fisher
C
C
Husband
J
J
Dearnaley
D P
DP
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005355:Fibrosis; D006801:Humans; D015993:Life Tables; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D016879:Salvage Therapy; D018239:Seminoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects
D014408:Biomarkers, Tumor; D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D016190:Carboplatin; D002945:Cisplatin