Adjuvant Chemotherapy in Non-Seminomatous Testis Cancer: “Mini-Vab” Regimen: Long-Term Followup

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Abstract
Since 40-50% (range 20-80%) of patients with stage II non-seminomatous germ cell tumors of the testis suffer relapse after orchiectomy and retroperitoneal lymph node dissection, relatively nontoxic adjuvant chemotherapy (consisting of vinblastine, actinomycin D, bleomycin and chlorambucil) was given to 62 patients after lymphadenectomy. Of these patients, 82% remained free of disease with a 4-yr median followup; 18% had relapse. Retrospective analysis reveals that no patient (0 of 33) with stage IIA and 38% (11 of 29) with stage IIB disease had relapse. Patients with histologic evidence of extranodal extension of disease (N3 category) had the highest relapse rate (62%). Patients with resected stage IIB disease, particularly those with extranodal extension of tumor, probably should receive aggressive adjuvant chemotherapy.