Adjuvant chemotherapy with VAB-3 of stage II-B testicular cancer

✍ Scribed by Davor Vugrin; Willet Whitmore; Esteban Cvitkovic; Harry Grabstald; Pramod Sogani; Robert B. Golbey

• Publisher: John Wiley and Sons
• Year: 1981
• Tongue: English
• Weight: 485 KB
• Volume: 48
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19810715)48:2<233::aid-cncr2820480204>3.0.co;2-u

✦ Synopsis

A recent report from the Memorial Sloan-Kettering Cancer Center has indicated that patients with resected Stage IIB (N-2B and N-3) testicular cancer are at significant risk for relapse. Of patients with resected Stage IIB disease (N-2B, 1%; N-3, M%), 34% relapsed after having undergone relatively mild adjuvant chemotherapy consisting of vinblastine, actinomycin D, bleomycin, and chlorambucil (VAB). In this study, 29 patients with resected Stage IIB testicular cancer underwent treatment with adjuvant VAB-3 which has been used as primary treatment for Stage 111 disease. All patients have remained in complete remission with a median follow-up time of 24 months. Three patients received broad spectrum antibiotics when fever and leukopenia developed. No patient experienced renal failure. The results of this study demonstrate the capability of aggressive adjuvant chemotherapy to prevent recurrence in the high-risk setting of resected Stage I1 (N-2B and N-3) disease. Optimal adjuvant treatment remains to be defined. Cancer 48233-237, 198 1.

F PATIENTS WITH Stage I1 nonseminomatous 0 germ cell tumor (NSGCT) of the testis, 40-50%(range, 20-80%) experience relapse following orchiectomy and retroperitoneal lymph node dissection (RPLND).lP6 Most of the recurrences are due to distant metastases. Risk factors for relapse in such cases have not been adequately established, although circumstantial evidence suggests that relapse is roughly proportional to the bulk of the retroperitoneal deposits. Thus, retrospective analysis of 62 patients undergoing mild adjuvant chemotherapy consisting of vinblastine, actinomycin D, bleomycin, and chlorambucil (VAB) demonstrated that ten of 29 patients (34%) with resected Stage IIB disease and none of 33 with minimal retroperitoneal metastatic disease (Stage IIA) experienced r e l a p ~e . ~ Of 11 patients with resected Stage 11-B disease treated with adjuvant actinomycin ~