Benign Transformation of Testicular Carcinoma by Chemotherapy

Merrin, Claude; Baumgartner, George; Wajsman, Zew

doi:10.1016/s0140-6736(75)92411-3

Cited by 75 publications

(28 citation statements)

References 12 publications

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“…In patients with differentiated teratoma when the residual disease was resected, the aggressive parts of the tumour were closely associated with the trophoblastic and yolk-sac elements of the teratoma, producing hCG and AFP respectively. In the 2 patients (1 male, 1 female) with unresectable differentiated teratomas, the markers have been normal and the clinical situation has been static, which agrees with the favourable prognosis reported in this situation (Merrin et al, 1975;Hong et al, 1977). Sixteen patients in this study have had surgery after bleomycin therapy, and so far there has been no pulmonary toxicity.…”

Section: Resultssupporting

confidence: 85%

Chemotherapy of advanced malignant teratomas

Newlands¹,

Begent²,

Kaye³

et al. 1980

Br J Cancer

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Between 1977 and November 1979 we have treated 53 patients with malignant teratomas (43 males, 10 females). Thirty (70%) out of the 43 male patients had advanced and bulky disease at the time of presentation. Using different drug combinations in a sequential manner as described below, results are as follows: of the initial 33 male patients, 22 (67%) have discontinued treatment (mean 9.5 months). Nineteen have responded completely and 3 have static computed tomography (CT) nodules. Life-table analysis projects a survival of 66% (analysis at 1 December 1979). Nine out of 10 ovarian teratoma patients are alive. Adverse prognostic factors at the start of treatment were recognized in 9/10 male patients and the 1 female patient who have died. Although the survival of patients with malignant teratomas has improved dramatically, there are still problems with drug resistance in patients with very advanced disease. Patients with these tumours should continue to be treated in centres specializing in managing what has now become a potentially curable disease in most cases.

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Section: Resultssupporting

confidence: 85%

Chemotherapy of advanced malignant teratomas

Newlands¹,

Begent²,

Kaye³

et al. 1980

Br J Cancer

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“…The phenomenon of change towards a more benign state in metastases from testicular germ-cell tumours has long been recognised (Smithers, 1969). Numerous reports describe differentiated teratoma metastases excised after chemotherapy and/or radiotherapy (Duari, 1967;Willis & Hajdu, 1973;Merrin et al, 1975;Stechmiller et al, 1976;Hong et al, 1977;Hendry et al, 1980;Einhorn et al, 1981;Vugrin et al, 1981;Stahel et al, 1982;Bracken et al, 1983;Callery et al, 1983;Oosterhuis et al, 1983;van Dongen et al, 1983). Whereas prior to the recent developments in chemotherapy this evolution towards morphological differentiation was uncommon it is now a well recognised feature.…”

Section: Discussionmentioning

confidence: 99%

Post-chemotherapy surgery in advanced non-seminomatous germ-cell testicular tumours: the significance of histology with particular reference to differentiated (mature) teratoma

Tait¹,

Peckham²,

Hendry³

et al. 1984

Br J Cancer

147

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Summary Of a total of 307 patients treated with chemotherapy for advanced non-seminomatous germ-cell testicular tumours between 1976 and 1983, 73 (23.8%) had masses excised after treatment. Resected tissue showed residual malignancy in 16 (22%), fibrosis and necrosis in 25 (34%) and differentiated (mature teratoma) in 32 (44%). Of the 16 patients with tumour only 7 (44%) are alive and disease-free compared with 21/25 (84%) and 27/32 (84%) for fibrosis/necrosis and differentiated teratoma respectively. In addition to histological evidence of residual tumour, elevated serum markers at the time of surgery and/or incomplete excision of residual masses were adverse prognostic features. Of 12 patients with differentiated teratoma or fibrosis who had incomplete resections or densely adherent masses excised with difficulty, 7 subsequently relapsed.The majority of differentiated teratoma patients (75%) had evidence of differentiation in their primary tumours; 88% showed cystic change in metastases and almost one-third showed an increase in the size of metastases during chemotherapy.The data suggest that post-chemotherapy surgery may have a therapeutic as well as a diagnostic role and that complete excision of residual disease should be attempted even if resection at one site has shown either fibrosis or differentiated teratoma. The significance of these findings in relation to treatment induced differentiation is discussed.

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“…That same year, John Dees of Duke University described the finding of a benign teratoma in a patient treated for 8 years with maintenance actinomycin D for primary embryonal testicular carcinoma. [4] In 1975, Merrin et al ,[6] reported a similar phenomenon in seven patients. Hong et al ,[7] in 1977, described the Memorial Sloan–Kettering Cancer Center experience with 12 patients of 600 presenting with germ cell testicular carcinoma.…”

Section: Historymentioning

confidence: 90%