Adjuvant Chemotherapy in Resected Stage-II Nonseminomatous Germ Cell Tumors of Testis

Canadian consensus guidelines for the management of testicular germ cell cancer

“…For patients with PS IIA and B, the risk of recurrence is 30% and 50%, respectively, with surveillance only. 82,85,87,[93][94][95] Relapses occur almost exclusively outside the retroperitoneum. Adjuvant chemotherapy with 2 cycles of BEP in all PS IIA/B patients after RPLND reduces this risk of recurrence to about 0 to 7%.…”

Evolution and controversies in the management of low-stage nonseminomatous germ-cell tumors of the testis

“…Relapses occurred in 8 of 10 patients who had not been treated with cisplatin but did not occur in any of the 11 treated patients. We concluded that PVB adjuvant chemotherapy was mandatory in PS-IIC disease, whereas PS-IIA and PS-IIB patients could undergo close observation and cisplatin-based chemotherapy in the event of relapse [11].…”

“…During this period, we performed bilateral RPLND for NSGCT of the testis in 134 consecutive patients with either normal bipedal lymphangiography (LAG) or pathological LAG and only moderate, if any, abnormalities of the upper urinary tract on intravenous pyelography (IVP) and no palpable abdominal mass [11,12]. Patients with negative histology (74 cases) received no further therapy; among the 60 patients with positive nodes, the first 16 received no adjuvant chemotherapy, the second 15 were treated with 3 courses of adjuvant VB (vinblastine given at 6 mg/m 2 on days 1 and 2 and Neomycin given at 15 mg/m 2 daily by continuous intravenous infusion for 5 consecutive days, with treatment being repeated every 4 weeks), and the last 29 received 5 courses of adjuvant PVB (vinblastine given at 6 mg/m 2 on days 1 and 2, cisplatin given at 20 mg/m 2 on days 1-5, and Neomycin given at 30 mg on days 2, 9, and 16, with treatment being repeated every 3-4 weeks).…”

“…Patients with low-stage disease were clinically classified according to Peckham and Hendry [7], whereas we adopted a slight modification [11] of the international pathological classification [9], and we abandoned adjuvant chemotherapy in pathological stages (PS) IIA and IIB [10]; adjuvant chemotherapy was restricted to patients with PS-IIC disease only. The first 36 patients with CS-I NSGCT of the testis underwent RPLND [8], and the next 90 cases underwent surveillance after orchiectomy alone [14].…”

The Role of Adjuvant Treatment in Low-Stage Germ Cell TesticularTumors

“…When we reviewed the 60 pathologic stage II NSCGT of the testis we operated in the seventies [27], we were able to detect a subgroup of 10 patients who had an 80% very high risk patients (stage IIC, table 5), while it is strongly advised in situations where a very careful obser vation cannot be guaranteed. Probably it is to be advised in pathological stage IIB patients, too.…”