title: Advances in the management of non-seminomatous germ cell tumors during the cisplatin era: a single-institution experience.
abstract: BACKGROUND
  The objectives of the present study were to review chronological changes in the long-term survival of patients with non-seminomatous germ cell tumor (NSGCT) who were treated at a single institution after the introduction of cisplatin-based combination chemotherapy.
  
  
  METHODS
  One hundred and twenty patients with NSGCT who were treated between January 1978 and October 2001 were enrolled in this study. To evaluate chronological changes in treatment outcome between 1978 and 2001, data were analyzed according to the timing of initial treatment in two consecutive 12-year periods. The numbers of patients who were treated during 1978-1989 and 1990-2001 were 59 and 61, respectively. Patients were classified according to criteria of both the Japanese Urological Association (JUA classification) and the International Germ Cell Cancer Collaborative Group (IGCCCG classification).
  
  
  RESULTS
  The mean follow up of surviving patients during the periods 1978-1989 and 1990-2001 was 84 months and 63 months, respectively. The overall 5-year survival rate of patients with NSGCT significantly increased from 72.8% during the period 1978-1989 to 83.6% during the period 1990-2001 (P = 0.02, log-rank test). A significant improvement in survival was found in the patients with stage III disease, according to the JUA classification, and in the patients with poor-risk disease, according to the IGCCCG classification (P = 0.004 and 0.05, respectively).
  
  
  CONCLUSIONS
  The overall 5-year survival rate of patients with NSGCT increased significantly from 72.8% during 1978-1989 to 83.6% during 1990-2001. This improvement resulted mainly from an increased survival of patients with metastatic poor-risk NSGCT.
authors.affiliation: Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. muramaki@med.kobe-u.ac.jp
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Muramaki
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.forename: Gaku
authors.initials: G
authors.lastname: Kawabata
authors.forename: Sadao
authors.initials: S
authors.lastname: Kamidono
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D005500:Follow-Up Studies; D018237:Germinoma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin