[Germ cell testicular tumors. Three therapeutic periods]

Survival of patients with testicular cancer was analysed with records of 3 patients observed during 3 periods between 1966 and 1985. This study was limited to Non Seminomatous Germ Cell Tumors (NSGCT): 922 cases were collected from 17 centres (Centres de Lutte Contre le Cancer) during 3 periods 1966-1974, 1975-1980, 1981-1985. Results indicated that cryptorchidism was present in 8-13% of cases. The age of the patients varied between a few months and 75 years but a large majority were between the ages of 20-40 years (75%). Clinical staging was homogeneous during the 20 years of study with one third of patients in each stage. Study of biological markers was only performed in the last period: alpha-foeto-protein was increased at initial staging in 64% of cases and bèta Human Chorionic Gonadotrophin (beta HCG) in 54%. Actuarial survival rates were stable in each series after 3 years: at 5 years these rates were 44% (1966-1974), 63% (1975-1980) and 79% (1981-1985). This benefit in survival was present in all stages at different time: for stage I, actuarial survival rates were 72% at 5 years initially and 96% and 98% respectively for the last 2 periods. For stage II, these rates were 64% and 65% for the first 2 periods and became similar to stage I for the last study (92%). In stage III, actuarial survival rates were 4% in 1966-1974, 23% for 1975-1980 and 48% for the last period. These results confirm the significant role of chemotherapy with Cisplatinum in stages 2 or 3. For stage I, new and less aggressive treatment was shown to give the same results as the previous one.