Improved management of nonseminomatous testis tumors

J. P. Donohue, Lawrence Einhorn, J. M. Perez

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Two contributions to the management of nonseminomatous germinal cell (NSGC) tumors of the testis are reviewed. First, a midline technique of extended retroperitoneal lymph node dissection (RPLND) has been developed allowing good access to both renal suprahilar zones as well as the traditional hilar and infrahilar areas. This has been employed at Indiana University Medical Center for staging patients with embryonal carcinoma or teratocarcinoma of the testis who had negative preoperative chest tomography. Of 58 consecutive patients from 1965-1975, 30 were Stage A and 28 Stage B. Thirty of 30 stage A patients survived (1005) and 24 of 28 (86%) operated stage B patients survived, for an overall survival of 54/58 (93%). The second contribution relates to development of a new combination chemotherapy protocol for Stage C disease. Preoperative Stage C lesions are treated with Platinum, Velban and Bleomycin (PVB). Those who achieve clearance of pulmonary tumors but who have anatomic or serologic evidence of persistent retroperitoneal tumor after PVB chemotherapy are later treated with RPLND. Six of 12 such patients have been rendered tumor free and now enjoy complete remission. Furthermore, 33 of 50 (66%) patients with disseminated Stage C disease achieved initial complete remission using this drug combination. Twenty-six remain in continuous complete remission with no evidence of disease from 2 to 4 years. Seven are alive, in partial remission, and 17 are dead. Improving chemotherapy opens alternative methods of managing advanced testis cancer.

Original languageEnglish
Pages (from-to)2903-2908
Number of pages6
JournalCancer
Volume42
Issue number6
StatePublished - 1978

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Testis
Neoplasms
Vinblastine
Bleomycin
Platinum
Lymph Node Excision
Embryonal Carcinoma
Teratocarcinoma
Drug Therapy
Testicular Neoplasms
Drug Combinations
Combination Drug Therapy
Thorax
Tomography
Kidney
Lung
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Donohue, J. P., Einhorn, L., & Perez, J. M. (1978). Improved management of nonseminomatous testis tumors. Cancer, 42(6), 2903-2908.

Improved management of nonseminomatous testis tumors. / Donohue, J. P.; Einhorn, Lawrence; Perez, J. M.

In: Cancer, Vol. 42, No. 6, 1978, p. 2903-2908.

Research output: Contribution to journalArticle

Donohue, JP, Einhorn, L & Perez, JM 1978, 'Improved management of nonseminomatous testis tumors', Cancer, vol. 42, no. 6, pp. 2903-2908.
Donohue JP, Einhorn L, Perez JM. Improved management of nonseminomatous testis tumors. Cancer. 1978;42(6):2903-2908.
Donohue, J. P. ; Einhorn, Lawrence ; Perez, J. M. / Improved management of nonseminomatous testis tumors. In: Cancer. 1978 ; Vol. 42, No. 6. pp. 2903-2908.
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