Orchiectomy in advanced germ cell XXXX following intensive chemotherapy: a comparison of systemic to testicular response.

@entity1 @entity66 @entity41 @entity5 @entity1062
A total of 16 @entity1 with advanced germ cell @entity5 underwent initial chemotherapy that was followed by a delayed orchiectomy for an unrecognized primary in 3 and for life-threatening distant metastatic @entity5 in 13. Of these @entity1 13 had a complete and 3 had a partial remission at the time of the delayed orchiectomy. Of the former 13 @entity1 3 (23 per cent) had persistent viable @entity5 in the @entity1062 . To date all 3 @entity1 have remained free of disease for more than 12, 20 and 30 months, respectively, without further therapy. One early relapse (1 month) was found in the remaining 10 @entity1 with a complete remission and without viable disease in the @entity1062 . Of the 3 @entity1 with a partial remission 1 had @entity41 in the @entity1062 and disease progressed despite further therapy. There was no evidence of @entity5 in the @entity1062 in the other 2 @entity1 . These data document the presence of a differential response of germ cell @entity5 in the primary and metastatic sites. Post-chemotherapy orchiectomy for a suspicious @entity5 of the @entity1062 is necessary because of the risk of persistent @entity66 . The post-chemotherapy pathological findings in the resected @entity5 do not reflect the systemic response.
