Factors that impact the outcomes in testicular germ cell tumors in low–middle-income countries

Saju, S. V.; Radhakrishnan, Venkatraman; Ganesan, Trivadi S.; Dhanushkodi, Manikandan; Raja, Anand; Ganesarajah, Selvaluxmy; Sagar, Tenali Gnana

doi:10.1007/s12032-019-1252-6

Cited by 22 publications

(28 citation statements)

References 28 publications

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“…This is similar to most of the published literature where the majority of the patients were categorised as good-risk group [17,18]. The proportion of poor-risk patients is comparable to previously published Indian data also [3,4].…”

Section: Discussionsupporting

confidence: 91%

“…Only nine patients were aged >40 years, and that may be the reason for the nonsignificant association. Cryptorchidism and scrotal violation had no association with survival in the present study similar to other studies [4]. Presence of embryonal carcinoma and LVSI was thought to be associated with increased risk of recurrence in stage I NSGCT [14].…”

Section: Discussionsupporting

confidence: 87%

“…The four-year survival for IS, II and III were 95%, 86.7% and 78.5%, respectively. The survival rates are better compared to the previously published Indian data [4,5]. Among the patients with metastatic disease, four-year OS was 93.6%,87.5% and for 52.6% for good, intermediate and poor-risk groups, respectively.…”

Section: Discussionmentioning

confidence: 57%

“…About half of the patients in our series presented with stage III disease. Other reported series from India has published a similar proportion of patients with NSGCT in advanced stages [3][4][5]. Only 27% of patients presented with stage I (IA and IB) disease.…”

Section: Discussionmentioning

confidence: 79%

“…The age-standardised incidence rate of testicular cancer in India is 0.5 per 100,000 population, while it is 6.7 and 5.6 per 100,000 population for Europe and the United States, respectively [2]. India has the lowest incidence globally, and hence Indian data on testicular germ cell tumours are sparse [3][4][5]. Here, we report the outcomes of patients with NSGCT of testis treated at a tertiary cancer centre in South India over a period of 10 years.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis—experience from a tertiary cancer centre in India

Nair¹,

Krishna²,

Kumar³

et al. 2020

ecancer

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis—experience from a tertiary cancer centre in India

Nair¹,

Krishna²,

Kumar³

et al. 2020

ecancer

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Blood testis barrier revisited—Analysis of post‐chemotherapy germ cell tumor orchidectomy and retroperitoneal lymph node dissection specimens

Gupta

Noronha

Bakshi

et al. 2021

Journal of Surgical Oncology

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Objective To assess the response of chemotherapy on the primary tumor, compare it with the response in retroperitoneal disease, and study factors associated with pathological complete response. Methods We conducted a retrospective audit of all high inguinal orchidectomies (HIOs) performed after chemotherapy between 2012 and 2019 at a tertiary cancer center in India. Patient characteristics and histopathological response were extracted from electronic medical records, and predictors of testicular disease response were assessed. Results Of the 260 retroperitoneal lymph node dissections (RPLNDs) performed in the study period, 37 HIOs (14.23%) were carried out after chemotherapy. The median age of presentation was 28 years (16–41). Histopathology was divided into a viable tumor, mature teratoma, and necrosis/scarring. Residual disease was seen in 17 RPLND (46.0%) and 18 HIO (48.6%) specimens respectively. Of these 18, three patients had a residual viable tumor in the testis, and the remaining had a mature teratoma. Clinico‐radiological assessment showed an average reduction of 61% in testicular disease size following chemotherapy. On orchidectomy histopathological assessment, the median tumor size was 9, 4, and 1.5 cm in specimens with a viable tumor, mature teratoma, and necrosis/scarring, respectively. Conclusions A low threshold for upfront chemotherapy in patients with a high disease burden may be considered as tumors within the testis respond to chemotherapy in more than half of the patients. Discordance rates of residual cancer in RPLND and HIO specimens exist but post‐chemotherapy tumor size in testis correlates with the presence of a residual viable tumor.

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Outcomes and prognostic variables of extracranial germ cell tumors in children and adolescents treated over a decade: A developing world perspective

Ramanathan

Prasad

Vora

et al. 2022

Pediatric Blood & Cancer

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Background:The purpose of this single-center study was to analyze the outcomes of extracranial germ cell tumors (GCTs) in children treated on a multimodality regimen. Methods: Retrospective study of children (<18 years) with a histopathologically confirmed diagnosis of extracranial GCT over a period of 10 years (January 2009 to December 2018) treated on a uniform institution-based protocol consisting of both cisplatin-and carboplatin-based regimens. All completely excised teratomas and stage I gonadal tumors received no further therapy (low risk [LR]); stage IV ovarian, stage III-IV extragonadal GCTs received six cycles of chemotherapy (high risk [HR]), and the remaining received four cycles of chemotherapy (intermediate risk [IR]).Results: A total of 297 children were treated with a female:male ratio of 1.72:1 and median age of 4 years. Forty-three children had pure teratomas. Gonadal GCTs (N = 180) were more common than extragonadal GCTs (N = 117) with ovary as primary site in 128 children (43%) and sacrococcygeal site being the commonest extragonadal location (N = 41; 14%). LR, IR, and HR disease were noted in 60 (20.2%), 125 (42%), and 112 (37.8%) patients, respectively. Three-fourths of ovarian tumors and half of testicular tumors operated prior to presentation needed upstaging. Forty-one patients relapsed and 43 children expired (disease-related: 33; toxic deaths: 9; unknown: 1). The 5-year event-free survival (EFS)/overall survival (OS) of malignant GCT (n = 254) was 72.50%/82.70%, respectively, with gonadal site (p = .001), LR and IR (p = .001) and nonmetastatic disease (p = .001) being favorable prognostic variables. Conclusions:The LR and IR GCTs in our cohort had an excellent outcome. A significant proportion of IR gonadal GCTs can be spared of systemic chemotherapy by adhering to strict surgical guidelines.

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Factors that impact the outcomes in testicular germ cell tumors in low–middle-income countries

Cited by 22 publications

References 28 publications

Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis—experience from a tertiary cancer centre in India

Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis—experience from a tertiary cancer centre in India

Blood testis barrier revisited—Analysis of post‐chemotherapy germ cell tumor orchidectomy and retroperitoneal lymph node dissection specimens

Outcomes and prognostic variables of extracranial germ cell tumors in children and adolescents treated over a decade: A developing world perspective

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