Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database.

Autor: Lauritsen J; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark., Sauvé N; European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium., Tryakin A; Department of Chemotherapy, N.N.Blokhin Russian Cancer Research Center, Moscow, Russia., Jiang DM; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Huddart R; Institute of Cancer Research and Royal Marsden Hospital, Downs Road, Sutton, Surrey, UK., Heng DYC; Division of Medical Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada., Terbuch A; Division of Oncology, Medical University of Graz, Graz, Austria., Winquist E; Department of Oncology, University of Western Ontario and London Health Sciences Centre, London, ON, Canada., Chovanec M; 2nd Department of Oncology, Faculty of Medicine, Comenius University, National Cancer Institute, Bratislava, Slovakia., Hentrich M; Department of Hematology/Oncology, Red Cross Hospital, Munich, Germany., Fankhauser CD; University of Zurich, Zurich, Switzerland.; University of Lucerne, Lucerne, Switzerland., Shamash J; Department of Oncology, St Bartholomew's Hospital, London, UK., Del Muro XG; Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, Spain., Vaughn D; Division of Hematology/Oncology, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, USA., Heidenreich A; Department of Urology, Uro-Oncology, Robot Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany., Sternberg CN; Englander Institute for Precision Medicine, Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York-Presbyterian, New York, NY, USA., Sweeney C; Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA., Necchi A; Vita-Salute San Raffaele University, Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy., Bokemeyer C; Department of Oncology, Hematology and BMT with section Pneumonology, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Bandak M; Department of Consulting and Research, International Drug Development Institute, Louvain-la-Neuve, Belgium., Jandari A; European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium., Collette L; European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium., Gillessen S; Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland.; University of Southern Switzerland, Lugano, Switzerland., Beyer J; Department of Medical Onccology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. joerg.beyer@insel.ch., Daugaard G; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2023 Nov; Vol. 129 (11), pp. 1759-1765. Date of Electronic Publication: 2023 Sep 30.
DOI: 10.1038/s41416-023-02443-3
Abstrakt: Background: Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.
Patients and Methods: In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.
Results: A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem.
Conclusion: Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.
(© 2023. The Author(s).)
Databáze: MEDLINE
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