Prognostic factors for relapse after complete response in patients with metastatic germ cell tumors.

Among 216 patients with metastatic germ cell tumors who achieved a complete response (CR) to cisplatin-based chemotherapy (CT), 38 have experienced a relapse. Prognostic factors for time to relapse from time of response were considered using the Cox proportional hazards model. Compared with patients who responded to CT and did not require surgery and patients whose surgery showed only either necrotic debris or mature teratoma, those who required surgery for residual tumor after CT were at much higher risk for relapse, although their residual tumor was totally resected. Of the 19 patients who required this surgery, eight have experienced a relapse. Other prognostic factors for relapse included lactate dehydrogenase (LDH) and human chorionic gonadatropin (hCG) at the time of initial CT. Although those who require surgery for residual tumor after CT receive additional CT, there is still a high risk of relapse.