[Results of close testicular tumor after-care]

Close monitoring schedules for patients with malignant germ cell tumors improved cure rates, since early detection and treatment of tumor recurrences was possible. In a retrospective analysis we evaluated 210 of 274 patients with malignant germ cell tumor, 189 (90%) of whom achieved complete remission after primary therapy. There were 15 patients (7.9%) who experienced tumor relapse, 14 patients attaining complete remission after a second treatment. Out of these, 4 patients experienced a second relapse after 5 months. In 2 patients only, a third complete remission was obtained. A total of 3 patients died to their disease. The 19 recurrences were detected by clinical symptoms in 4 cases, by chest X-ray in 10, and by elevation tumor markers in 5. In 6 patients a second malignant germ cell tumor was discovered during follow up by palpation of the testis (n = 4) or marker elevation (n = 2). A second complete remission was achieved in 5 of these patients, while 1 died of chemotherapy-induced sepsis. Of the 19 tumor recurrences, 17 were detected within the first 2 years. The patients with a second malignant germ cell tumor perceived their disease within the first 5 years in 83% of cases. These results support the necessity on close monitoring for a minimum of 5 years after the initial treatment. After 5 years yearly examination is recommended for early detection of any late recurrences and second malignant germ cell tumors.