Combination radical surgery and multiple sequential chemotherapy for the treatment of advanced carcinoma of the testis (stage III).

Nineteen patients with advanced testicular carcinomas (Stage III) were treated by a combination of multisequential chemotherapy with vinblastine, bleomycin, platinum, adriamycin, cytoxan, actinomycin D, and reductive surgery. Of the sixteen patients who were operated on 10 patients are alive and free of disease from 5 to 15 months. Two patients are alive with residual disease and four patients died. (Three were free of malignant tumor and one had residual malignant disease.) Three patients are still receiving preoperative chemotherapy. Pathology reported benign tumors in 8 out of 16 patients operated on. All these patients were previously treated with multiple chemotherapy. Several facts emerge from this study: (1) the great effectiveness of the combination of multisequential chemotherapy and reductive surgery to produce complete clinical remission in advanced testicular carcinomas (63.6%, 13 out of 19 patients); (2) the possibility of benign transformation of these tumors (50%, 8 out of 16); (3) the importance of the second-look surgery in testicular tumors.