ROBERT J. MOTZER, M.D.; GEORGE J. BOSL, M.D.; NANCY L. GELLER, Ph.D.; DARRYL PENENBERG, M.A.; ALAN YAGODA, M.D.; ROBERT GOLBEY, M.D.; WILLET F. WHITMORE Jr., M.D.; WILLIAM R. FAIR, M.D.; PRAMOD SOGANI, M.D.; HARRY HERR, M.D.; MICHAEL MORSE, M.D.; ROBERT W. CAREY, M.D.; NICHOLAS VOGELZANG, M.D.
Study Objective: To determine the effectiveness of chemotherapy and adjunctive surgery in managing patients with advanced seminoma.
Design: Nonrandomized prospective clinical trial of chemotherapy in a cohort of patients with advanced seminoma.
Setting: Referral cancer hospital.
Patients: Consecutive sample of 62 patients with primary extragonadal, stage IIC (> 5-cm retroperitoneal adenopathy) and stage III seminoma; 45 patients were previously untreated, 13 had received radiotherapy, and 4 had previously received radiotherapy and chemotherapy.
Intervention: Cisplatin-based chemotherapy (100 to 120 mg/m2 body surface area per cycle of treatment); 45 patients received vinblastine, bleomycin, cisplatin, dactinomycin, and cyclophosphamide; 15, etoposide and cisplatin; and 2, both regimens.
Measurements and Main Results: Fifty-three of the sixty (88%) evaluable patients achieved a complete remission, and only 6 patients had relapses. Fifty-three of the sixty-two patients (85%) remain alive and disease-free. The regimen of etoposide and cisplatin was equivalent to regimens using more drugs. An elevated level of human chorionic gonadotropin at the initiation of treatment was associated with a worse prognosis.
Conclusions: Cisplatin-based chemotherapy is effective treatment for patients with extragonadal, stage IIC, and stage III seminoma and should be considered as initial therapy.
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MOTZER RJ, BOSL GJ, GELLER NL, PENENBERG D, YAGODA A, GOLBEY R, et al. Advanced Seminoma: The Role of Chemotherapy and Adjunctive Surgery. Ann Intern Med. 1988;108:513–518. doi: 10.7326/0003-4819-108-4-513
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Published: Ann Intern Med. 1988;108(4):513-518.
Hematology/Oncology, Hospital Medicine.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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