Ten patients required postchemotherapy surgery with findings of teratoma (four patients), teratoma plus non-germ cell elements (two patients), necrosis (two patients), residual viable cancer (one patient), and incomplete resection of residual germ cell cancer (one patient). Of the 18 patients obtaining disease free status, ten have remained continuously disease free. Two patients had a relapse of teratoma that was successfully resected. Three patients relapsed from complete remission with recurrent germ cell tumors. Three patients in complete remission developed a hematologic malignancy at 13, 39, and 105 months after initial therapy. buy cipro
Comparable results have been obtained in other series. Overall, complete remission rates of 50 to 70 percent are obtained in most series with approximately 50 percent of the patients expected to be long term survivors. In most series with modern treatment, equivalent results were obtained with all histologic subtypes including yolk sac tumors of the mediastinum. These results of modem integrated chemotherapy and surgical management contrasts sharply to results just a decade ago. Economou and colleagues summarized the experience of a number of groups prior to 1978. Of 63 patients with mediastinal nonseminomatous germ cell tumors, two patients (3 percent) survived beyond 16 months.
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