Outcome of testicular non-seminomatous germ cell tumours: report from a tertiary cancer centre in eastern India

Abstract

Non-seminomatous germ cell tumour (NSGCT) is a rare but highly curable malignancy. The literature on the management and outcomes of NSGCT is scarce from India. Here, we report the demography and treatment outcomes of NSGCT treated at our centre. This is a retrospective analysis of testicular and retroperitoneal NSGCT patients treated from March 2011 to December 2019. Patients were staged appropriately with imaging, pre- and post-operative tumour marker. Patients received stage adjusted adjuvant treatment after high inguinal orchiectomy. Patients with advanced disease were risk stratified as per International Germ Cell Cancer Collaborative Group (IGCCCG) classification. A total of 100 patients were treated with a median age of 28 years (Range: 18–51). Primary site was testis in 92 and retroperitoneum in 8 patients. Testicular violation was present in 17 (18%) patients. The stage of the disease was I in 32, II in 19 and III in 49 patients, respectively. IGCCCG risk groups were good in 29 (46%), intermediate in 13 (21%) and poor in 21 (33%) patients. Eleven patients (24%) underwent retroperitoneal lymph node dissection amongst 45 with post-chemotherapy residual disease. After a median follow-up of 26.6 months (range: 2.2–100.7), 3-year event-free survival and overall survival (OS) were 70.7% ± 5.6% and 78.2% ± 5.4%, respectively. S3 tumour marker ( p = 0.01) and non-pulmonary visceral metastasis ( p < 0.001) emerged as independent poor prognostic factors for OS in multivariate analysis. To conclude, testicular NSGCT has very high cure rate. Two-third patients present with advanced disease and one-third of them had poor risk disease. S3 tumour marker and non-pulmonary visceral metastasis are poor risk factors for OS.

Survival outcomes of postchemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell tumors: A retrospective cohort study from a single tertiary center in South India

“…In our literature review, we identified only six other institutes in the country that published their experience in India. [ 2-6 32 ] Of these, only one study projected an estimated RFS at 5 years after a 33-month median follow-up period after open pcRPLND. [ 5 ] Another study published their experience with 37 patients after robot-assisted pcRPLND with a median follow-up of 41 months.…”

“…[ 1 ] In India, about 30%–55% of the presenting population have International Union Against Cancer (UICC) prognostic group stage III disease at presentation, of which 20%–37% were of the Intermediate, and 13%–50% were of the Poor International Germ Cell Consensus Classifcation (IGCCC) prognostic risk groups at presentation. [ 2 3 4 5 6 ]…”