904 Outcome analysis after salvage treatment of testicular germ cell tumours

Long-term outcome of salvage treatment was reviewed in 67 unselected patients relapsing during or after their primary cisplatin-based chemotherapy for metastatic testicular cancer. Salvage treatment predominantly consisted of cisplatin-ifosfamide-based chemotherapy ± surgery. With a median follow-up of 90 months 20 patients (30%) are alive with no evidence of disease. Prognostic factor analysis included year of diagnosis, age, primary site (testicular versus extragonadal), initial tumour burden, relative dose intensity of cisplatin, response to primary therapy, relapse-free interval, and tumour burden and marker status at relapse. Univariate analysis identified age ≤35 years, testicular origin, low tumour burden at diagnosis and at relapse, complete response (CR) to primary therapy and a relapse-free interval >3 months as predictors of favourable outcome. Multivariate analysis confirmed age ≤35, CR to primary therapy, and a relapse-free interval >3 months. Patients with these good-risk features had a 5-year survival of 72%. Prognosis for the remaining patients is poor with only 11% 5-year survival emphasising the need for innovative and more aggressive approaches.