Cary, ClintJacob, Joseph M.Albany, CostantineMasterson, Timothy A.Hanna, Nasser H.Einhorn, Lawrence H.Foster, Richard S.2017-12-012017-12-012017Cary, C., Jacob, J. M., Albany, C., Masterson, T. A., Hanna, N. H., Einhorn, L. H., & Foster, R. S. (2017). Long-term Survival of Good Risk Germ Cell Tumor Patients following Post-chemotherapy Retroperitoneal Lymph Node Dissection: A comparison of BEPx3 vs. EPx4 and treating institution. Clinical Genitourinary Cancer. https://doi.org/10.1016/j.clgc.2017.10.008https://hdl.handle.net/1805/14714Background Patients with International Germ Cell Cancer Collaborative Group (IGCCCG) good-risk testicular cancer might receive either 4 cycles of etoposide and cisplatin (EP × 4) or 3 cycles of bleomycin, etoposide, and cisplatin (BEP × 3). We sought to examine differences in survival after retroperitoneal lymph node dissection (PC-RPLND) between patients who received EP × 4 compared with BEP × 3. Patients and Methods The Indiana University Testis Cancer database was queried to identify IGCCCG good-risk PC-RPLND patients who received either EP × 4 or BEP × 3 induction chemotherapy. The primary outcome was overall survival (OS). Kaplan–Meier plots were generated for the EP × 4 and BEP × 3 groups and compared using the log rank test. Cox regression analysis was used to determine risk of mortality. Results A total of 223 patients met inclusion criteria between 1985 and 2011. Induction chemotherapy consisted of EP × 4 in 45 (20%) patients and BEP × 3 in 178 (80%). Most patients (78%) received their chemotherapy at outside institutions and were subsequently referred for PC-RPLND. The location of treating institution did not influence outcomes significantly when similar chemotherapy regimens were compared in this good-risk cohort. The 10-year OS for the EP × 4 and BEP × 3 groups were 91% and 98%, respectively (log rank P < .01). The adjusted risk of death in the EP × 4 group showed a nonsignificant trend of 3 times greater compared with the BEP × 3 group (hazard ratio, 3.1; 95% confidence interval, 0.8-12.0; P = .10). Conclusion The regimen of BEP × 3 resulted in a trend toward improved survival, however, this did not reach statistical significance. The location of treating institution seems less important in this risk group of patients.enPublisher Policybleomycintesticular neoplasmslymph node excisionArticle