Predictors of Outcome in Patients with Advanced Nonseminomatous Germ Cell Testicular Tumors
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Dosyalar
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Asian Pacific Organization Cancer Prevention
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.
Açıklama
Anahtar Kelimeler
Advanced disease, germ cell tumor, nonseminomatous germ cell tumor, prognostic factors, Council European Organization, Lymph-Node Dissection, Clinical Stage-I, Prognostic-Factors, Randomized-Trial, Phase-Iii, Consensus Conference, Embryonal Carcinoma, Dose Cisplatin, Cancer
Kaynak
Asian Pacific Journal of Cancer Prevention
WoS Q Değeri
Q3
Scopus Q Değeri
Q3
Cilt
15
Sayı
2
