Impact of teratoma on survival probabilities of patients with metastatic non-seminomatous germ cell cancer: Results from the IGCCCG Update Consortium

Emanuel Bührer, David D'Haese, Gedske Daugaard, Ronald de Wit, Costantine Albany, Alexey Tryakin, Karim Fizazi, Olof Stahl, Jourik A. Gietema, Ugo De Giorgi, Fay H. Cafferty, Aaron R. Hansen, Torgrim Tandstad, Robert A. Huddart, Andrea Necchi, Christopher J. Sweeney, Xavier Garcia-Del-Muro, Daniel Y.C. Heng, Anja Lorch, Michal ChovanecEric Winquist, Peter Grimison, Darren R. Feldman, Angelika Terbuch, Marcus Hentrich, Carsten Bokemeyer, Helene Negaard, Christian Fankhauser, Jonathan Shamash, David J. Vaughn, Cora N. Sternberg, Axel Heidenreich, Laurence Collette, Silke Gillessen, Jörg Beyer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aims: 

To resolve the ongoing controversy surrounding the impact of teratoma (TER) in the primary among patients with metastatic testicular non-seminomatous germ-cell tumours (NSGCT). 

Patients and methods: 

Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method. 

Results: 

Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001).

Conclusion: 

Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.

Original languageEnglish
Article number114042
JournalEuropean Journal of Cancer
Volume202
DOIs
Publication statusPublished - May 2024

Bibliographical note

Publisher Copyright:
© 2024

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