Skip to main content

Treatment of Relapse

  • Chapter
  • First Online:
Cancer of the Testis
  • 797 Accesses

Abstract

Any tissue from the testis can develop a tumour. The tumours from the non specialized testicular stroma have the same pathology aspects that in another anatomical places, but the tumours from the germ cell and the sex cord and Gonadal stroma are completely different. The object of this chapters is to describe these tumors. Half of the adult testicular germ cell tumors are pure seminomas and the other half non seminomas, the majority with more that one histological subtype. This peculiar morphology suggest that the different types can have a common origin. Its biology in adults is aggressive (even in the teratoma form). The Sex cord/Gonadal Stromal tumors are less frequents that the germ cell tumors, generally in pure forms and the majority are benign. The differential diagnosis of these tumors can be difficult, but the wide sampling, the strict morphological criteria and the immunohistochemical markers can help.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Albers P, Ganz A, Hannig E, Miersch WD, Muller SC (2000) Salvage surgery of chemorefractory germ cell tumors with elevated tumor markers. J Urol 164(2):381–384

    Article  PubMed  CAS  Google Scholar 

  • Andre F, Fizazi K, Culine S et al (2000) The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients. Eur J Cancer 36(11):1389–1394

    Article  PubMed  CAS  Google Scholar 

  • Anon (1997) International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 15(2):594–603

    Google Scholar 

  • Bajorin DF, Sarosdy MF, Pfister DG et al (1993) Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multiinstitutional study. J Clin Oncol 11(4):598–606

    PubMed  CAS  Google Scholar 

  • Bajorin DF, Nichols CR, Schmoll HJ et al (1995) Recombinant human granulocyte-macrophage colony-stimulating factor as an adjunct to conventional-dose ifosfamide-based chemotherapy for patients with advanced or relapsed germ cell tumors: a randomized trial. J Clin Oncol 13(1):79–86

    PubMed  CAS  Google Scholar 

  • Barnett MJ, Coppin CM, Murray N et al (1993) High-dose chemotherapy and autologous bone marrow transplantation for patients with poor prognosis nonseminomatous germ cell tumours. Br J Cancer 68(3):594–598

    Article  PubMed  CAS  Google Scholar 

  • Bedano PM, Brames MJ, Williams SD, Juliar BE, Einhorn LH (2006) Phase II study of cisplatin plus epirubicin salvage chemotherapy in refractory germ cell tumors. J Clin Oncol 24(34):5403–5407

    Article  PubMed  CAS  Google Scholar 

  • Beyer J, Kramar A, Mandanas R et al (1996) High-dose chemotherapy as salvage treatment in germ cell tumors: a multivariate analysis of prognostic variables. J Clin Oncol 14(10):2638–2645

    PubMed  CAS  Google Scholar 

  • Beyer J, Kingreen D, Krause M et al (1997) Long-term survival of patients with recurrent or refractory germ cell tumors after high dose chemotherapy. Cancer 79(1):161–168

    Article  PubMed  CAS  Google Scholar 

  • Beyer J, Stenning S, Gerl A, Fossa S, Siegert W (2002) High-dose versus conventional-dose chemotherapy as first-salvage treatment in patients with non-seminomatous germ-cell tumors: a matched-pair analysis. Ann Oncol 13(4):599–605

    Article  PubMed  CAS  Google Scholar 

  • Bhatia S, Abonour R, Porcu P et al (2000) High-dose chemotherapy as initial salvage chemotherapy in patients with relapsed testicular cancer. J Clin Oncol 18(19):3346–3351

    PubMed  CAS  Google Scholar 

  • Blijham G, Spitzer G, Litam J et al (1981) The treatment of advanced testicular carcinoma with high dose chemotherapy and autologous marrow support. Eur J Cancer 17(4):433–441

    PubMed  CAS  Google Scholar 

  • Bokemeyer C, Beyer J, Metzner B et al (1996) Phase II study of paclitaxel in patients with relapsed or cisplatin-refractory testicular cancer. Ann Oncol 7(1):31–34

    Article  PubMed  CAS  Google Scholar 

  • Bosl GJ, Motzer RJ (1997) Testicular germ-cell cancer. N Engl J Med 337(4):242–253

