The Role of Maintenance Therapy in Disseminated Testicular Cancer

We concluded a prospective study of the value of maintenance therapy in disseminated testicular cancer after chemotherapy-induced complete remission or chemotherapy cytoreduction followed by surgical resection of residual teratoma. A group of 171 patients were randomized to treatment consisting of cisplatin, vinblastine, and bleomycin, or these drugs plus doxorubicin. There was no apparent difference between these two induction regimens. Complete remission was achieved in 113 patients (66 per cent), and 19 (11 per cent) were free of disease by surgical resection of residual tumor. Of the 171 who started, 113 were eligible to receive either maintenance doses of vinblastine (58 patients) or no further therapy (55 patients) after remission-induction therapy. There was a 9 per cent relapse rate during maintenance with vinblastine and a 7 per cent relapse rate with no maintenance therapy; the overall relapse rate was 8 per cent (nine of 113). Our data indicate that maintenance therapy is unnecessary in disseminated testicular cancer.