Adjuvant chemotherapy with VAB-3 of stage II-B testicular cancer.

A recent report from the Memorial Sloan-Kettering Cancer Center has indicated that patients with resected Stage IIB (N-2B and N-3) testicular cancer are at significant risk for relapse. Of patients with resected Stage IIB disease (N-2B, 19%; N-3, 54%), 34% relapsed after having undergone relatively mild adjuvant chemotherapy consisting of vinblastine, actinomycin D, bleomycin, and chlorambucil (VAB). In this study, 29 patients with resected Stage IIB testicular cancer underwent treatment with adjuvant VAB-3 which has been used as primary treatment for Stage III disease. All patients have remained in complete remission with a median follow-up time of 24 months. Three patients received broad spectrum antibiotics when fever and leukopenia developed. No patient experienced renal failure. The results of this study demonstrate the capability of aggressive adjuvant chemotherapy to prevent recurrence in the high-risk setting of resected Stage II (N-2B and N-3) disease. Optimal adjuvant treatment remains to be defined.