    Article  PubMed  CAS  Google Scholar 

  • Bosl GJ, Bajorin DF, Sheinfeld J, Motzer RJ, Chaganti RSK (2007) Cancer of the testis. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer. Principles and practice of oncology, 7th edn. Lippincott Williams & Wilkins, Philadelphia, 1269–1293

    Google Scholar 

  • Broun ER, Nichols CR, Tricot G, Loehrer PJ, Williams SD, Einhorn LH (1991) High dose carboplatin/VP-16 plus ifosfamide with autologous bone marrow support in the treatment of refractory germ cell tumors. Bone Marrow Transplant 7(1):53–56

    PubMed  CAS  Google Scholar 

  • Broun ER, Nichols CR, Mandanas R et al (1995) Dose escalation study of high-dose carboplatin and etoposide with autologous bone marrow support in patients with recurrent and refractory germ cell tumors. Bone Marrow Transplant 16(3):353–358

    PubMed  CAS  Google Scholar 

  • Broun ER, Nichols CR, Gize G et al (1997) Tandem high dose chemotherapy with autologous bone marrow transplantation for initial relapse of testicular germ cell cancer. Cancer 79(8):1605–1610

    Article  PubMed  CAS  Google Scholar 

  • Buckner CD, Clift RA, Fefer A et al (1974) High-dose cyclophosphamide (NSC-26271) for the treatment of metastatic testicular neoplasms. Cancer Chemother Rep 58(5 Pt 1):709–714

    PubMed  CAS  Google Scholar 

  • Coogan CL, Foster RS, Rowland RG et al (1997) Postchemotherapy retroperitoneal lymph node dissection is effective therapy in selected patients with elevated tumor markers after primary chemotherapy alone. Urology 50(6):957–962

    Article  PubMed  CAS  Google Scholar 

  • Cooper MA, Einhorn LH (1995) Maintenance chemotherapy with daily oral etoposide following salvage therapy in patients with germ cell tumors. J Clin Oncol 13(5):1167–1169

    PubMed  CAS  Google Scholar 

  • de Wit R, Louwerens M, de Mulder PH, Verweij J, Rodenhuis S, Schornagel J (1999) Management of intermediate-prognosis germ-cell cancer: results of a phase I/II study of Taxol-BEP. Int J Cancer 83(6):831–833

    Article  PubMed  Google Scholar 

  • de Wit R, Roberts JT, Wilkinson PM et al (2001) Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. J Clin Oncol 19(6):1629–1640

    PubMed  Google Scholar 

  • Dieckmann KP, Albers P, Classen J et al (2005) Late relapse of testicular germ cell neoplasms: a descriptive analysis of 122 cases. J Urol 173(3):824–829

    Article  PubMed  Google Scholar 

  • Droz JP, Culine S (1998) New prospects for the treatment of germ-cell tumours. Expert Opin Investig Drugs 7(7):1139–1157

    Article  PubMed  CAS  Google Scholar 

  • Droz JP, Pico JL, Ghosn M et al (1991) Long-term survivors after salvage high dose chemotherapy with bone marrow rescue in refractory germ cell cancer. Eur J Cancer 27(7):831–835

    Article  PubMed  CAS  Google Scholar 

  • Droz JP, Kramar A, Rey A (1992) Prognostic factors in metastatic disease. Semin Oncol 19(2):181–189

    PubMed  CAS  Google Scholar 

  • Eastham JA, Wilson TG, Russell C, Ahlering TE, Skinner DG (1994) Surgical resection in patients with nonseminomatous germ cell tumor who fail to normalize serum tumor markers after chemotherapy. Urology 43(1):74–80

    Article  PubMed  CAS  Google Scholar 

  • Einhorn LH (1990) Treatment of testicular cancer: a new and improved model. J Clin Oncol 8(11):1777–1781

    PubMed  CAS  Google Scholar 

  • Einhorn LH, Donohue J (1977) Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med 87(3):293–298

    PubMed  CAS  Google Scholar 

  • Einhorn LH, Williams SD, Loehrer PJ et al (1989) Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a Southeastern Cancer Study Group protocol. J Clin Oncol 7(3):387–391

    PubMed  CAS  Google Scholar 

  • Einhorn LH, Williams SD, Chamness A, Brames MJ, Perkins SM, Abonour R (2007) High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. N Engl J Med 357(4):340–348

