Abstract:
OBJECTIVE:To assess the impact on patterns of recurrence of adjuvant chemotherapy in patients with stage 1 nonseminomatous germ cell tumours (NSGCT) of the testis, who have a high likelihood of relapse on surveillance if certain risk factors are identified in the orchidectomy specimen, and thus the theoretical need for retroperitoneal lymph node dissection (RPLND). PATIENTS AND METHODS:The incidence of abdominal relapse was recorded in 417 men presenting with stage 1 NSGCT over the past 18 years. Up to 1986, 161 men were managed by surveillance alone, and abdominal relapse occurred in 26. From 1986 onwards, men with positive risk factors in the orchidectomy specimen were offered two courses of chemotherapy; 60 accepted and one relapsed in the abdomen, and 196 underwent surveillance and 19 relapsed in the abdomen. RESULTS:Abdominal relapse was significantly reduced from 16% before 1986 to 8% afterward (P = 0.014). Mortality from testicular tumour or treatment toxicity remained low, at 0.6% before 1986 and 2.0% since then. CONCLUSION:The need for RPLND in stage 1 NSGCT remains highly doubtful.
journal_name
BJU Intjournal_title
BJU internationalauthors
Hendry WF,Norman A,Nicholls J,Dearnaley DP,Peckham MJ,Horwich Adoi
10.1046/j.1464-410x.2000.00722.xkeywords:
subject
Has Abstractpub_date
2000-07-01 00:00:00pages
89-93issue
1eissn
1464-4096issn
1464-410Xpii
bju722journal_volume
86pub_type
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doi:10.1046/j.1464-410x.2000.00771.x
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更新日期:2005-08-01 00:00:00
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更新日期:2007-02-01 00:00:00
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更新日期:2003-09-01 00:00:00
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更新日期:2003-04-01 00:00:00