Prognostic Factors and Treatment Results After Bleomycin, Etoposide, and Cisplatin in Germ Cell Cancer: A Population-based Study

Kier, Maria Gry Gundgaard; Lauritsen, Jakob; Mortensen, Mette Saksø; Bandak, Mikkel; Andersen, Klaus Kaae; Hansen, Morten; Agerbæk, Mads; Holm, Niels V.; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Daugaard, Gedske

doi:10.1016/j.eururo.2016.09.015

Cited by 66 publications

(45 citation statements)

References 30 publications

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“…TC treatment may, however, cause detrimental long‐term health effects for TC survivors. Previous studies have shown that radiotherapy is associated with increased morbidity and mortality from second malignant neoplasms (SMNs) . A recent study from our group observed that chemotherapy was associated with SMN incidence as well .…”

Section: Introductionmentioning

confidence: 83%

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Groot

Leeuwen

Lubberts

et al. 2019

Cancer

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BACKGROUND: Although testicular cancer (TC) treatment has been associated with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), cause-specific excess mortality has been rarely studied among patients treated in the platinum era. METHODS: In a large, multicenter cohort including 6042 patients with TC treated between 1976 and 2006, causespecific mortality was compared with general population mortality rates. Associations with treatment were assessed with proportional hazards analysis. RESULTS: With a median follow-up of 17.6 years, 800 patients died; 40.3% of these patients died because of TC. The cumulative mortality was 9.6% (95% confidence interval [CI], 8.5%-10.7%) 25 years after TC treatment. In comparison with general population mortality rates, patients with nonseminoma experienced 2.0 to 11.6 times elevated mortality from lung, stomach, pancreatic, rectal, and kidney cancers, soft-tissue sarcomas, and leukemia; 1.9-fold increased mortality (95% CI, 1.3-2.8) from IHD; and 3.9-fold increased mortality (95% CI, 1.5-8.4) from pneumonia. Seminoma patients experienced 2.5 to 4.6 times increased mortality from stomach, pancreatic, bladder cancer and leukemia. Radiotherapy and chemotherapy were associated with 2.1 (95% CI, 1.8-2.5) and 2.5 times higher SMN mortality (95% CI, 2.0-3.1), respectively, in comparison with the general population. In a multivariable analysis, patients treated with platinum-containing chemotherapy had a 2.5-fold increased hazard ratio (HR; 95% CI, 1.8-3.5) for SMN mortality in comparison with patients without platinum-containing chemotherapy. The HR for SMN mortality increased 0.29 (95% CI, 0.19-0.39) per 100 mg/m 2 platinum dose administered (P trend < .001). IHD mortality was increased 2.1-fold (95% CI, 1.5-4.2) after platinum-containing chemotherapy in comparison with patients without platinum exposure. CONCLUSIONS: Platinum-containing chemotherapy is associated with a dosedependent increase in the risk of SMN mortality. Cancer 2020;126:628-639.

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Section: Introductionmentioning

confidence: 83%

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Groot

Leeuwen

Lubberts

et al. 2019

Cancer

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“…2 The common treatments for TGCT patients include surgery, chemotherapy, radiotherapy, surveillance, and high-dose chemotherapy with stem cell transplantation. [4][5][6][7] TGCT can usually be cured in patients receiving adjuvant chemotherapy after surgery treatment. 8,9 Appropriate management of TGCT was based on many important factors which include tumor characteristics, sociodemographic variables, and treatment-related factors.…”

Section: Introductionmentioning

confidence: 99%

A nomogram for predicting survival and retroperitoneal lymph node dissection treatment in patients with resected testicular germ cell tumors

Meyers

Shi

et al. 2019

Journal of Surgical Oncology

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Background and Objectives To build nomogram incorporating potential prognostic factors for predicting survival outcomes of testicular germ cell tumors (TGCT) patients after resection of the primary tumor. Methods Data of TGCT patients from the Surveillance, Epidemiology, and End Results database (2010‐2016) who underwent resection of the primary tumor were collected. Overall survival (OS) and cancer‐specific survival (CSS) were analyzed by using Cox regression models, nomogram, Kaplan‐Meier method, and log‐rank test. Results We identified 7272 TGCT patients. Age at diagnosis, histology, tumor size, American Joint Committee on Cancer (AJCC) staging system, and number of metastases sites were independent prognostic factors and were integrated into nomograms. The nomograms had higher C‐indexes for both OS and CSS compared with the AJCC 7th staging system (0.881 vs 0.831 and 0.895 vs 0.856, respectively). Moreover, the new stratification of risk groups based on the nomograms showed a more significant distinction between Kaplan‐Meier curves for survival outcomes than the AJCC staging system. Retroperitoneal lymph node dissection was associated with statistically improved survival probability in the nomogram middle‐risk group in resected TGCT patients. Conclusion The novel nomogram‐based staging system could provide satisfactory risk stratification and survival prediction ability beyond traditional AJCC staging systems.

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“…4 Furthermore, increasing age at diagnosis has been reported to have a poor prognostic effect in GCT patients receiving first-line chemotherapy. [5][6][7] In a large study by Danish authors and another double-institution dataset, age was identified as a statistically significant poor prognostic factor in multivariable analyses. For this reason, it is possible that older patients with GCT have an inherently negative prognostic factor related to their age, which may partly explain the inability to administer timely curative chemotherapy in some cases due to the haematological toxicity of bleomycin, etoposide, and cisplatin (BEP) chemotherapy.…”

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confidence: 99%

Administration of high-dose chemotherapy with stem cell support in patients 40 years of age or older with advanced germ cell tumours: a retrospective study from the European Society for Blood and Marrow Transplantation database

Necchi

Vullo

Rosti

et al. 2017

Bone Marrow Transplant

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Prognostic Factors and Treatment Results After Bleomycin, Etoposide, and Cisplatin in Germ Cell Cancer: A Population-based Study

Cited by 66 publications

References 30 publications

Platinum exposure and cause‐specific mortality among patients with testicular cancer

Platinum exposure and cause‐specific mortality among patients with testicular cancer

A nomogram for predicting survival and retroperitoneal lymph node dissection treatment in patients with resected testicular germ cell tumors

Administration of high-dose chemotherapy with stem cell support in patients 40 years of age or older with advanced germ cell tumours: a retrospective study from the European Society for Blood and Marrow Transplantation database

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