Testis cancer: the pendulum swings. Experience in 430 patients.

A review of 430 patients with testis cancer followed for at least 3 years is presented. A protocol for actinomycin D therapy before and after node dissection had been instituted in 1966. In the 58 protocol cases studied there appeared to be an increase in the survival of patients with stage A disease and a significant increase in the survival of patients with stage B disease. There was an improvement in the survival of patients with stage C disease treated with actinomycin D alone. Since 1976 all patients with stages B and C disease have been treated with multiple drug regimens, showing dramatic results. The therapy of testis tumors is multimodal, using lymphadenectomy, radiation therapy and chemotherapy, but the pendulum has swung so that chemotherapy has assumed the vital role in management.