[Salvage surgery following chemotherapy of advanced testicular cancer]

Advanced testicular cancer is best treated with cisplatinum-based combination chemotherapy. Fifty-two patients with advanced disease were treated with cisplatinum, vinblastine, and bleomycin (PVB therapy). The PVB therapy produced 53.8% complete and 46.3% partial remissions. Of 24 patients failing to achieve complete remission, 18 underwent retroperitoneal lymphadenectomy either to remove persistent residual mass (in 12 patients) or to confirm a clinical complete response (in 6 patients), 4 patients underwent resection for residual pulmonary lesions, one patient underwent resection for cervical mass, and 2 patients underwent craniotomy for metastatic brain lesions. Scarring was found in 10 patients (40%), teratoma in 7 (28%), and active cancer in 8 (32%). All 10 patients with fibrous tissue and 5 of 7 patients with teratoma have been continuously free of disease. However, only 3 of 8 patients with active cancer are alive without evidence of disease. The salvage surgery achieved a 17.3% disease-free status. As the final result, of the 52 patients, 35 (67.3%) are alive with no evidence of disease.