Long-term outcome in patients with germ cell tumours treated with pomb/ace chemotherapy: comparison of commonly used classification systems of good and poor prognosis

Long-term outcome in patients with germ cell tumours treated with pomb/ace chemotherapy: comparison of commonly used classification systems of good and poor prognosis


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ABSTRACT We analysed outcome in 206 consecutive male patients treated for metastatic non-seminomatous germ cell tumour (NSGCT) of testicular or extragonadal origin treated with the POMB/ACE


(cisplatin, vincristine, methotrexate, bleomycin, actinomycin D, cyclophosphamide, etoposide) regimen after division into prognostic groups by commonly used clinical classification systems


and definitions of adverse prognosis. The adverse prognostic groups of all classification systems and definitions examined showed similar, but only moderate, sensitivity (71-81%) and


specificity (52-56%) in predicting death. A simple definition of poor prognosis based on raised initial levels of serum tumour markers alpha fetoprotein (aFP) and human chorionic


gonadotrophin (hCG) proved at least as useful (sensitivity 80%, specificity 55%) as other more complicated systems in predicting failure to achieve long-term survival. Comparison of survival


between ultra-high dose cisplatin-based combination chemotherapy and patients treated with POMB/ACE shows no advantage from this more toxic approach. This suggests that good results in


adverse prognosis patients can be achieved using conventional dose regimens administered intensively. Access through your institution Buy or subscribe This is a preview of subscription


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December 2022 AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Medical Oncology, Charing Cross Hospital, London, UK RN Hitchins Authors * RN Hitchins View author publications You


can also search for this author inPubMed Google Scholar * ES Newlands View author publications You can also search for this author inPubMed Google Scholar * DB Smith View author


publications You can also search for this author inPubMed Google Scholar * RHJ Begent View author publications You can also search for this author inPubMed Google Scholar * GJS Rustin View


author publications You can also search for this author inPubMed Google Scholar * KD Bagshawe View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND


PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hitchins, R., Newlands, E., Smith, D. _et al._ Long-term outcome in patients with germ cell tumours treated with


POMB/ACE chemotherapy: comparison of commonly used classification systems of good and poor prognosis. _Br J Cancer_ 59, 236–242 (1989). https://doi.org/10.1038/bjc.1989.48 Download citation


* Issue Date: 01 February 1989 * DOI: https://doi.org/10.1038/bjc.1989.48 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link


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