    Article  PubMed  CAS  Google Scholar 

  • Elias AD, Ayash LJ, Wheeler C et al (1994) High-dose ifosfamide/carboplatin/etoposide with autologous hematopoietic stem cell support: safety and future directions. Semin Oncol 21(5 suppl 12):83–85

    PubMed  CAS  Google Scholar 

  • Farhat F, Culine S, Theodore C, Bekradda M, Terrier-Lacombe MJ, Droz JP (1996) Cisplatin and ifosfamide with either vinblastine or etoposide as salvage therapy for refractory or relapsing germ cell tumor patients: the Institut Gustave Roussy experience. Cancer 77(6):1193–1197

    Article  PubMed  CAS  Google Scholar 

  • Fizazi K, Tjulandin S, Salvioni R et al (2001) Viable malignant cells after primary chemotherapy for disseminated nonseminomatous germ cell tumors: prognostic factors and role of postsurgery chemotherapy–results from an international study group. J Clin Oncol 19(10):2647–2657

    PubMed  CAS  Google Scholar 

  • Flechon A, Biron P, Droz JP (1999) High-dose chemotherapy with hematopoietic stem-cell support in germ-cell tumor patient treatment: the French experience. Int J Cancer 83(6):844–847

    Article  PubMed  CAS  Google Scholar 

  • Flechon A, Rivoire M, Biron P, Droz JP (2001) Importance of surgery as salvage treatment after high dose chemotherapy failure in germ cell tumors. J Urol 165(6 Pt 1):1920–1926

    Article  PubMed  CAS  Google Scholar 

  • Flechon A, Culine S, Theodore C, Droz JP (2005) Pattern of relapse after first line treatment of advanced stage germ-cell tumors. Eur Urol 48(6):957–963

    Article  PubMed  CAS  Google Scholar 

  • Fossa SD, Stenning SP, Gerl A et al (1999a) Prognostic factors in patients progressing after cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumours. Br J Cancer 80(9):1392–1399

    Article  PubMed  CAS  Google Scholar 

  • Fossa SD, Bokemeyer C, Gerl A et al (1999b) Treatment outcome of patients with brain metastases from malignant germ cell tumors. Cancer 85(4):988–997

    Article  PubMed  CAS  Google Scholar 

  • Fox EP, Weathers TD, Williams SD et al (1993) Outcome analysis for patients with persistent nonteratomatous germ cell tumor in postchemotherapy retroperitoneal lymph node dissections. J Clin Oncol 11(7):1294–1299

    PubMed  CAS  Google Scholar 

  • Geller NL, Bosl GJ, Chan EY (1989) Prognostic factors for relapse after complete response in patients with metastatic germ cell tumors. Cancer 63(3):440–445

    Article  PubMed  CAS  Google Scholar 

  • Gerl A, Clemm C, Schmeller N, Hartenstein R, Lamerz R, Wilmanns W (1995) Prognosis after salvage treatment for unselected male patients with germ cell tumours. Br J Cancer 72(4):1026–1032

    Article  PubMed  CAS  Google Scholar 

  • Ghosn M, Droz JP, Theodore C et al (1988) Salvage chemotherapy in refractory germ cell tumors with etoposide (VP-16) plus ifosfamide plus high-dose cisplatin. A VIhP regimen. Cancer 62(1):24–27

    Article  PubMed  CAS  Google Scholar 

  • Gietema JA, Meinardi MT, Sleijfer DT, Hoekstra HJ, van der Graaf WT (2002) Routine chest X-rays have no additional value in the detection of relapse during routine follow-up of patients treated with chemotherapy for disseminated non-seminomatous testicular cancer. Ann Oncol 13(10):1616–1620

    Article  PubMed  CAS  Google Scholar 

  • Greene FL (2002) Testis cancer. In: Page DL, Fleming IDFA et al (eds) AJCC cancer staging handbook. Springer, New York, p 469

    Google Scholar 

  • Higby DJ, Wallace HJ Jr, Albert D, Holland JF (1974) Diamminodichloroplatinum in the chemotherapy of testicular tumors. J Urol 112(1):100–104

    PubMed  CAS  Google Scholar 

  • Hildebrandt MO, Blaser F, Beyer J et al (1998) Detection of tumor cells in peripheral blood samples from patients with germ cell tumors using immunocytochemical and reverse transcriptase-polymerase chain reaction techniques. Bone Marrow Transplant 22(8):771–775

