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

Journal Article

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 orchiectomy 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.

Full Text

Duke Authors

Cited Authors

  • Williams, SD; Stablein, DM; Einhorn, LH; Muggia, FM; Weiss, RB; Donohue, JP; Paulson, DF; Brunner, KW; Jacobs, EM; Spaulding, JT

Published Date

  • December 3, 1987

Published In

Volume / Issue

  • 317 / 23

Start / End Page

  • 1433 - 1438

PubMed ID

  • 2446132

International Standard Serial Number (ISSN)

  • 0028-4793

Digital Object Identifier (DOI)

  • 10.1056/NEJM198712033172303

Language

  • eng

Conference Location

  • United States