Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer

S. D. Williams, D. M. Stablein, Lawrence Einhorn, F. M. Muggia, R. B. Weiss, J. P. Donohue, D. F. Paulson, K. W. Brunner, E. M. Jacobs, J. T. Spaulding, W. D. DeWys, E. D. Crawford

Research output: Contribution to journalArticle

273 Citations (Scopus)

Abstract

Between 1979 and 1984, 195 evaluable patients were entered in an international multicenter study comparing two regimens for patients with completely resected pathological Stage II testicular cancer (that is, with positive retroperitoneal lymph nodes). All patients had undergone orchiectomyy and dissection of the retroperitoneal lymph nodes. They were randomly assigned to be treated with two cycles of immediate adjuvant cisplatin-based chemotherapy or to be observed monthly with treatment at relapse. The median follow-up period was four years. Of the 97 patients assigned to adjuvant chemotherapy, 6 (6 percent) had a recurrence; however, only 1 had received adjuvant chemotherapy before the recurrence. Three died (one of testicular cancer), and 94 of the 97 survived. Of the 98 patients who were observed, 48 (49 percent) had a relapse. However, almost all patients with relapses were effectively treated, and 93 of the 98 are alive and disease-free; 3 have died of testicular cancer. No identifiable factors were strongly associated with the risk of relapse. We conclude that two courses of cisplatin-based adjuvant chemotherapy will almost always prevent relapse in pathological Stage II testicular cancer treated with orchiectomy and retroperitoneal-lymph-node dissection. However, when surgery, follow-up, and chemotherapy are optimal, observation with chemotherapy only for relapse will lead to equivalent cure rates.

Original languageEnglish
Pages (from-to)1433-1438
Number of pages6
JournalNew England Journal of Medicine
Volume317
Issue number23
StatePublished - 1987

Fingerprint

Testicular Neoplasms
Adjuvant Chemotherapy
Observation
Recurrence
Therapeutics
Lymph Node Excision
Drug Therapy
Cisplatin
Orchiectomy
Multicenter Studies
Lymph Nodes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Williams, S. D., Stablein, D. M., Einhorn, L., Muggia, F. M., Weiss, R. B., Donohue, J. P., ... Crawford, E. D. (1987). Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer. New England Journal of Medicine, 317(23), 1433-1438.

Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer. / Williams, S. D.; Stablein, D. M.; Einhorn, Lawrence; Muggia, F. M.; Weiss, R. B.; Donohue, J. P.; Paulson, D. F.; Brunner, K. W.; Jacobs, E. M.; Spaulding, J. T.; DeWys, W. D.; Crawford, E. D.

In: New England Journal of Medicine, Vol. 317, No. 23, 1987, p. 1433-1438.

Research output: Contribution to journalArticle

Williams, SD, Stablein, DM, Einhorn, L, Muggia, FM, Weiss, RB, Donohue, JP, Paulson, DF, Brunner, KW, Jacobs, EM, Spaulding, JT, DeWys, WD & Crawford, ED 1987, 'Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer', New England Journal of Medicine, vol. 317, no. 23, pp. 1433-1438.
Williams, S. D. ; Stablein, D. M. ; Einhorn, Lawrence ; Muggia, F. M. ; Weiss, R. B. ; Donohue, J. P. ; Paulson, D. F. ; Brunner, K. W. ; Jacobs, E. M. ; Spaulding, J. T. ; DeWys, W. D. ; Crawford, E. D. / Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer. In: New England Journal of Medicine. 1987 ; Vol. 317, No. 23. pp. 1433-1438.
@article{8596506fc3424b048bd6cc8645449ae8,
title = "Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer",
abstract = "Between 1979 and 1984, 195 evaluable patients were entered in an international multicenter study comparing two regimens for patients with completely resected pathological Stage II testicular cancer (that is, with positive retroperitoneal lymph nodes). All patients had undergone orchiectomyy and dissection of the retroperitoneal lymph nodes. They were randomly assigned to be treated with two cycles of immediate adjuvant cisplatin-based chemotherapy or to be observed monthly with treatment at relapse. The median follow-up period was four years. Of the 97 patients assigned to adjuvant chemotherapy, 6 (6 percent) had a recurrence; however, only 1 had received adjuvant chemotherapy before the recurrence. Three died (one of testicular cancer), and 94 of the 97 survived. Of the 98 patients who were observed, 48 (49 percent) had a relapse. However, almost all patients with relapses were effectively treated, and 93 of the 98 are alive and disease-free; 3 have died of testicular cancer. No identifiable factors were strongly associated with the risk of relapse. We conclude that two courses of cisplatin-based adjuvant chemotherapy will almost always prevent relapse in pathological Stage II testicular cancer treated with orchiectomy and retroperitoneal-lymph-node dissection. However, when surgery, follow-up, and chemotherapy are optimal, observation with chemotherapy only for relapse will lead to equivalent cure rates.",
author = "Williams, {S. D.} and Stablein, {D. M.} and Lawrence Einhorn and Muggia, {F. M.} and Weiss, {R. B.} and Donohue, {J. P.} and Paulson, {D. F.} and Brunner, {K. W.} and Jacobs, {E. M.} and Spaulding, {J. T.} and DeWys, {W. D.} and Crawford, {E. D.}",
year = "1987",
language = "English",
volume = "317",
pages = "1433--1438",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "23",