    Article  PubMed  CAS  Google Scholar 

  • Horwich A, Wilson C, Cornes P, Gildersleve J, Dearnaley D (1993) Increasing the dose intensity of chemotherapy in poor-prognosis metastatic non-seminoma. Eur Urol 23(1):219–222

    PubMed  CAS  Google Scholar 

  • Ibrahim A, Zambon E, Bourhis JH et al (1993) High-dose chemotherapy with etoposide, cyclophosphamide and escalating dose of carboplatin followed by autologous bone marrow transplantation in cancer patients. A pilot study. Eur J Cancer 29A(10):1398–1403

    Article  PubMed  CAS  Google Scholar 

  • Jeffery GM, Theaker JM, Lee AH, Blaquiere RM, Smart CJ, Mead GM (1991) The growing teratoma syndrome. Br J Urol 67(2):195–202

    Article  PubMed  CAS  Google Scholar 

  • Kollmannsberger C, Beyer J, Droz JP et al (1998) Secondary leukemia following high cumulative doses of etoposide in patients treated for advanced germ cell tumors. J Clin Oncol 16(10):3386–3391

    PubMed  CAS  Google Scholar 

  • Kollmannsberger C, Nichols C, Bokemeyer C (2006) Recent advances in management of patients with platinum-refractory testicular germ cell tumors. Cancer 106(6):1217–1226

    Article  PubMed  CAS  Google Scholar 

  • Kondagunta GV, Sheinfeld J, Motzer RJ (2003) Recommendations of follow-up after treatment of germ cell tumors. Semin Oncol 30(3):382–389

    Article  PubMed  Google Scholar 

  • Lederman GS, Garnick MB, Canellos GP, Richie JP (1983) Chemotherapy of refractory germ cell cancer with Etoposide. J Clin Oncol 1(11):706–709

    PubMed  CAS  Google Scholar 

  • Linkesch W, Greinix A, Hocker P, Krainer M, Wagner A (1993) Long-term follow-up of a phase I/II trial ultra-high dose carboplatin, VP-16, Cyclophosphamide with ABMT in refractory or relapsed NSCGCT.(Abstract). Proc Am Assoc Cancer Res 34:232

    Google Scholar 

  • Loehrer PJ Sr, Lauer R, Roth BJ, Williams SD, Kalasinski LA, Einhorn LH (1988) Salvage therapy in recurrent germ cell cancer: ifosfamide and cisplatin plus either vinblastine or etoposide. Ann Intern Med 109(7):540–546

    PubMed  Google Scholar 

  • Loehrer PJ Sr, Johnson D, Elson P, Einhorn LH, Trump D (1995) Importance of bleomycin in favorable-prognosis disseminated germ cell tumors: an Eastern Cooperative Oncology Group trial. J Clin Oncol 13(2):470–476

    PubMed  Google Scholar 

  • Loehrer PJ Sr, Gonin R, Nichols CR, Weathers T, Einhorn LH (1998) Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol 16(7):2500–2504

    PubMed  CAS  Google Scholar 

  • Logothetis CJ, Samuels ML, Trindade A, Johnson DE (1982) The growing teratoma syndrome. Cancer 50(8):1629–1635

    Article  PubMed  CAS  Google Scholar 

  • Lorch A, Kollmannsberger C, Hartmann JT et al (2007) Single versus sequential high-dose chemotherapy in patients with relapsed or refractory germ cell tumors: a prospective randomized multicenter trial of the German Testicular Cancer Study Group. J Clin Oncol 25(19):2778–2784

    Article  PubMed  CAS  Google Scholar 

  • Lotz JP, Machover D, Malassagne B et al (1991) Phase I-II study of two consecutive courses of high-dose epipodophyllotoxin, ifosfamide, and carboplatin with autologous bone marrow transplantation for treatment of adult patients with solid tumors. J Clin Oncol 9(10):1860–1870

    PubMed  CAS  Google Scholar 

  • Lotz JP, Bui B, Gomez F et al (2005) Sequential high-dose chemotherapy protocol for relapsed poor prognosis germ cell tumors combining two mobilization and cytoreductive treatments followed by three high-dose chemotherapy regimens supported by autologous stem cell transplantation. Results of the phase II multicentric TAXIF trial. Ann Oncol 16(3):411–418

