Resultaten van 15 jaar behandeling van niet-seminomateuze testiscarcinomen: 84% 5-jaarsoverleving

To review the results 5 years after treatment of patients with testicular non-seminoma.

Design

Retrospective, descriptive.

Method

The records were studied of the 146 patients treated in Leiden University Hospital, the Netherlands, in 1979-1993 for non-seminoma of the testicle. The median age was 27 years (range: 16-76). The median follow-up duration was 65 months (range: 4-172).The Kaplan-Meier method was used to calculate the recurrence and survival rates.

Results

In all, 21 of the 146 patients died (5-year survival rate: 84). Five patients died as a result of treatment. A relapse occurred in 14 of the 49 stage I patients after frequent controls according to the European Organization for Research and Treatment of Cancer (EORTC) standards. One of these patients died after he refused further treatment for his relapse (5-year survival rate: 96). 92 patients, including 13 from the stage I group, were treated according to protocol with chemotherapy because of metastatic disease, of whom 51 underwent surgery following primary treatment. The histology of the resected material showed vital tumour tissue in 14 of the 51 patients (27). Seven patients never reached complete remission after chemotherapy and died. In 12 of the 92 patients a relapse occurred after chemotherapy; seven of these died despite further treatment. The 5-year survival rate of the 92 patients with metastatic disease was 82. None of the surviving patients developed a second primary or major pulmonary, renal or auditory problem.

Conclusion

The chance of cure and survival in patients suffering from testicular non-seminoma with the help of chemotherapy and surgery is over 80. In stage I patients intensive surveillance, and chemotherapy in case of a relapse, is effective. Even patients with metastatic disease have a high probability of being cured with few long-term side effects.