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JNCI Journal of the National Cancer Institute 1999 91(10):816-818;
© 1999 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 91, No. 10, 816-818, May 19, 1999
© 1999 Oxford University Press

EDITORIALS

Does Size Matter? Association Between Number of Patients Treated and Patient Outcome in Metastatic Testicular Cancer

Eric J. Feuer, Joel Sheinfeld, George J. Bosl

Affiliations of authors: E. J. Feuer, Surveillance Modeling and Methods Section, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD; J. Sheinfeld (Urology Service, Department of Surgery), G. J. Bosl (Department of Medicine), Memorial Sloan-Kettering Cancer Center, New York, NY.

Correspondence to: Eric J. Feuer, Ph.D., National Cancer Institute, Executive Plaza North, Rm. 313, MSC 7344, Bethesda, MD 20892-7344 (e-mail: rf41u@nih.gov).

There is increasing evidence that, in the treatment of advanced testicular cancer, centers that do not treat a certain "critical mass" of patients may not achieve optimal treatment outcome. In this issue of the Journal, Collette et al. (1) further substantiate and extend past observation by finding that, in a large (n = 380) four-arm European Organization for Research and Treatment of Cancer/Medical Research Council (EORTC/MRC) trial for "poor-prognosis" metastatic nonseminomatous germ cell tumors (GCTs) (2), patients treated at institutions accruing fewer than five patients to the trial had an inferior failure-free and overall survival compared with that among patients treated at institutions accruing five or more patients. These results are disconcerting, given the high cure rate of GCTs and the widespread knowledge of treatment success.

The first highly successful clinical trial for the treatment of advanced testicular cancer was initiated in 1974 (3). . . . [Full Text of this Article]

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