Combination chemotherapy including VP-16 for poor prognosis germ cell neoplasms

Fifteen patients with germ cell neoplasms (9 testicular primary, 4 extragonadal, 2 adult teratoma syndrome) with features indicative of a poor prognosis were treated with chemotherapy followed by surgery. In patients with testicular primary sites, 2 patients have relapsed and all 9 remain alive (median follow-up 36 months). In patients with extragonadal tumors 2/4 are alive without disease, and both patients with the adult teratoma syndrome have died. Combination chemotherapy and surgery can be employed successfully in this subset of patients with germ cell neoplasms.