For patients who have gone into first remission with minimal therapy, such as abdominal lymph nodal radiotherapy, the chances of curing any relapse should be good with standard chemotherapy.
The problem patients are those who have already received chemotherapy in full dose and relapse soon afterwards. These are clearly a higher risk group who are much more difficult to cure, but some good response can be obtained with other drugs such as iphosphamide, methotrexate andactinomycin with pr without repeat exposure to platinum, and in patients who achieve a remission after this second line therapy some consideration should be given to high dose chemotherapy and a peripheral stem cell auto-transplant.
It has been shown that aggressive management of teratoma or relapsed seminoma can still achieve cures in the relapse situation.
