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Bührer E, D'Haese D, Daugaard G, de Wit R, Albany C, Tryakin A, Fizazi K, Stahl O, Gietema JA, De Giorgi U, Cafferty FH, Hansen AR, Tandstad T, Huddart RA, Necchi A, Sweeney CJ, Garcia-Del-Muro X, Heng DYC, Lorch A, Chovanec M, Winquist E, Grimison P, Feldman DR, Terbuch A, Hentrich M, Bokemeyer C, Negaard H, Fankhauser C, Shamash J, Vaughn DJ, Sternberg CN, Heidenreich A, Collette L, Gillessen S, Beyer J. Impact of teratoma on survival probabilities of patients with metastatic non-seminomatous germ cell cancer: Results from the IGCCCG Update Consortium. Eur J Cancer 2024; 202:114042. [PMID: 38564927 DOI: 10.1016/j.ejca.2024.114042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
AIMS To resolve the ongoing controversy surrounding the impact of teratoma (TER) in the primary among patients with metastatic testicular non-seminomatous germ-cell tumours (NSGCT). PATIENTS AND METHODS Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method. RESULTS Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001). CONCLUSION Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.
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Affiliation(s)
- Emanuel Bührer
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - David D'Haese
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Gedske Daugaard
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ronald de Wit
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Costantine Albany
- Horizon Oncology Research, 1345 Unity PI Ste 345, Lafayette, IN, United States of America
| | - Alexey Tryakin
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Olof Stahl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | | | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Italy and the Italian Germ Cell Cancer Group (IGG), Italy
| | - Fay H Cafferty
- Medical Research Council Clinical Trials Unit, University College London (UCL), London, United Kingdom; Institute of Cancer Research Clinical Trials and Statistics Unit, Sutton, United Kingdom
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Torgrim Tandstad
- The Cancer Clinic, St Olavs University Hospital and Department of Clinical and Molecular Medicine, The Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Andrea Necchi
- Vita-Salute San Raffaele University, Milan, Italy; Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Christopher J Sweeney
- South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia
| | - Xavier Garcia-Del-Muro
- Catalan Institute of Oncology, IDIBELL Institute of Research, University of Barcelona, Barcelona, Spain
| | - Daniel Y C Heng
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Anja Lorch
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland; Department of Urology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia; Cancer Research Institute, Biomedical Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Eric Winquist
- Division of Medical Oncology, Western University and London Health Sciences Centre, London, Ontario, Canada
| | - Peter Grimison
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, Australia
| | - Darren R Feldman
- Memorial Sloan Kettering Cancer Centre, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America
| | - Angelika Terbuch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital, University of Munich, Munich, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and BMT with Section Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Helene Negaard
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | | | - David J Vaughn
- University of Pennsylvania, Philadelphia, PA, United States of America
| | | | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Austria
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland; Universita della Svizzera Italiana (USI), Lugano, Switzerland
| | - Jörg Beyer
- University Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
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Pratsinis M, Fankhauser C, Pratsinis K, Beyer J, Bührer E, Cathomas R, Fischer N, Hermanns T, Hirschi-Blickenstorfer A, Kamradt J, Alex Kluth L, Zihler D, Mingrone W, Müller B, Nestler T, Rothschild SI, Seifert B, Templeton AJ, Terbuch A, Ufen MP, Woelky R, Gillessen S, Rothermundt C. Metastatic Potential of Small Testicular Germ Cell Tumors: Implications for Surveillance of Small Testicular Masses. EUR UROL SUPPL 2022; 40:16-18. [PMID: 35515270 PMCID: PMC9062248 DOI: 10.1016/j.euros.2022.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
Patient summary
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Beyer J, Berthold D, Bode PK, Cathomas R, Fankhauser CD, Fischer S, Gillessen S, Gross T, Hermanns T, Honecker F, Lorch A, Omlin A, Papachristofilou A, Roth B, Rothermundt C, Seiler R, Spahn M, Stenner F, Bührer E. Swiss germ-cell cancer consensus recommendations. Swiss Med Wkly 2021; 151. [PMID: 34495606 DOI: 10.4414/smw.2021.w30023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Approximately 420 men are diagnosed with germ-cell cancer (GCC) in Switzerland each year. Recent international guidelines outline management issues, but many aspects remain controversial in an area of highly individualised treatments. Even more than in other tumour types, in GCC the challenge is to choose exactly the correct treatment for an individual patient. Overtreatment in patients likely to be cured must be avoided to reduce long-term toxicities. On the other hand, treatment intensification is required in patients presenting with adverse prognostic factors. Therefore, referral to expert centres or consultations with an expert for a second opinion is strongly recommended. In 2020, Swiss experts discussed their strategies in a consensus meeting during the virtual Swiss Oncology and Haematology Congress (SOHC) in order to harmonise their concepts and to suggest optimal strategies for the management of GCC patients in Switzerland. Votes on controversial issues were obtained and are presented in this review wherever applicable.
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Affiliation(s)
- Jörg Beyer
- Universitätsklinik für Medizinische Onkologie, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Switzerland
| | - Dominik Berthold
- Département d'oncologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Peter-Karl Bode
- Institut für Pathologie und Molekularpathologie, Universitätsspital Zurich, Switzerland
| | - Richard Cathomas
- Onkologie/Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
| | | | - Stefanie Fischer
- Kantonsspital St. Gallen, Klinik für Onkologie und Hämatologie, St. Gallen, Switzerland
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Tobias Gross
- Universitätsklinik für Urologie, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Switzerland
| | - Thomas Hermanns
- Universitätsspital Zürich, Klinik für Urologie, Universität Zürich, Zürich, Switzerland
| | | | - Anja Lorch
- Klinik für medizinische Onkologie und Hämatologie, Universitätsspital Zürich, Switzerland
| | - Aurelius Omlin
- Kantonsspital St. Gallen, Klinik für Onkologie und Hämatologie, St. Gallen, Switzerland
| | | | - Beat Roth
- Service d'urologie, Centre hospitalier universitaire vaudois, University of Lausanne, Switzerland
| | - Christian Rothermundt
- Kantonsspital St. Gallen, Klinik für Onkologie und Hämatologie, St. Gallen, Switzerland
| | - Roland Seiler
- Universitätsklinik für Urologie, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Switzerland
| | - Martin Spahn
- Urologie Boxler und Spahn / Lindenhofspital Bern; Klinik für Urologie, Universitätsklinik Essen, Germany
| | - Frank Stenner
- Universitätsklinik Basel, Abteilung für Onkologie, Basel, Switzerland
| | - Emanuel Bührer
- Universitätsklinik für Medizinische Onkologie, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Switzerland
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