Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database.
Date
2023-11-23ICR Author
Author
Lauritsen, J
Sauvé, N
Tryakin, A
Jiang, DM
Huddart, R
Heng, DYC
Terbuch, A
Winquist, E
Chovanec, M
Hentrich, M
Fankhauser, CD
Shamash, J
Del Muro, XG
Vaughn, D
Heidenreich, A
Sternberg, CN
Sweeney, C
Necchi, A
Bokemeyer, C
Bandak, M
Jandari, A
Collette, L
Gillessen, S
Beyer, J
Daugaard, G
Type
Journal Article
Metadata
Show full item recordAbstract
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.
Collections
Subject
Male
Humans
Testicular Neoplasms
Prognosis
Neoplasms, Germ Cell and Embryonal
Progression-Free Survival
Seminoma
Neoplasms, Second Primary
Recurrence
Research team
Clinic Acad RT Huddart
Language
eng
Date accepted
2023-09-14
License start date
2023-11-23
Citation
British Journal of Cancer, 2023, 129 (11), pp. 1759 - 1765
Publisher
SPRINGERNATURE