[Multidisciplinary treatment of advanced testicular tumors]

Present status and problems of multidisciplinary treatment for advanced testicular tumors were reviewed. In this paper, we presented the treatment results of 69 patients with advanced testicular cancer treated by multidisciplinary treatment. The primary PVB therapy induced a CR in 39 patients (56.5%), and 8 patients of them relapsed. After primary chemotherapy 40 patients, incomplete responders and relapsed cases, underwent salvage therapy. Salvage chemotherapy with CDDP and VM-26 or VP-16 was performed in 19 patients, and induced a CR in 10 (58.5%). Salvage surgery was done in 29, and produced NED in 22 patients (75.9%). As overall results of salvage therapy, 25 of 40 patients are living with NED, 3 are alive with tumors, and 12 patients died of the disease. As final results of the multidisciplinary treatment, of 69 patients with advanced testicular tumors 48 patients are living with NED and 3 patients with tumors, and 18 patients died of the disease. A overall cure rate was 73.9%. The overall 8-year survival rates of the 69 patients was 70.5%. The survival rate of 39 CR-patients, 23 PRs and 7 NRs was 94.9%, 45.7% and 0% at 4 years, respectively. The 8-year survival rates according to clinical stage for the last 10 years were 100% in stage I, 74.0% in stage II, and 70% in stage III. The survival rates for 10 years from 1968 to 1978 were 88.3% in stage I. 60% in stage II, and 33.3% in stage III. The treatment results were so satisfactory. To reach the treatment goal for advanced testicular tumors, importance of aggressive multidisciplinary treatment was emphasized.