    Article  PubMed  Google Scholar 

  • Mardiak J, Salek T, Sycova-Mila Z et al (2005) Paclitaxel plus ifosfamide and cisplatin in second-line treatment of germ cell tumors: a phase II study. Neoplasma 52(6):497–501

    PubMed  CAS  Google Scholar 

  • Margolin K, Doroshow JH, Ahn C et al (1996) Treatment of germ cell cancer with two cycles of high-dose ifosfamide, carboplatin, and etoposide with autologous stem-cell support. J Clin Oncol 14(10):2631–2637

    PubMed  CAS  Google Scholar 

  • Margolin KA, Doroshow JH, Frankel P et al (2005) Paclitaxel-based high-dose chemotherapy with autologous stem cell rescue for relapsed germ cell cancer. Biol Blood Marrow Transplant 11(11):903–911

    Article  PubMed  CAS  Google Scholar 

  • Mayer F, Honecker F, Looijenga LH, Bokemeyer C (2003) Towards an understanding of the biological basis of response to cisplatin-based chemotherapy in germ-cell tumors. Ann Oncol 14(6):825–832

    Article  PubMed  CAS  Google Scholar 

  • McCaffrey JA, Mazumdar M, Bajorin DF, Bosl GJ, Vlamis V, Motzer RJ (1997) Ifosfamide- and cisplatin-containing chemotherapy as first-line salvage therapy in germ cell tumors: response and survival. J Clin Oncol 15(7):2559–2563

    PubMed  CAS  Google Scholar 

  • McNeish IA, Kanfer EJ, Haynes R et al (2004) Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours. Br J Cancer 90(6):1169–1175

    Article  PubMed  CAS  Google Scholar 

  • Mead GM, Cullen MH, Huddart R et al (2005) A phase II trial of TIP (paclitaxel, ifosfamide and cisplatin) given as second-line (post-BEP) salvage chemotherapy for patients with metastatic germ cell cancer: a medical research council trial. Br J Cancer 93(2):178–184

    Article  PubMed  CAS  Google Scholar 

  • Mostofi FK, Sesterhen IA (1994) Revised international classification of testicular tumors. In: Jones WG, Harnden P, Appleyard I (eds) Germ cell tumors III. Oxford Pergamon, London, p 153

    Google Scholar 

  • Motzer RJ, Gulati SC, Tong WP et al (1993) Phase I trial with pharmacokinetic analyses of high-dose carboplatin, etoposide, and cyclophosphamide with autologous bone marrow transplantation in patients with refractory germ cell tumors. Cancer Res 53(16):3730–3735

    PubMed  CAS  Google Scholar 

  • Motzer RJ, Bajorin DF, Schwartz LH et al (1994) Phase II trial of paclitaxel shows antitumor activity in patients with previously treated germ cell tumors. J Clin Oncol 12(11):2277–2283

    PubMed  CAS  Google Scholar 

  • Motzer RJ, Mazumdar M, Bosl GJ, Bajorin DF, Amsterdam A, Vlamis V (1996) High-dose carboplatin, etoposide, and cyclophosphamide for patients with refractory germ cell tumors: treatment results and prognostic factors for survival and toxicity. J Clin Oncol 14(4):1098–1105

    PubMed  CAS  Google Scholar 

  • Motzer RJ, Sheinfeld J, Mazumdar M et al (2000a) Paclitaxel, ifosfamide, and cisplatin second-line therapy for patients with relapsed testicular germ cell cancer. J Clin Oncol 18(12):2413–2418

    PubMed  CAS  Google Scholar 

  • Motzer RJ, Mazumdar M, Sheinfeld J et al (2000b) Sequential dose-intensive paclitaxel, ifosfamide, carboplatin, and etoposide salvage therapy for germ cell tumor patients. J Clin Oncol 18(6):1173–1180

    PubMed  CAS  Google Scholar 

  • Motzer RJ, Nichols CJ, Margolin KA et al (2007) Phase III randomized trial of conventional-dose chemotherapy with or without high-dose chemotherapy and autologous hematopoietic stem-cell rescue as first-line treatment for patients with poor-prognosis metastatic germ cell tumors. J Clin Oncol 25(3):247–256

