We report on 26 patients who presented with widespread, massive metastatic disease from non-seminomatous germinal cell tumors of the testis. Of these 26 patients 22 (85%) are well and 21 (80%) are presumed to be cured after initial chemotherapy with platinum, vinblastine and bleomycin cytoreduction followed by secondary retroperitoneal lymph node dissection. The most critical prognostic determinant was the nature of the tissue resected. Patients with only fibrous or cystic elements and those with mature teratoma fared well. All 22 patients are well from 1 to 5 years postoperatively. However, of 9 patients with persistent cancer in the resected tissue 4 are dead and 2 other were salvaged only after extensive further chemotherapy. Of the several options available pre-treatment with 4 courses of platinum, vinblastine and bleomycin before any surgical treatment in those with massive bulk metastatic disease seems to provide the most effective cytoreduction and best survival.
|Original language||English (US)|
|Number of pages||4|
|Journal||Journal of Urology|
|State||Published - Jan 1 1980|
ASJC Scopus subject areas