Human chorionic gonadotropin-positive seminoma patients: A registry compiled by the global germ cell tumor collaborative group (G3)
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Human chorionic gonadotropin-positive seminoma patients: A registry compiled by the global germ cell tumor collaborative group (G3). / Seidel, Christoph; Daugaard, Gedske; Nestler, Tim; Tryakin, Alexey; Fedyanin, Mikhail; Fankhauser, Christian; Hermanns, Thomas; Aparicio, Jorge; Heinzelbecker, Julia; Paffenholz, Pia; Heidenreich, Axel; De Giorgi, Ugo; Cathomas, Richard; Lorch, Anja; Fingerhut, Anna; Gayer, Fabian; Bremmer, Felix; Giannatempo, Patrizia; Necchi, Andrea; Aurilio, Gaetano; Casadei, Chiara; Tran, Ben; Dieckmann, Klaus-Peter; Brito, Margarida; Ruf, Christian; Oing, Christoph; Bokemeyer, Carsten.
In: EUR J CANCER, Vol. 132, 06.2020, p. 127-135.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Human chorionic gonadotropin-positive seminoma patients: A registry compiled by the global germ cell tumor collaborative group (G3)
AU - Seidel, Christoph
AU - Daugaard, Gedske
AU - Nestler, Tim
AU - Tryakin, Alexey
AU - Fedyanin, Mikhail
AU - Fankhauser, Christian
AU - Hermanns, Thomas
AU - Aparicio, Jorge
AU - Heinzelbecker, Julia
AU - Paffenholz, Pia
AU - Heidenreich, Axel
AU - De Giorgi, Ugo
AU - Cathomas, Richard
AU - Lorch, Anja
AU - Fingerhut, Anna
AU - Gayer, Fabian
AU - Bremmer, Felix
AU - Giannatempo, Patrizia
AU - Necchi, Andrea
AU - Aurilio, Gaetano
AU - Casadei, Chiara
AU - Tran, Ben
AU - Dieckmann, Klaus-Peter
AU - Brito, Margarida
AU - Ruf, Christian
AU - Oing, Christoph
AU - Bokemeyer, Carsten
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - BACKGROUND: The prognostic role of human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH) serum levels in seminoma patients remains uncertain. This observational study evaluates the prognostic impact of tumour marker levels, and other clinicopathological findings, in hCG-positive seminoma patients.METHODS: Seminoma patients with serum hCG levels above normal at first diagnosis were eligible for recruitment. Statistical analysis, including multivariate regression, was performed to identify risk factors. Primary end-points were overall survival (OS) and recurrence-free survival (RFS).RESULTS: We recruited 1031 hCG-positive patients (stage I: n = 586; stage II + III: n = 427) diagnosed between 1981 and 2018. In metastatic disease, LDH levels ≥3 above upper normal limit (UNL) pre- (n = 109) or post-orchiectomy (n = 73) and patients aged ≥40 years (n = 187) were associated with poor prognosis: 5-year OS rates of 84% (LDH ≥3 UNL pre-orchiectomy) versus 92% (<3 UNL pre-orchiectomy) (hazard ratio [HR]: 3.155, [95% confidence interval {CI}: 1.28-7.75], P = 0.012), 82% (≥3 UNL post-orchiectomy) versus 92% (<3 UNL post-orchiectomy) (HR: 6.877, [95% CI: 1.61-29.34]; P = 0.009) and 86% (≥40 years) versus 91% (<40 years) (HR: 6.870, [95% CI: 1.45-13.37], P = 0.009), respectively. A subset of patients with hCG levels ≥2000 IU/l pre-orchiectomy (n = 17) exhibited a poor prognosis, with 5-year OS rates of 73% (≥2000 IU/l) versus 94% (<2000 IU/l) (HR: 3.936, [95% CI: 1.02-12.61], P = 0.047).CONCLUSIONS: Age and LDH levels are significantly associated with poor prognosis in hCG-positive seminoma patients. A small number of patients, with levels of hCG ≥2000 IU/l, may represent a separate prognostic subgroup associated with impaired survival rates.
AB - BACKGROUND: The prognostic role of human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH) serum levels in seminoma patients remains uncertain. This observational study evaluates the prognostic impact of tumour marker levels, and other clinicopathological findings, in hCG-positive seminoma patients.METHODS: Seminoma patients with serum hCG levels above normal at first diagnosis were eligible for recruitment. Statistical analysis, including multivariate regression, was performed to identify risk factors. Primary end-points were overall survival (OS) and recurrence-free survival (RFS).RESULTS: We recruited 1031 hCG-positive patients (stage I: n = 586; stage II + III: n = 427) diagnosed between 1981 and 2018. In metastatic disease, LDH levels ≥3 above upper normal limit (UNL) pre- (n = 109) or post-orchiectomy (n = 73) and patients aged ≥40 years (n = 187) were associated with poor prognosis: 5-year OS rates of 84% (LDH ≥3 UNL pre-orchiectomy) versus 92% (<3 UNL pre-orchiectomy) (hazard ratio [HR]: 3.155, [95% confidence interval {CI}: 1.28-7.75], P = 0.012), 82% (≥3 UNL post-orchiectomy) versus 92% (<3 UNL post-orchiectomy) (HR: 6.877, [95% CI: 1.61-29.34]; P = 0.009) and 86% (≥40 years) versus 91% (<40 years) (HR: 6.870, [95% CI: 1.45-13.37], P = 0.009), respectively. A subset of patients with hCG levels ≥2000 IU/l pre-orchiectomy (n = 17) exhibited a poor prognosis, with 5-year OS rates of 73% (≥2000 IU/l) versus 94% (<2000 IU/l) (HR: 3.936, [95% CI: 1.02-12.61], P = 0.047).CONCLUSIONS: Age and LDH levels are significantly associated with poor prognosis in hCG-positive seminoma patients. A small number of patients, with levels of hCG ≥2000 IU/l, may represent a separate prognostic subgroup associated with impaired survival rates.
U2 - 10.1016/j.ejca.2020.03.022
DO - 10.1016/j.ejca.2020.03.022
M3 - SCORING: Journal article
C2 - 32361383
VL - 132
SP - 127
EP - 135
JO - EUR J CANCER
JF - EUR J CANCER
SN - 0959-8049
ER -