PTU - Polskie Towarzystwo Urologiczne
list of articles:

Late relapses in patients with testicular cancer
Article published in Urologia Polska 2003/56/1.


Paweł Wiechno, Małgorzata Sadowska, Beata Paluchowska, Tomasz Demkow
Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curic w Warszawie. Klinika Nowotworów Układu Moczowego Kierownik kliniki: dr hab. Tomasz Demkow


testis, testicular cancer, late relapse, treatment


Aim of the study. The aim of this study is to present the experience of the Oncology Center in Warsaw in the treatment of late relapses of testicular cancer.
Material and methods. A retrospective analysis was made of 1013 patients treated at our center between 1974 and 1996 for tumor of the testis. In 27 of 1013 patients (2,7%) late relapse, e.g. recurrence observed at least 2 years after complete remission of the primary tumor, was diagnosed. The frequency of late relapses was 3.6% for patients treated previously for seminoma, and 2.3% for those with nonseminomatous neoplasm.
Results. Of 27 patients with late relapse, in 11 patients (41%) seminoma, and in 16 (59%) nonseminoma was diagnosed. The treatment of whole group consisted of cytostatics, combined with surgery in 6. and with radiotherapy in 8 patients (one of them underwent retroperitoneal lymphadenectomy before irradiation). In 21 of 27 patients (78%) complete remission after treatment of the recurrence was noted. In 4 patients (15%) we observed partial remission followed by progression of the disease. Progression during treatment appeared in 2 patients (2%). In 8 patients initial complete remission was followed by progression of the neoplastic disease. In general, durable remission was observed in 13 of 2 7 patients (48%). Twelve patients died.
Conclusions. Late relapses of testicular cancer are rare {2,7% in our material), hi patients with primary seminoma the recurrences are more frequent than in nonseminoma group (3.6% and 2.3%. respectively). Increase of testicular tumor marker values is often associated with relapse. Because of the possibility of late recurrences, long-term follow-up after successful treatment of primary tumor is needed in this group of patients.


  1. 1. Einhom LH, Williams SD, Troner M i wsp: The role of maintenance chemotherapy in disseminated testicular cancer. N Eng Med J 1981; 305: 727-731.
  2. 2. Madej G: Chemioterapia nowotworów układu moczowo-płciowego; w Madej G: Chemioterapia Onkologiczna Dorosłych i Dzieci, Warszawa PZWL 1999; 372-374.
  3. 3. Rorlh M, Jacobson GK, von der Maase I-I, Madscn EL, Nielsen OS, Pedersen M, Schultz H: Surveillance alone versus radiotherapy after orchiectomy for clinical stage Inonseminotnatous testicular cancer. Danish Testicular Cancer Study Group. J Clin Oncol 1991; 9: 1543-1548.
  4. 4. Van der Hem KG, van Groeningen CI, Pincdo HM: Late relapse of testicular cancer. A case report and a review of the literature. Nelh J Med 1991; 39 (5-6): 353-355.
  5. 5. DeLeo MJ, Greco FA, Hainssworth JD, Johnson DH: Late recurrences in long-temn survivors ofgeim cell neoplasms. Cancer 1988; 62 (5); 985-988.
  6. 6. Tcrebelo HR, Taylor HG, Brown A, Martin N, Stutz FH, Blom J, Gcier L: Late relapse of testicular cancer. J Clin Oncol 1983: 1 (9): 566-571.
  7. 7. Baniel J, Foster RS, Gonin R, Messemer JE, Donohue JP, Einliorn LH: Late relapse of testicular cancer. J Clin Oncol 1995; 13 (5): 1170-1176.
  8. 8. Papadimitris C, Papadimitriou C, Kokolakis N, Athanassiades R Dimopoulos MA: Late relapse of nonseminomatous germ cell tumor of testis; successful treatment with salvage chemoterapy alone. Urology 1997; 49 (3): 469-470.
  9. 9. Kuzmits R, Ludwig H: Late relapse in testicular cancer from a residual tumour. Lancet 1986; 1:1207-1208.
  10. 10. Borge N, Fossa SD, Ous S i wsp: Late recurrence of testicular cancer. J Clin Oncol 1988; 8:1248-1253.
  11. 11. Baniel J, Foster RS, Einhorn LH, Donohue JP: iMte /elapse of clinical stage I testicular cancer. J Urol V 1995; 154 (4): 1370-1372.


Pawel Wiechno
Centrum Onkologii - Instytut im. Marit Sklodowskiei-Curie
Klinikti Nowotworów Układu Moczowego
ul. Roentgena 5
02-781 Warszawa
lei/fiu: (0...22) 643 92 31