Bilateral germ cell cancer of the testis: a report of 11 patients with a long-term follow-up

PURPOSE This study was performed to determine the effectiveness of postoperative adjuvant chemotherapy in patients with surgically resected ovarian germ cell tumors. PATIENTS AND METHODS After tumor removal and thorough surgical staging, patients were enrolled on this study and treated with three courses of cisplatin, etoposide, and bleomycin (BEP). Reassessment laparotomy was required of consenting, appropriate patients initially, but became an optional procedure in 1989. RESULTS Of 93 patients assessable on this trial, 89 are continuously free of germ cell cancer. At second-look laparotomy, two other patients were found to have small foci of immature teratoma; both remain clinically free of recurrence. One received subsequent alternate chemotherapy and one did not. Thus, 91 of 93 patients are currently free of germ cell cancer. Follow-up duration ranges from 4.0 to 90.3 months, with 67 patients monitored for longer than 2 years. Acute toxicity was moderate. One patient developed acute myelomonocytic leukemia 22 months after diagnosis. Another patient was noted to have a malignant lymphoma 69 months after protocol treatment. CONCLUSION Three courses of BEP will nearly always prevent recurrence in well-staged patients with completely resected ovarian germ cell tumors and should be given to all such patients. The development of acute leukemia as a complication of treatment is disturbing and mandates careful long-term follow-up, but is unusual and does not alter the risk-to-benefit ratio of treatment.

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Long Term Follow Up of Anglian Germ Cell Cancer Group Studies of Chemotherapy for Stage 1 Non Seminoma

Germ Cell Tumours V ◽

10.1007/978-1-4471-3281-3_59 ◽

2002 ◽

pp. 247-248

Author(s):

R. T. D. Oliver ◽

J. Ong ◽

R. Ravi ◽

J. Shamash ◽

J. Ostrowski ◽

...

Keyword(s):

Germ Cell ◽

Cell Cancer ◽

Germ Cell Cancer ◽

Cancer Group ◽

Long Term Follow Up ◽

Stage 1

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long-term follow-up of anglian germ cell cancer group surveillance versus patients with stage 1 nonseminoma treated with adjuvant chemotherapy

Urology ◽

10.1016/j.urology.2003.10.023 ◽

2004 ◽

Vol 63 (3) ◽

pp. 556-561 ◽

Cited By ~ 73

Author(s):

R.T.D Oliver ◽

J Ong ◽

J Shamash ◽

R Ravi ◽

V Nagund ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Germ Cell ◽

Cell Cancer ◽

Germ Cell Cancer ◽

Cancer Group ◽

Long Term Follow Up ◽

Stage 1

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Enhanced pulmonary toxicity in smokers with germ-cell cancer treated with Cis-platinum, vinblastine and bleomycin: A long-term follow-up

European Journal of Cancer and Clinical Oncology ◽

10.1016/0277-5379(89)90211-3 ◽

1989 ◽

Vol 25 (4) ◽

pp. 733-736 ◽

Cited By ~ 26

Author(s):

Steen W. Hansen ◽

Steffen Groth ◽

Peter G. Sørensen ◽

Niels Rossing ◽

Mikael Rørth

Keyword(s):

Germ Cell ◽

Pulmonary Toxicity ◽

Cell Cancer ◽

Germ Cell Cancer ◽

Long Term Follow Up

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Bilateral germ cell cancer of the testis: a report of 11 patients with a long-term follow-up

BJU International ◽

10.1111/j.1464-410x.2001.052-2.x ◽

2001 ◽

Vol 87 (3) ◽

pp. 278-280 ◽

Cited By ~ 2

Author(s):

A. Heidenreich ◽

L. Weissbach

Keyword(s):

Germ Cell ◽

Cell Cancer ◽

Germ Cell Cancer ◽

Long Term Follow Up

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Long-term effects on renal function and blood pressure of treatment with cisplatin, vinblastine, and bleomycin in patients with germ cell cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1988.6.11.1728 ◽

1988 ◽

Vol 6 (11) ◽

pp. 1728-1731 ◽

Cited By ~ 56

Author(s):

S W Hansen ◽

S Groth ◽

G Daugaard ◽

N Rossing ◽

M Rørth

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Germ Cell ◽

Cell Cancer ◽

Germ Cell Cancer ◽

Long Term Effects ◽

Increased Risk ◽

The Mean

Long-term effects of cisplatin on renal function were investigated in 34 patients with germ cell cancer observed for a median of 65 months (range, 43 to 97 months). All patients achieved a complete remission after treatment with cisplatin (median dose 583 mg/m2), vinblastine, and bleomycin. None of the patients relapsed during follow-up. During treatment the glomerular filtration rate (GFR) decreased by 18% (P less than .05). During follow-up kidney function recovered in ten patients and partly improved in eight patients. Changes in plasma creatinine did not consistently correspond to alterations in GFR. The mean increase in systolic blood pressure during follow-up did not differ from the increase seen in a group of age-matched healthy men. The mean increase in diastolic pressure, however, was significant (P less than .05), but was entirely due to hypertension observed in six patients. Renography of these patients was normal. We conclude that the decrease in GFR observed during treatment with cisplatin is partly reversible. Cisplatin-treated patients have an increased risk of developing hypertension years after treatment.

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The long term side effects of adjuvant carboplatin for stage 1 seminoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.5089 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 5089-5089 ◽

Cited By ~ 1

Author(s):

T. Powles ◽

T. Oliver ◽

M. Ostrowski ◽

J. Levay ◽

J. Shamash ◽

...

Keyword(s):

Cardiovascular Disease ◽

Radiation Therapy ◽

Germ Cell ◽

Cell Cancer ◽

Single Agent ◽

Germ Cell Cancer ◽

Second Cancer ◽

Stage 1

5089 Background: Radiotherapy is associated with an increase of second cancer and cardiovascular disease. Because of difficulties in detecting recurrence on surveillance which can occur out to 10 years, this unit has developed Carboplatin as the treatment for these patients and this abstract summarises late events in these 3 cohorts. Methods: Radiation therapy consisted of para-aortic and pelvis treatment (3,000 cGy). This occurred between 1960 and 1978. Surveillance began in 1980 and Carboplatin studies in 1984 with 2 courses of 450 mg/m2 being standard until 1987 when 1 course AUC × 7 was introduced and with increased confidence became standard. Results: Seventy-eight patients were treated with radiotherapy (median follow up 17 years). Overall mortally was 24% at 20 years compared with expected 10%. Death from germ cell cancer was 4.0%, deaths from 2nd non-germ cell cancer were 13%, and deaths from other causes was 7.0%. For surveillance (n=110, median follow up 9.8 years) there were 1.7% deaths, with no germ cell or non-germ cell cancer related deaths., and 1.7% deaths due to non cancer. Carboplatin (n=186, median follow up 9.5 years 97>10 yrs, and 38 >15 yrs) was associated with 98% survival at 10 years with 0 deaths due to GCC (3% relapse all before 3 years) 1% due to second non-GCC cancer and 1% to other causes. Conclusion: The numbers of cases are too small to be absolutely confident of these figures. However, this data suggests there are no late relapses and no excess of cancer or cardiovascular deaths in the single agent carboplatin cohort. No significant financial relationships to disclose.

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