    Article  PubMed  CAS  Google Scholar 

  • Mulder PO, de Vries EG, Koops HS et al (1988) Chemotherapy with maximally tolerable doses of VP 16-213 and cyclophosphamide followed by autologous bone marrow transplantation for the treatment of relapsed or refractory germ cell tumors. Eur J Cancer Clin Oncol 24(4):675–679

    Article  PubMed  CAS  Google Scholar 

  • Murphy BR, Breeden ES, Donohue JP et al (1993) Surgical salvage of chemorefractory germ cell tumors. J Clin Oncol 11(2):324–329

    PubMed  CAS  Google Scholar 

  • National Cancer Centre Network (NCCN) (2007) http://www.nccn.org/professionals/physician_gls/PDF/testicular.pdf. Ref Type: Internet Communication

  • Nichols CR, Tricot G, Williams SD et al (1989) Dose-intensive chemotherapy in refractory germ cell cancer–a phase I/II trial of high-dose carboplatin and etoposide with autologous bone marrow transplantation. J Clin Oncol 7(7):932–939

    PubMed  CAS  Google Scholar 

  • Nichols CR, Williams SD, Loehrer PJ et al (1991) Randomized study of cisplatin dose intensity in poor-risk germ cell tumors: a Southeastern Cancer Study Group and Southwest Oncology Group protocol. J Clin Oncol 9(7):1163–1172

    PubMed  CAS  Google Scholar 

  • Nichols CR, Andersen J, Lazarus HM et al (1992) High-dose carboplatin and etoposide with autologous bone marrow transplantation in refractory germ cell cancer: an Eastern Cooperative Oncology Group protocol. J Clin Oncol 10(4):558–563

    PubMed  CAS  Google Scholar 

  • Nichols CR, Catalano PJ, Crawford ED, Vogelzang NJ, Einhorn LH, Loehrer PJ (1998) Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol 16(4):1287–1293

    PubMed  CAS  Google Scholar 

  • O’Reilly SM, Rustin GJ, Smith DB, Newlands ES (1992) Single agent activity of carboplatin in patients with previously untreated non-seminomatous germ cell tumours. Ann Oncol 3(2):163–164

    PubMed  Google Scholar 

  • Pico JL, Rosti G, Kramar A et al (2005) A randomised trial of high-dose chemotherapy in the salvage treatment of patients failing first-line platinum chemotherapy for advanced germ cell tumours. Ann Oncol 16(7):1152–1159

    Article  PubMed  Google Scholar 

  • Pizzocaro G, Salvioni R, Piva L, Faustini M, Nicolai N, Gianni L (1992) Modified cisplatin, etoposide (or vinblastine) and ifosfamide salvage therapy for male germ-cell tumors. Long-term results. Ann Oncol 3(3):211–216

    PubMed  CAS  Google Scholar 

  • Pont J, Bokemeyer C, Harstrick A, Sellner F, Greinix H, Stoiber F (1997) Chemotherapy for germ cell tumors relapsing after high-dose chemotherapy and stem cell support: a retrospective multicenter study of the Austrian Study Group on Urologic Oncology. Ann Oncol 8(12):1229–1234

    Article  PubMed  CAS  Google Scholar 

  • Porcu P, Bhatia S, Sharma M, Einhorn LH (2000) Results of treatment after relapse from high-dose chemotherapy in germ cell tumors. J Clin Oncol 18(6):1181–1186

    PubMed  CAS  Google Scholar 

  • Postmus PE, Mulder NH, Sleijfer DT, Meinesz AF, Vriesendorp R, de Vries EG (1984) High-dose etoposide for refractory malignancies: a phase I study. Cancer Treat Rep 68(12):1471–1474

    PubMed  CAS  Google Scholar 

  • Ravi R, Ong J, Oliver RT, Badenoch DF, Fowler CG, Hendry WF (1998) Surgery as salvage therapy in chemotherapy-resistant nonseminomatous germ cell tumours. Br J Urol 81(6):884–888

    Article  PubMed  CAS  Google Scholar 

  • Rick O, Beyer J, Kingreen D et al (1998) High-dose chemotherapy in germ cell tumours: a large single centre experience. Eur J Cancer 34(12):1883–1888

