Physician-dependent prognostic variables in the management of testicular cancer.

A study of 246 cases of germ cell testicular cancer in Ireland between 1980 and 1985 confirmed that the personnel and the manner of management can significantly influence the outcome. Inadequate staging by omitting marker assays or CT scan reduced prognosis. Failure to use standard chemotherapy (PVB, BEP, POMBACE, VAB) or a reduced dosage diminished survival. Regular investigations are necessary during treatment, including marker assays, chest X-ray and CT scan. Frequent monitoring is important in later follow-up. Management by a urologist improved survival, especially if he was involved from the outset. The results also favoured the concept of combined management by a urologist and an oncologist.