Late relapse of testicular cancer.

The complete response (CR) rate of disseminated germ-cell tumors with current aggressive chemotherapy and surgical resection of localized residual disease is between 70%-80%. Most patients who relapse do so within the first year of therapy. We have observed seven patients with germ-cell tumors treated with a variety of modalities who relapsed after more than two years in CR (45-87 months). Five patients are alive after salvage therapy with follow-up too short to assess the durability of second remission. There were no features distinguishing late relapse patients from all patients treated with chemotherapy for germ-cell tumors. Follow-up in patients treated for germ-cell tumors with chemotherapy should be extended to five years before curability can be established.