[Experiences in the treatment of advanced nonseminomatous testicular tumor]

48 patients with nonseminomatous testicular tumours were treated between 1980 and 1984. 19 patients had bulky stage II c or disseminated disease; according the Royal Marsden staging classification 5 patients had stage II c, 2 patients III and 12 patients stage IV. The pT stage of the primary tumour showed no correlation to low stage disease, but pT was only found in advanced disease. In disseminated disease histological examination revealed more cases of malignant teratoma undifferentiated (MTU) and malignant teratoma trophoblastic (MTT) than malignant teratoma intermediate (MTI). Before therapy 14 patients had elevated serum markers, whilst in 5 patients markers were negative. Combination chemotherapy with Vinblastin, Bleomycin and Cisplatin (Einhorn) was given and afterwards 13 patients had to undergo operation to remove a residual mass. Scarring was found in 4 patients (31%), teratoma in 6 (46%) and active tumour in 3 (23%). At a median survival time of 3 years 16 of 19 patients (84%) are alive. The two patients with elevated tumour markers before operation are also alive and disease-free. Altogether out of 48 patients with advanced nonseminomatous testicular tumours 94% of the patients are alive.