Results of treatment in testicular nonseminoma

Seventy-one testicular nonseminomatous germ cell tumours were treated in the Helsinki University Central Hospital between 1980 and 1990. Thirty-five (49%) were stage I, 16 (23%) stage II and 20 (28%) stage III tumours. The 5-year survival rates were 91%, 94% and 70%, respectively. Five of the eight patients relapsing in stage I had adverse histopathological risk factors in their tumours. In the retrospective evaluation two stage I patients had actually a higher stage. The good results in stage II were achieved with a routine combination of chemotherapy and retroperitoneal lymph node dissection. All five patients lost for stage III nonseminoma had risk factors for unfavourable prognosis: liver metastases or very high serum markers at diagnosis. The results presented here are considerably better than in the 1970s in this country and well comparable to results from countries where this malignancy is more common. Still some patients were lost. Co-operation in different fields of medicine is essential to find and treat optimally those with more aggressive disease and those who are cured with less strenuous treatment modalities.