If the remaining mass is less than 3 cm (1¼ in.), only scar tissue or benign teratoma may be found in the pathological specimen and no further treatment will be required because the relapse rate is less than 10 percent. But the relapse rate increases to 20 to 30 percent in men found to have viable (living) tumor (it is not unusual to find small areas of viable tumor in larger masses). In these cases, more chemotherapy , with a salvage regimen, must be given. Thereafter, careful follow-up is required.
Five-Year Survival More than 70 to 90 percent
Investigational
• The etoposide + carboplatin + bleomycin combination is now being evaluated.
• Depending on the definition used for poor risk, no more than 25 to 50 percent, at best, will attain complete
response. For patients not attaining a complete response and whose AFP and HCG markers are not
decreasing at the normal half-life rate, consideration should be given to autologous bone marrow
transplantation, which can cure at least 30 percent of heavily pretreated cases.
