Cis-platin combination chemotherapy for non-seminomatous germ-cell tumours of the testis.

Eighteen patients with metastatic non-seminomatous germ-cell tumours (NSGCTs) of the testis were treated with cis-platin combination chemotherapy between 1979 and 1985. Three of the patients received chemotherapy after a staging lymphadenectomy (stage 2 disease) and were free of disease at follow-up. Fifteen patients with stage II disease and adverse prognostic factors or stage III disease received initial chemotherapy followed in 11 cases by surgical exploration. Eleven of these patients were free of disease at a median follow-up of 52 months, 1 was alive at 35 months with a mature teratoma, which is non-progressive, 2 died of their cancer, and 1 died of acute respiratory distress syndrome after surgery. The patients who failed to respond to therapy had associated bulky disease. The overall 5-year survival rate is 81%. Before the introduction of cis-platin there were no survivors among 9 patients with metastatic NSGCTs treated initially with chemotherapy. These findings indicate that the good results reported with cis-platin combination chemotherapy for NSGCTs are reproducible in other populations and centres.