Table 3.

Staging, Chemotherapy Regimens, Response, and Latest Status.

All studied patients were contacted by the departmental secretary on January 1, 2012 and were found to be alive with no evidence of their previous testicular tumor. Remission was assessed and confirmed clinically, radiologically, and biochemically (B-HCG, LDH).

Pt. No. (Age at Diagnosis) Side of Disease Pathologic Staging of Testicular Seminoma Stage Regimen × No. of Cycles Side Effects Response
#1 (60) Left T2 IIC BEP × 4
  • Neutropenic fever
  • Mild peripheral neuropathy
CR
#2 (17) Left T1 IIC BEP × 3 CR
#3 (39) Right T2 IIC a BEP × 3 CR
#4 (47) Left T1 IIC b BEP × 3; EP × 1
  • Bleomycin lung toxicity c
  • Mild peripheral neuropathy
CR
#5 (55) Left T1 IIC d BEP × 1; Carboplatin/etoposide/bleomycin × 2; Carboplatin/etoposide × 1 CR e
#6 (36) Left T1 IIC BEP × 3 Bleomycin lung toxicity f CR
#7 (42) Right T1 IIIA g BEP × 3 Mucositis grade II CR
#8 (43) Right T2 IIC Carboplatin/bleomycin/etoposide × 4 CR
#9 (41) Right T1 IIC EP × 3 Neutropenic fever CR
#10 (33) Left T1 IIC BEP × 3 CR
#11 (50) Left T1 IIC CDDP/VP-16 × 4 Neutropenic fever CR
#12 (53) Bilateral T1 IIC BEP × 4 Mild hearing loss CR
#13 (23) Right T1 IIB BEP × 3; EP × 1 CR
#14 (66) Right T1 IIIA BEP × 3; EP × 1 CR
#15 (32) Right T2 h IIC BEP × 3; EP × 1 CR
#16 (46) Right T2 IIC i BEP × 3 Mucositis grade III CR
#17 (42) Right T1 IIB BEP × 3 Mild tinnitus CR
#18 (27) Left T1 IIIB BEP × 3 CR
#19 (29) Right T1 h IIC BEP × 3 CR j
#20 (34) Left T2 j IIB BEP × 3 Bleomycin lung toxicity k CR
#21 (32) Right T1 IIB BEP × 3 CR
#22 (21) Right T1 IIC BEP × 4 CR l
#23 (31) Right T1 IIB BEP × 3 Herpes zoster CR m
#24 (43) Left T1 IIC BEP × 3 CR n
#25 (51) Left T1 IIIA o BEP × 3 CR
#26 (33) Right T1 IIB BEP × 4 Neutropenic fever CR
aPatient #3 presented with very advanced retroperitoneal mass, measuring 10 × 9 × 13 cm; unilateral hydronephrosis; involved right-sided ureter.
bPatient #4 presented with massive retroperitoneal and pelvic lymphadenopathy, hydronephrosis and hydroureter.
cBleomycin lung toxicity (BIP) = clinically asymptomatic, radiological diagnosis; cumulative bleomycin dose 180 units.
dRetroperitoneal lymphadenopathy, measuring 9.5 × 13.5 × 7.5 cm; left-sided hydronephrosis; involved diaphragmatic crus.
eSlow radiological response—it took several months until complete resolution of residual mass.
fClinically asymptomatic, radiological manifestation; reaching total bleomycin dose 240 units.
gIIIA = retroperitoneal, mediastinal, and left-sided supraclavicular groove lymphadenopathy; pathologically confirmed.
hSeminoma with intratubular germ cell tumor.
iHuge retroperitoneal mass, obstructed left kidney with resulting hydronephrosis, necrotic mass in the midline, inguinal and external iliac lymphadenopathy.
jPatient preferred surveillance initially; relapsed 9 months later with abdominal pain and retroperitoneal mass (52 mm); in complete remission.
kVery symptomatic with radiological signs; treated successfully with high-dose steroids; cumulative bleomycin dose 240 units.
lPatient relapsed with lung metastasis 1 year following BEP; responded to second-line chemotherapy with ifosfamide-based chemotherapy for 4 years; disease recurred in lungs and pelvis; entered third CR following HDCT with APSCT and local radiation therapy; alive NED for 168 months.
mPET-CT-confirmed CR.
nGallium scan-proven CR.
oBiopsy-proven metastatic lymphadenopathy in the left supraclavicular groove.

CR, complete response; EP, etoposide/cisplatinum.

RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2014 January; 5(1): e0005. ISSN: 2076-9172
Published online 2014 January 21. doi: 10.5041/RMMJ.10139.