    Article  PubMed  CAS  Google Scholar 

  • Rick O, Bokemeyer C, Beyer J et al (2001) Salvage treatment with paclitaxel, ifosfamide, and cisplatin plus high-dose carboplatin, etoposide, and thiotepa followed by autologous stem-cell rescue in patients with relapsed or refractory germ cell cancer. J Clin Oncol 19(1):81–88

    PubMed  CAS  Google Scholar 

  • Rick O, Bokemeyer C, Weinknecht S et al (2004) Residual tumor resection after high-dose chemotherapy in patients with relapsed or refractory germ cell cancer. J Clin Oncol 22(18):3713–3719

    Article  PubMed  CAS  Google Scholar 

  • Rodenhuis S, de Wit R, de Mulder PH et al (1999) A multi-center prospective phase II study of high-dose chemotherapy in germ-cell cancer patients relapsing from complete remission. Ann Oncol 10(12):1467–1473

    Google Scholar 

  • Samson MK, Rivkin SE, Jones SE et al (1984) Dose-response and dose-survival advantage for high versus low-dose cisplatin combined with vinblastine and bleomycin in disseminated testicular cancer. A Southwest Oncology Group study. Cancer 53(5):1029–1035

    Article  PubMed  CAS  Google Scholar 

  • Samuels ML, Johnson DE, Holoye PY (1975) Continuous intravenous bleomycin (NSC-125066) therapy with vinblastine (NSC-49842) in stage III testicular neoplasia. Cancer Chemother Rep 59(3):563–570

    PubMed  CAS  Google Scholar 

  • Sandler AB, Cristou A, Fox S et al (1998) A phase II trial of paclitaxel in refractory germ cell tumors. Cancer 82(7):1381–1386

    Article  PubMed  CAS  Google Scholar 

  • Schmoll HJ (1989) The role of ifosfamide in testicular cancer. Semin Oncol 16(1 suppl 3):82–95

    PubMed  CAS  Google Scholar 

  • Schmoll HJ, Souchon R, Krege S et al (2004) European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG). Ann Oncol 15(9):1377–1399

    Article  PubMed  CAS  Google Scholar 

  • Siegert W, Beyer J, Strohscheer I et al (1994) High-dose treatment with carboplatin, etoposide, and ifosfamide followed by autologous stem-cell transplantation in relapsed or refractory germ cell cancer: a phase I/II study. The German Testicular Cancer Cooperative Study Group. J Clin Oncol 12(6):1223–1231

    PubMed  CAS  Google Scholar 

  • Sonpavde G, Hutson TE, Roth BJ (2007) Management of recurrent testicular germ cell tumors. Oncologist 12(1):51–61

    Article  PubMed  Google Scholar 

  • Vaena DA, Abonour R, Einhorn LH (2003) Long-term survival after high-dose salvage chemotherapy for germ cell malignancies with adverse prognostic variables. J Clin Oncol 21(22):4100–4104

    Article  PubMed  CAS  Google Scholar 

  • van der WE, Richel DJ, Holtkamp MJ et al (1994) Bone marrow reconstitution after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation: effect of graft size. Ann Oncol 5(9):795–802

    Google Scholar 

  • Vuky J, Tickoo SK, Sheinfeld J et al (2002) Salvage chemotherapy for patients with advanced pure seminoma. J Clin Oncol 20(1):297–301

    Article  PubMed  CAS  Google Scholar 

  • White PM, Adamson DJ, Howard GC, Wright AR (1999) Imaging of the thorax in the management of germ cell testicular tumours. Clin Radiol 54(4):207–211

    Article  PubMed  CAS  Google Scholar 

  • Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ (1987) Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med 316(23):1435–1440

    Article  PubMed  CAS  Google Scholar 

  • Zon RT, Nichols C, Einhorn LH (1998) Management strategies and outcomes of germ cell tumor patients with very high human chorionic gonadotropin levels. J Clin Oncol 16(4):1294–1297

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank Marie-Dominique Reynaud for editing the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aude Fléchon .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag London Limited

About this chapter

Cite this chapter

Fléchon, A., Droz, JP. (2011). Treatment of Relapse. In: Laguna, M., Albers, P., Bokemeyer, C., Richie, J. (eds) Cancer of the Testis. Springer, London. https://doi.org/10.1007/978-1-84800-370-5_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-84800-370-5_14

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84800-369-9

  • Online ISBN: 978-1-84800-370-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics