Identification of a subgroup with worse prognosis among patients with poor‐risk testicular germ cell tumor. (18th June 2015)

• Record Type: Journal Article
• Authors: Kojima, Takahiro; Kawai, Koji; Tsuchiya, Kunihiko; Abe, Takashige; Shinohara, Nobuo; Tanaka, Toshiaki; Masumori, Naoya; Yamada, Shigeyuki; Arai, Yoichi; Narita, Shintaro; Tsuchiya, Norihiko; Habuchi, Tomonori; Nishiyama, Hiroyuki
• Is Part Of: International journal of urology. Volume 22:Number 10(2015)
• Page Start: 923
• Page End: 927
• Publication Date: 2015-06-18
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12844
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main" id="iju12844-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12844-sec-0001" sec-type="section"> <title>Objectives</title> <p>To clarify the significance of the International Germ Cell Cancer Collaborative Group classification in the 2000s, especially in intermediate‐ and poor‐prognosis testicular germ cell tumor in Japan.</p> </sec> <sec id="iju12844-sec-0002" sec-type="section"> <title>Methods</title> <p>We retrospectively analyzed 117 patients with intermediate‐ and poor‐prognosis testicular non‐seminomatous germ cell tumor treated at five university hospitals in Japan between 2000 and 2010. Data collected included age, levels of tumor markers, spread to non‐pulmonary visceral metastases, treatment details and survival.</p> </sec> <sec id="iju12844-sec-0003" sec-type="section"> <title>Results</title> <p>The median follow‐up period of all patients was 57 months. A total of 50 patients (43%) were classified as having intermediate prognosis, and 67 patients (57%) as poor prognosis according to the International Germ Cell Cancer Collaborative Group classification. As first‐line chemotherapy, 92 patients (79%) received bleomycin, etoposide and cisplatin. Of all patients, 74 patients (63%) received second‐line chemotherapy. The most commonly used second‐line chemotherapy regimens were a combination of taxanes, ifosfamide and platinum in 49 cases (66%). Overall, 33 patients (28%) received third‐line chemotherapy. A total of 88 patients (75%) underwent post‐chemotherapy surgery. The 5‐year overall survival for intermediate (<italic>n</italic> = 50) and poor prognosis (<italic>n</italic> = 67) was 89% and 83% (<italic>P</italic> = 0.21), respectively. In poor prognosis patients, patients with two or more risk factors (any of high lactic dehydrogenase, alpha‐fetoprotein and human chorionic gonadotropin levels, and presence of non‐pulmonary visceral metastases) had significantly worse survival than those with only one risk factor (71% and 91%, respectively, <italic>P</italic> = 0.01).</p> </sec> <sec id="iju12844-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The 5‐year overall survivals of poor‐prognosis testicular non‐seminomatous germ cell tumor patients reached 83%. Further stratification of poor‐prognosis patients based on a number of risk factors has the potential to further identify those with poorer prognosis.</p> </sec> </abstract>