[Long-term results of multimodality therapy of testicular germ cell tumor].
OBJECTIVE
To study the clinical characteristics, outcome, prognostic factors and survival of patients with testicular germ cell tumors (TGCTs).


METHODS
107 TGCT patients received chemotherapy after orchiectomy. The median age of the patients was 32 years. 30.8% (33/107) patients had seminomas with 14 (42.4%) stage I lesions. Seventy-four patients had non-seminomatous germ cell tumors (NSGCTT) with 21 (28.4%) stage I lesions. The response rate was analyzed with chi(2) test. The survival rate was calculated with Kaplan-Meier method and log-rank test. Therapy including chemotherapy, radiation and necessary salvage operation were performed after orchiectomy.


RESULTS
Clinical stage and pathological type were the main prognostic factors. The 3-, 5- and 10-year survival rates were 75.8%, 73.5%, 73.5% for all patients, 100%, 96.8%, 96.8% for seminoma and 63.5%, 61.7%, 61.7% for NSGCTTs, respectively. Sixty-four patients were evaluable for response. Seventeen (26.6%) patients achieved CR by chemotherapy alone and an additional 8 patients (12.5%) achieved CR by chemotherapy plus salvage operation or radiation. The 5-year survival rates were 91.7% and 26.2% for patients who achieved CR or not.


CONCLUSIONS
The long-term outcome for stage I germ cell tumors is excellent. The treatment outcome and survival in patients with metastatic TGCTs can be greatly improved by adopting multi-modality therapy with combined chemotherapy as the chief means.
Wang
Jin-wan
JW
Department of Medical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China.
Yang
Lin
L
Wang
Jia-yu
JY
Qu
Tao
T
Cai
Rui-gang
RG
Huang
Jing
J
Sun
Yan
Y
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide / Q000627:therapeutic use; D005500:Follow-Up Studies; D018237:Germinoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D018239:Seminoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin