Four cycles of single agent carboplatin AUC 7 do not safely eradicate retroperitoneal metastases in patients with stage IIA/B seminoma.

Our data demonstrate that bladder surface is the most important factor for increased absorption but time dependent histological changes of the integrated intestinal mucosa also influence absorption. There is a broad interindividual discrepancy. Therefore, general rules in patients with urinary diversion may not be justified.

Objective: We initiated a prospective phase II trial to assess the outcome of complete surgical removal of metastases from different tumor entities (renal cell cancer n = 32, bladder cancer n = 45, prostate cancer n = 13, and penile cancer n = 2) with regard to survival and quality of life. Patients and Methods: 92 patients with asymptomatic (n = 21) and symptomatic (n = 71) secondaries from genitourinary cancers (testicular cancer were excluded) refractory to systemic therapy were included. We removed secondaries metastatic to lymph nodes, peritoneum, skin, adrenals, bone, lung, and liver and measured survival and performance score. Results: With a 1-year survival rate of 36% prognosis is unfavorable independent from histopathology and site of metastasis, revealing no benefit regarding survival. However, 83% of the patients with symptomatic secondaries did benefit from surgery regarding quality of life, i.e. performance score. Conclusion: Surgical removal of metastases from genitourinary cancers refractory of systemic therapy has an impact on quality of life limited to patients with symptomatic disease.

We present long-term results (minimum follow-up 5 years) in 145 patients with advanced non-seminomatous germ cell tumours, who underwent radical retroperitoneal lymphadenectomy (RPLA) after chemotherapy. We correlated patients' outcomes (death of disease) to different kinds of chemotherapy and to intraoperative findings. We found that patients who were treated by a modified Einhorn scheme with cisplatin, etoposide and bleomycin have a good prognosis. In all, 90% showed no evidence of disease (NED). The NED rate was significantly lower in patients who were treated by sequential alternative chemotherapy (DOD = 37%). We determined the following prognostic factors which predict a poor outcome: salvage RPLA in the case of progressive disease or tumour marker increase during chemotherapy (DOD = 89%, P < 0.0001) residual tumour in multiple-organ systems (DOD = 41%, P = 0.0006) vital tumour in RPLA specimen (DOD = 53%, P < 0.0001) residual tumour mass > 5 cm (DOD = 41%, P = 0.0188). We found that histopathological findings of the primary tumour and tumour stage IIc-IIIc according to the Lugano classification have no prognostic significance for death of disease.