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

  • Jakob Lauritsen (Shared first author)
  • Nicolas Sauvé (Shared first author)
  • Alexey Tryakin
  • Di Maria Jiang
  • Robert Huddart
  • Daniel Y C Heng
  • Angelika Terbuch
  • Eric Winquist
  • Michal Chovanec
  • Marcus Hentrich
  • Christian D Fankhauser
  • Jonathan Shamash
  • Xavier Garcia Del Muro
  • David Vaughn
  • Axel Heidenreich
  • Cora N Sternberg
  • Christopher Sweeney
  • Andrea Necchi
  • Carsten Bokemeyer
  • Mikkel Bandak
  • Abolghassem Jandari
  • Laurence Collette
  • Silke Gillessen
  • Joerg Beyer
  • Gedske Daugaard

Related Research units

Abstract

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.

Bibliographical data

Original languageEnglish
ISSN0007-0920
DOIs
Publication statusPublished - 11.2023

Comment Deanary

© 2023. The Author(s).

PubMed 37777577