{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:23:57Z","timestamp":1791869037930,"version":"4.3.4"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2010,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Controversy arises regarding the optimal management of patients with nonseminomatous germ cell tumor (NSGCT) who achieve a serologic and radiographic complete remission (CR) to systemic chemotherapy. Some authors recommend postchemotherapy retroperitoneal lymph node dissection (PC-RPLND), whereas others omit surgery and observe these patients. In an attempt to address this question, we report the long-term follow-up of patients treated at Indiana University who were observed without PC-RPLND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This is a retrospective analysis of patients with NSGCT who achieved a CR to first-line chemotherapy and were monitored without further therapy. CR was defined as normalization of serum tumor markers and resolution of radiographic disease (residual mass &lt; 1 cm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred forty-one patients were identified. Five patients (4%) had less than 2 years of follow-up. After a median follow-up of 15.5 years, 12 patients (9%) experienced relapse. Of these 12 patients, eight patients currently have no evidence of disease (NED), and four patients died of disease. The estimated 15-year recurrence-free survival (RFS) and cancer-specific survival rates were 90% and 97%, respectively. The estimated 15-year RFS for good-risk patients (n = 109) versus intermediate- or poor-risk patients (n = 32) was 95% and 73% (P = .001), respectively. Six patients (4%) experienced recurrence in the retroperitoneum, of whom two patients died of disease. Five patients had late relapse (range, 3 to 13 years), including two patients in the retroperitoneum. All five patients currently have NED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients obtaining a CR after first-line chemotherapy can be safely observed without PC-RPLND. Relapses are rare and potentially curable with further treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2009.23.0714","type":"journal-article","created":{"date-parts":[[2009,12,21]],"date-time":"2009-12-21T21:42:51Z","timestamp":1261431771000},"page":"531-536","source":"Crossref","is-referenced-by-count":136,"title":["Long-Term Follow-Up of Cisplatin Combination Chemotherapy in Patients With Disseminated Nonseminomatous Germ Cell Tumors: Is a Postchemotherapy Retroperitoneal Lymph Node Dissection Needed After Complete Remission?"],"prefix":"10.1200","volume":"28","author":[{"given":"Yaron","family":"Ehrlich","sequence":"first","affiliation":[{"name":"From the Department of Urology and Division of Hematology-Oncology, School of Medicine, Melvin and Bren Simon Cancer Center, Indianapolis IN; and Lance Armstrong Foundation, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary J.","family":"Brames","sequence":"additional","affiliation":[{"name":"From the Department of Urology and Division of Hematology-Oncology, School of Medicine, Melvin and Bren Simon Cancer Center, Indianapolis IN; and Lance Armstrong Foundation, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D.W.","family":"Beck","sequence":"additional","affiliation":[{"name":"From the Department of Urology and Division of Hematology-Oncology, School of Medicine, Melvin and Bren Simon Cancer Center, Indianapolis IN; and Lance Armstrong Foundation, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Foster","sequence":"additional","affiliation":[{"name":"From the Department of Urology and Division of Hematology-Oncology, School of Medicine, Melvin and Bren Simon Cancer Center, Indianapolis IN; and Lance Armstrong Foundation, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence H.","family":"Einhorn","sequence":"additional","affiliation":[{"name":"From the Department of Urology and Division of Hematology-Oncology, School of Medicine, Melvin and Bren Simon Cancer Center, Indianapolis IN; and Lance Armstrong Foundation, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.08.043"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.3.387"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.5.1837"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2006.06.047"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.03.184"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(18)31070-X"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(18)31071-1"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000119121.36427.09"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.4.1455"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.4528"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.7.1163"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.23.16_suppl.4580"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.2.594"},{"key":"B14","first-page":"45","volume":"64","author":"Hill ME","year":"2001","journal-title":"Soc Secur Bull"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1995.13.2.470"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980401)82:7<1343::AID-CNCR18>3.0.CO;2-6"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10440"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.5037"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(09)60925-3"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.4791"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1995.13.5.1170"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.7453"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm062"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.0899"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.01.116"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64458-8"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2009.23.0714","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T20:33:12Z","timestamp":1653510792000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2009.23.0714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,2,1]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2010,2,1]]}},"alternative-id":["10.1200\/JCO.2009.23.0714"],"URL":"https:\/\/doi.org\/10.1200\/jco.2009.23.0714","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1927976.1482080","asserted-by":"object"}]},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,2,1]]}}}