Initial chemotherapy for stage II testicular non-seminoma

A retrospective survival analysis was performed on 287 patients treated with chemotherapy following orchidectomy for stage II testicular non-seminoma between 1982 and 1986 at a number of centres in the United Kingdom and 1 centre in Norway. A total of 80 patients had lymphadenectomy for a residual mass after chemotherapy. In 17 of these cases the histology was undifferentiated malignancy, in 44 it was differentiated teratoma, in 18 there was necrosis only and in 1 case histology was unknown. The overall survival in 47 patients with initial stage IIA disease (nodes measuring < 2 cm in transverse diameter) was 98% [95% confidence interval (CI), 96%-100%] at 3 years. In 175 patients with stage IIB disease (nodal diameter, 2-5 cm) the 3-year survival was 96% (95% CI, 93%-99%) and in 65 patients with stage IIC disease (nodal diameter, > 5 cm) it was 84% (95% CI, 75%-93%). In stage IIA and stage IIB disease this approach leads to survival equivalent to that obtained with the approach of initial retroperitoneal lymph-node dissection.