Improved survival of poor-risk non-seminomatous germ cell tumor patients: real-world data from a single institute in Japan

Abstract

Objectives The International Germ Cell Cancer Collaborative Group Update Consortium showed the improved survival of patients with a non-seminomatous germ cell tumor. We updated the survival data of the non-seminomatous germ cell tumor patients treated at our hospital. Patients and Methods We analyzed the outcomes of 138 patients treated in 1981–2018. We compared the survival of the patients treated in the early (1981–99) and later (2000–18) periods and determined the groups’ progression-free survival and overall survival using the Kaplan–Meier method. We used a web-based application of the International Germ Cell Cancer Collaborative Group Update model to calculate each patient’s predicted 3-year progression-free survival. Results The 5-year progression-free survival rates of the good, intermediate and poor prognosis groups were 91, 83 and 64%, and their 5-year overall survival rates were 97, 89 and 82%, respectively. There were no significant differences in the progression-free survival or overall survival of the good and intermediate prognosis groups by treatment year. The 5-year progression-free survival of the poor prognosis group was almost identical in both treatment year (60 and 65%, respectively). By contrast, the 5-year overall survival in the later period (85%) was higher than that in the early period (70%). The median-predicted 3-year progression-free survival rates of the good, intermediate and poor prognosis groups were 92, 83 and 51% (P < 0.01), respectively. The concordance index for the good, intermediate and poor prognosis groups were 0.56, 0.79 and 0.67, respectively. Conclusion The survival of our poor prognosis non-seminomatous germ cell tumor patients improved over time. The 5-year overall survival of patients treated in 2000–18 reached 85%.