Changing Concepts in the Treatment of Nonseminomatous Germ Cell Tumors of the Testis

Abstract

The development of effective chemotherapy for advanced nonseminomatous germ cell tumors of the testis has dramatically changed the outlook for this once uniformly fatal disease. Experience with changing modalities of therapy during a 7-yr period in the treatment of 152 patients with all stages of testis tumor was reviewed. Survival rates have increased from 84% for patients with stage A, B1 or B2 tumors treated with sandwich irradiation therapy and retroperitoneal lymph node dissection to 100% for patients with node dissection with or without chemotherapy. Survival rates continuously free of disease for patients with advanced (stage B3 or C) disease have increased from 53% in 1975-1977 to 82% by the addition of platinum-based polychemotherapy and judicious lymphadenectomy. A unified plan of management for patients with low stage and advanced stage nonseminomatous testicular tumors has evolved.