Relapse-free and overall survival in patients with pathologic stage II nonseminomatous germ cell cancer treated with etoposide and cisplatin adjuvant chemotherapy Journal Article


Authors: Kondagunta, G. V.; Sheinfeld, J.; Mazumdar, M.; Mariani, T. V.; Bajorin, D.; Bacik, J.; Bosl, G. J.; Motzer, R. J.
Article Title: Relapse-free and overall survival in patients with pathologic stage II nonseminomatous germ cell cancer treated with etoposide and cisplatin adjuvant chemotherapy
Abstract: Purpose: To assess the long-term relapse-free survival and overall survival of patients with stage II nonseminomatous germ cell tumor (NSGCT) who received two cycles of adjuvant etoposide and cisplatin (EP) after primary retroperitoneal lymph node dissection. Patients and Methods: Eighty-seven patients with completely resected pathologic stage II NSGCT were treated with adjuvant EP chemotherapy. Adjuvant EP consisted of two cycles of etoposide (100 mg/m2) plus cisplatin (20 mg/m2) per day, administered days 1 to 5 at a 21-day interval. Results: Ten patients (11%) had pN1 disease, 73 (84%) had pN2 disease, and four (5%) had pN3 disease. Eighty-six patients received two cycles of EP, and one patient received an additional two cycles of EP after a transient marker increase after his first cycle. Eighty-seven patients are alive, and 86 patients (99%) remain relapse-free at a median follow-up of 8 years (range, 0.9 to 13.5 years). Conclusion: Two cycles of adjuvant EP is highly effective in preventing relapse in patients with pathologic stage II pN1 and pN2 NSGCT. An alternative treatment strategy is surveillance with full-course chemotherapy at relapse. Because there is a higher risk of relapse for patients with pN2 disease, these patients are offered adjuvant chemotherapy. © 2004 by American Society of Clinical Oncology.
Keywords: adolescent; adult; cancer survival; disease-free survival; middle aged; survival rate; retrospective studies; major clinical study; clinical trial; mortality; cisplatin; disease free survival; chemotherapy, adjuvant; cancer staging; follow up; follow-up studies; antineoplastic agent; lymph nodes; neoplasm staging; lymph node excision; lymphadenectomy; phase 2 clinical trial; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; pathology; retrospective study; tumor recurrence; adjuvant chemotherapy; lymph node; testis tumor; testicular neoplasms; bleomycin; cancer relapse; vp p protocol; vp-p protocol; germ cell tumor; non seminomatous germinoma; retroperitoneum; retroperitoneal space; germinoma; humans; human; male; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 22
Issue: 3
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2004-02-01
Start Page: 464
End Page: 467
Language: English
DOI: 10.1200/jco.2004.07.178
PROVIDER: scopus
PUBMED: 14752068
DOI/URL:
Notes: J. Clin. Oncol. -- Cited By (since 1996):43 -- Export Date: 16 June 2014 -- CODEN: JCOND -- Source: Scopus
Altmetric Score
MSK Authors
  1. Dean Bajorin
    404 Bajorin
  2. Robert Motzer
    744 Motzer
  3. Madhu Mazumdar
    120 Mazumdar
  4. Joel Sheinfeld
    195 Sheinfeld
  5. George Bosl
    255 Bosl
  6. Jennifer M Bacik
    46 Bacik