Abstract
Background:
The residual mass so frequently found after chemotherapy of advanced seminoma may consist entirely of benign tissue or may contain residual disease amenable to adjuvant therapy.
Patients and methods:
A detailed retrospective analysis was performed on 45 patients treated with cisplatin based chemotherapy for advanced seminoma between 1978 and 1994.
Results:
The probability of a residual mass after chemotherapy was higher if the pre-treatment mass diameter was > 5 cm (78% versus 15%, P = 0.0009). Of 33 patients with residual masses following cisplatin chemotherapy, 4 were explored surgically showing fibrosis only, 15 were treated by adjuvant radiotherapy and 14 were managed by observation alone. Recurrence occurred in 2 of 14 patients managed by observation and in 2 of 15 managed by radiotherapy. There was no evidence that risk of recurrence was related to diameter of residual mass.
Conclusion:
Residual masses persisted following cisplatin based combination chemotherapy for seminoma in 73% of cases. In our study, recurrence was rare and there was no evidence that this was influenced by either the size of the residual mass or the use of adjuvant therapy.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Biomarkers, Tumor / analysis
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Bleomycin / administration & dosage
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Bleomycin / adverse effects
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Carboplatin / administration & dosage
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Carboplatin / adverse effects
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Cisplatin / administration & dosage
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Cisplatin / adverse effects
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Combined Modality Therapy
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Etoposide / administration & dosage
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Etoposide / adverse effects
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Fibrosis
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Humans
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Life Tables
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Male
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Neoplasm Recurrence, Local
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Neoplasm Staging
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Neoplasm, Residual
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Neoplasms, Second Primary / etiology
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Radiotherapy, Adjuvant / adverse effects
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Retrospective Studies
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Salvage Therapy
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Seminoma / drug therapy
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Seminoma / mortality
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Seminoma / pathology*
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Seminoma / radiotherapy
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Survival Analysis
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Testicular Neoplasms / drug therapy
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Testicular Neoplasms / mortality
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Testicular Neoplasms / pathology*
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Testicular Neoplasms / radiotherapy
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Treatment Outcome
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Vinblastine / administration & dosage
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Vinblastine / adverse effects
Substances
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Biomarkers, Tumor
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Bleomycin
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Vinblastine
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Etoposide
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Carboplatin
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Cisplatin
Supplementary concepts
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BEP protocol
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PVB protocol