High dose chemotherapy and stem cell rescue for metastatic germ cell tumours: long-term results from a single...

To evaluate the long term results and the characteristics of patients treated with high dose chemotherapy (HDCT) for an advanced germ cell tumour at Ghent University Hospital from 1996 to 2010.

A retrospective analysis of patients treated with HDCT for germ cell tumours was performed. Data about stage at diagnosis, different prognostic scoring systems, timing of HDCT, response to HDCT and relapse-free period were collected. The following endpoints were evaluated: complete or incomplete response to HDCT, relapse free survival and overall survival time.

Of the 148 patients treated with chemotherapy for an advanced germ cell tumour from 1996 to 2010, 10 (6.8%) needed salvage treatment by means of HDCT. Six patients achieved a complete response to one cycle of HDCT and 2 additional patients achieved a complete response to a second cycle of HDCT. A retrospective analysis showed 8 long-term survivors with a maximum follow-up time of 152 months. Two patients were recently transplanted and are not evaluable for survival yet.

Our study suggests that long-term survival can be obtained by means of HDCT for metastatic germ cell tumours, even in patients with bad prognostic features at diagnosis. The question of whether to use 1 or 2 cycles of HDCT still remains unanswered.