Risk of residual cancer after complete response following first-line chemotherapy in men with metastatic non-seminomatous germ cell tumour and International Germ Cell Cancer Cooperative Group intermediate/poor prognosis: A multi-institutional retrospective cohort study

被引：5

作者：

Antonelli, Luca ^{[1
,2
]}

Ardizzone, Davide ^{[3
]}

Ravi, Praful ^{[4
]}

Bagrodia, Aditya ^{[5
]}

Mego, Michal ^{[6
]}

Daneshmand, Siamak ^{[7
]}

Nicolai, Nicola ^{[8
]}

Nazzani, Sebastiano ^{[8
]}

Giannatempo, Patrizia ^{[8
]}

Franza, Andrea ^{[8
]}

Heidenreich, Axel ^{[9
,10
,11
]}

Paffenholz, Pia ^{[9
,10
]}

Saoud, Ragheed ^{[12
]}

Eggener, Scott ^{[12
]}

Ho, Matthew ^{[12
]}

Oswald, Nathaniel ^{[13
]}

Olson, Kathleen ^{[13
]}

Tryakin, Alexey ^{[14
]}

Fedyanin, Mikhail ^{[14
]}

Naoun, Natacha ^{[15
]}

Javaud, Christophe ^{[15
]}

Fizazi, Karim ^{[15
]}

King, Jennifer M.

Adra, Nabil ^{[16
]}

Douglawi, Antoin ^{[16
]}

Cary, Clint ^{[16
]}

Sweeney, Christopher ^{[4
]}

Fankhauser, Christian D. ^{[1
,17
]}

机构：

[1] Univ Lucerne, Dept Urol, Luzerner Kantonsspital, Luzern, Switzerland

[2] Policlin Umberto 1, Dept Urol, Rome, Italy

[3] Univ Zurich, Fac Med, Zurich, Switzerland

[4] Harvard Med Sch, Dana Farber Canc Inst, Dept Med, Boston, MA USA

[5] Univ Texas Southwestern, Dept Urol, Dallas, TX USA

[6] Comenius Univ, NCI, Dept Oncol, Bratislava, Slovakia

[7] Univ Southern Calif, Inst Urol, Keck Sch Med, Los Angeles, CA USA

[8] Fdn IRCCS Ist Nazl Tumori, Urol Oncol Unit, Milan, Italy

[9] Univ Cologne, Fac Med, Dept Urol, Uro Oncol,Robot Assisted & Reconstruct Urolog Sur, Cologne, Germany

[10] Univ Hosp Cologne, Cologne, Germany

[11] Med Univ, Dept Urol, Vienna, Austria

[12] Univ Chicago, Dept Surg, Sect Urol, Med Ctr, Chicago, IL USA

[13] Mayo Clin, Dept Urol, Scottsdale, AZ USA

[14] NN Blokhin Russian Canc Res Ctr, Moscow, Russia

[15] Inst Gustave Roussy, Villejuif, France

[16] Indiana Univ Sch Med, Div Med Oncol, Indianapolis, IN USA

[17] Univ Zurich, Zurich, Switzerland

来源：

EUROPEAN JOURNAL OF CANCER | 2023年 / 182卷

关键词：

Non-seminomatous germ cell tumour; Retroperitoneal lymph node dissection; International Germ Cell Cancer Cooperative Group; Teratoma; LYMPH-NODE DISSECTION; POSTCHEMOTHERAPY RETROPERITONEAL SURGERY; TESTICULAR CANCER; LATE-RELAPSE; SURVEILLANCE; CISPLATIN; FREQUENCY; TEMPLATE; OUTCOMES; DISEASE;

D O I：

10.1016/j.ejca.2022.12.032

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Current guidelines recommend surveillance in metastatic non-semi-nomatous germ cell tumour patients treated with first-line-chemotherapy and a complete clin-ical response (normalisation of serum tumour markers and residual masses <1 cm). However, this recommendation is based on a series including patients with good prognosis according to International Germ Cell Cancer Cooperative Group prognostic group (IGCCCG-PG). The aim of this study was to analyse the proportion of residual teratoma and survival among pa-tients with intermediate/poor IGCCCG-PG and a complete clinical response after first-line -chemotherapy. Material & methods: This is a retrospective study of men with intermediate/poor IGCCCG-PG, who had a complete clinical response after first-line chemotherapy. Patients were either followed by surveillance or treated with post-chemotherapy retroperitoneal lymph node dissection (pcRPLND). Results: Between 2009 and 2018, 143 men with intermediate (n = 83) or poor (n = 60) IGCCCG-PG were treated at 11 international centres. Among 33 patients treated with pcRPLND, the specimen showed teratoma and viable cancer in 16 (48%) and 4 (12%). During a median a 7-year follow-up, 20/110 (18%) patients managed with surveillance relapsed, of whom seven (6%) had a retroperitoneal-only relapse versus 2/33 patients managed with pcRPLND relapsed. No difference was observed regarding overall survival (OS) among men treated with pcRPLND or surveillance (5-year OS, 93% and 89%, p-value = 0.35). The median time-to-recurrence among men on surveillance was 1.3 years (range: 0.3-9.1), and the most common sites of relapses included retroperitoneum (11%), chest (5%), and bones (4%). Conclusions: While most men with intermediate/poor IGCCCG-PG harbour teratoma/cancer in the retroperitoneum despite a complete response to first-line-chemotherapy, only 6% managed with surveillance relapsed in the retroperitoneum. There was no significant difference in OS between the two groups. 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：144 / 154

页数：11

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