Management of testicular cancer with combined-modality treatment

Thirty consecutive patients with germinal testis tumours were treated with combined-modality programme. Seven patients were entered in the surveillance protocol, 7 patients had irradiation of the paraaortic and ipsilateral pelvic lymph nodes, 16 patients were treated with four courses of chemotherapy. Of the patients 5 underwent surgical removal of residual masses. After the combined-modality treatment 27 (90%) patients had complete remission, 2 patients showed progression on therapy and the other had incomplete resection of residual masses. After a median follow-up period of 41.5 months, 27 (90%) remain continuously disease-free, 2 patients died and one patient is still alive with his enlarged mediastinal lymph nodes. The treatment policy stage by stage was defined by the current roles of surgery, irradiation and chemotherapy in our efforts.