title: Risk adapted management with adjuvant chemotherapy in patients with high risk clinical stage i nonseminomatous germ cell tumor.
abstract: OBJECTIVE
  We propose that patients with high risk, clinical stage I nonseminomatous germ cell tumors receive 2 cycles of chemotherapy initially, instead of undergoing surgery or observation.
  
  
  METHODS
  A total of 59 patients with high risk, clinical stage I nonseminomatous germ cell tumor received risk adapted adjuvant chemotherapy. Until June 1987, 20 patients were treated with 2 courses of adjuvant cisplatin, vinblastine and bleomycin at 3-week intervals. After June 1987 another 39 patients were treated with 2 cycles of bleomycin, etoposide and cisplatin.
  
  
  RESULTS
  Long-term results with this treatment strategy have been excellent with limited morbidity.
  
  
  CONCLUSIONS
  Adjuvant chemotherapy may be of particular value in patients with compromised followup.
authors.affiliation: Department of Urology, University of Berne, Inselspital-Anna Seiler-Haus, Berne, Switzerland.
authors.forename: U E
authors.initials: UE
authors.lastname: Studer
authors.forename: F C
authors.initials: FC
authors.lastname: Burkhard
authors.forename: R W
authors.initials: RW
authors.lastname: Sonntag
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018237:Germinoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D013736:Testicular Neoplasms / Q000188:drug therapy*