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

Nair, Lekha; Krishna, K M Jagathnath; Kumar, Aswin; Mathews, Susan; Joseph, John; James, Francis V.

doi:10.3332/ecancer.2020.1145

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…IGCCCG poor risk group was identified as a poor risk factor in previous studies including a study from India [ 13 ] which reflects the burden of disease and similarly, in our series S3 marker emerged as a poor prognostic factor for OS. Another study from India [ 14 ] reported non-pulmonary visceral metastasis as a poor prognostic factor for outcome similar to our finding ( Figure 2c ).…”

Section: Discussionsupporting

confidence: 91%

“…Well established data are available from developed countries with mature outcome data. Apart from two with large amounts of data [ 13 , 14 ], there are only a few published reports available from India on NSGCT [ 8 – 12 ]. Those are also limited by improper risk stratification or treatment details and minimal outcome data ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Those are also limited by improper risk stratification or treatment details and minimal outcome data ( Table 4 ). The majority of patients from India present with a heavy burden of disease, with bulky retroperitoneal lymph nodes [ 13 , 14 ]. Similar results are reflected in our publication as one-third of patients presented with poor risk disease ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…There is a scarcity of literature on non-seminomatous germ cell tumours (NSGCTs) of testis from the Indian subcontinent with reports showing advanced stage of disease at presentation, scrotal violation and poor compliance to treatment [ 8 – 14 ]. Most of those publications are of very small patient numbers except the two latest publications [ 13 , 14 ]. Testicular tumour has excellent cure rates and thus the focus should be on minimising the acute and long-term toxicities [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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

Biswas¹,

Dabkara²,

Ganguly³

et al. 2021

ecancer

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Biswas¹,

Dabkara²,

Ganguly³

et al. 2021

ecancer

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Kumar,

Sadanala,

Nagasubramanian

et al. 2024

Indian Journal of Urology

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Introduction: Chemotherapy, postchemotherapy retroperitoneal lymph node dissection (pcRPLND), and metastasectomy remain the standard of care for the management of advanced nonseminomatous germ cell tumor (NSGCT). Methods: We retrospectively studied 73 patients who had pcRPLND at a single tertiary-care center (2003–2022). Surgical and clinicopathological features and oncological outcomes are presented. Results: The mean age was 28.27 years (15–48). Three-fourths had Stage III disease at diagnosis. International Germ Cell Cancer Collaborative Group risk stratification was 54.54% and 21.21% in intermediate risk, and poor risk, respectively. Sixty-two patients had Standard, 7 had Salvage and 4 underwent Desperation pcRPLND. Eleven patients (15.06%) required adjunctive procedures. Thirteen patients (17.8%) had ≥ class 3 Clavien–Dindo complications and postoperative mortality occurred in 5 (6.8%) patients. The histopathologies (HPE) of the pcRPLNDs were necrosis, teratoma, and viable tumor in 39.7%, 45.2%, and 15.1%, respectively. Seven patients underwent metastasectomy. An 85% size reduction in the size of RPLN predicted necrosis. There was 71.4% concordance between pcRPLND and metastasectomy HPEs. The median follow-up was 26.72 months (inter-quartile range – 13.25–47.84). The 2-year recurrence-free survival (RFS) rate was 93% (95% confidence interval [CI]–83%–97%) and the overall survival (OS) rate was 90% (95% CI–80%–95%). This is the largest series of pcRPLND for NSGCT in India to our knowledge. Conclusion: Although most of the cohort belonged to stage III, an RFS and OS rate of >90% at 2 years was achieved. We believe that successful management of postchemotherapy residual masses in NSGCT is contingent on the availability of multidisciplinary expertise and is therefore best done at tertiary-care referral centers.

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Quality of life assessment in testicular non-seminomatous germ cell tumour survivors

et al. 2023

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Purpose: Patients with Germ cell tumours (GCT) are at risk of long-term toxicities due to multimodality therapy. It is debatable whether there is an impact on the quality of life(QoL) of GCT survivors.Methods: A case-control study was conducted at a tertiary care centre in India, using the EORTC QLQ C30 questionnaire, to compare the QoL between GCT survivors(disease free> 2 years) and healthy matched controls. A multivariate regression model was used to identify factors affecting QoL.Results: A total of 55 cases and 100 controls were recruited. Cases had a median age of 32 years (interquartile range, IQR 28-40 years), ECOG PS of 0-1(75%), advanced stage III (58%), chemotherapy (94%) and 66% were >5 years from diagnosis. The median age of controls: 35 years (IQR 28-43 years).

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

Cited by 7 publications

References 25 publications

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

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

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

Quality of life assessment in testicular non-seminomatous germ cell tumour survivors

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