}

TY - JOUR

T1 - Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological Stage II testicular cancer

AU - Williams, S. D.

AU - Stablein, D. M.

AU - Einhorn, Lawrence

AU - Muggia, F. M.

AU - Weiss, R. B.

AU - Donohue, J. P.

AU - Paulson, D. F.

AU - Brunner, K. W.

AU - Jacobs, E. M.

AU - Spaulding, J. T.

AU - DeWys, W. D.

AU - Crawford, E. D.

PY - 1987

Y1 - 1987

N2 - Between 1979 and 1984, 195 evaluable patients were entered in an international multicenter study comparing two regimens for patients with completely resected pathological Stage II testicular cancer (that is, with positive retroperitoneal lymph nodes). All patients had undergone orchiectomyy and dissection of the retroperitoneal lymph nodes. They were randomly assigned to be treated with two cycles of immediate adjuvant cisplatin-based chemotherapy or to be observed monthly with treatment at relapse. The median follow-up period was four years. Of the 97 patients assigned to adjuvant chemotherapy, 6 (6 percent) had a recurrence; however, only 1 had received adjuvant chemotherapy before the recurrence. Three died (one of testicular cancer), and 94 of the 97 survived. Of the 98 patients who were observed, 48 (49 percent) had a relapse. However, almost all patients with relapses were effectively treated, and 93 of the 98 are alive and disease-free; 3 have died of testicular cancer. No identifiable factors were strongly associated with the risk of relapse. We conclude that two courses of cisplatin-based adjuvant chemotherapy will almost always prevent relapse in pathological Stage II testicular cancer treated with orchiectomy and retroperitoneal-lymph-node dissection. However, when surgery, follow-up, and chemotherapy are optimal, observation with chemotherapy only for relapse will lead to equivalent cure rates.

AB - Between 1979 and 1984, 195 evaluable patients were entered in an international multicenter study comparing two regimens for patients with completely resected pathological Stage II testicular cancer (that is, with positive retroperitoneal lymph nodes). All patients had undergone orchiectomyy and dissection of the retroperitoneal lymph nodes. They were randomly assigned to be treated with two cycles of immediate adjuvant cisplatin-based chemotherapy or to be observed monthly with treatment at relapse. The median follow-up period was four years. Of the 97 patients assigned to adjuvant chemotherapy, 6 (6 percent) had a recurrence; however, only 1 had received adjuvant chemotherapy before the recurrence. Three died (one of testicular cancer), and 94 of the 97 survived. Of the 98 patients who were observed, 48 (49 percent) had a relapse. However, almost all patients with relapses were effectively treated, and 93 of the 98 are alive and disease-free; 3 have died of testicular cancer. No identifiable factors were strongly associated with the risk of relapse. We conclude that two courses of cisplatin-based adjuvant chemotherapy will almost always prevent relapse in pathological Stage II testicular cancer treated with orchiectomy and retroperitoneal-lymph-node dissection. However, when surgery, follow-up, and chemotherapy are optimal, observation with chemotherapy only for relapse will lead to equivalent cure rates.

UR - http://www.scopus.com/inward/record.url?scp=0023243140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023243140&partnerID=8YFLogxK

M3 - Article

C2 - 2446132

AN - SCOPUS:0023243140

VL - 317

SP - 1433

EP - 1438

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 23

ER -