If patients relapse, the total amount of chemotherapy required is higher than if the drugs were given preemptively. Based on this, researchers have debated which option presents the least cumulative morbidity. Interpretation errors are also made. So if patients' markers and abdominal CT scans are normal, plain chest x-ray is sufficient. Those who relapsed did so within 2 years.
Testis cancer grows rapidly and has the shortest doubling time of any tumor.
The sites of relapse were the retroperitoneal nodes and the lungs. The factors that best predicted relapse were vascular channel invasion first of all and then predominance of embryonal carcinoma on histology. The overall survival of this group of patients remained excellent. Others have tried to develop additional markers to determine risk, but none of those are sufficiently sensitive or specific to change clinical practice. Carboplatin was chosen so that the patients could receive the chemotherapy on an outpatient basis.