Springer Science and Business Media LLC

Approximately 20% of patients with germ cell tumours do not respond fully to standard therapy, or relapse after treatment. The prognosis of these patients is poor with conventional chemotherapy. Preliminary data suggest that they may have a higher durable response rate with high dose chemotherapy and peripheral blood stem cell support. To treat a group of testicular cancer patients, either with relapsed disease or with poor prognostic features initially, with high dose chemotherapy and stem cell support, and evaluate their outcome. Five patients with testicular cancer were treated with high dose chemotherapy and stem cell support. Of these, four underwent this treatment as salvage therapy and one patient with poor prognostic features was treated as primary treatment. At an average follow-up of 18 months, four patients remain free of disease while one patient has developed relapse. This report provides further support for high dose chemotherapy in this setting although randomised, controlled trials are essential to clarify its use.

Breast cancer is the leading cancer in women globally. Despite decreasing mortality rates, largely due to early detection and modern treatment, the effectiveness of screening on long-term survival outcomes remains unclear. This study evaluates the 15-year survival outcomes of a national breast cancer screening program initiated in Hungary in 2002. Using a prospectively maintained patient database, the study included individuals from the first 6 years of the program who underwent surgery for histologically confirmed breast cancer and had available follow-up information. Patients were categorized based on the method of breast cancer detection into two groups: those diagnosed during or 2 years after the population-based screening exam (Group A), and those who self-detected or sought medical attention for symptoms (Group B). Of the 309 patients who underwent breast cancer surgery, 208 were screen-detected (Group A) and 101 were symptomatic (Group B). The 15-year overall survival was 75.0% for Group A and 76.2% for Group B (p = 0.927). The 15-year disease-specific survival was 85.6% and 81.2% (p = 0.249), respectively. A statistically not significant positive trend in disease-free survival was observed in Group A (81.7% vs. 75.2%; p = 0.144). The study underscores the importance of extended follow-up periods in evaluating the outcomes of breast cancer screening programs. While the screening program may not significantly enhance overall survival rates, it has demonstrated a reduction in the mastectomy rate and could potentially extend periods of disease-free survival. These findings contribute to the ongoing discourse about the long-term benefits of breast cancer screening programs.