Salvage treatment in male patients with germ cell tumours

Josefsen, Dag; Ous, S.; Høie, J; Stenwig, Anna E.; Fosså, Sophie D.

doi:10.1038/bjc.1993.104

Cited by 34 publications

(15 citation statements)

References 18 publications

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“…disease-free long-term survival between 20% and 30% (Harstrick et al, 1991;Motzer et al, 1991;Josefsen et al, 1993;Einhorn et al, 1994). The 30% disease-free survival rate at a median follow-up of 90 months observed in our study is thus comparable to the results of other authors and stresses the need for continued investigation of potentially more efficacious salvage treatment.…”

Section: Survivalsupporting

confidence: 79%

“…As described by several investigators the prognostic relevance of the relapse-free interval was substantiated by our study (Horwich et al, 1993;Josefsen et al, 1993;Steyerberg et al, 1993;Gerl et al, 1995), although it reached only borderline significance in our multivariate model.…”

Section: Survivalsupporting

confidence: 59%

“…However, 20-25% of patients develop disease progression during or after their initial chemotherapy and require effective salvage treatment. The prognosis of the latter patient group is relatively poor with only 20-30% disease-free long-term survival (Motzer et al, 1991;Josefsen et al, 1993;Einhorn et al, 1994).…”

mentioning

confidence: 99%

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Prognosis after salvage treatment for unselected male patients with germ cell tumours

Gerl¹,

Clemm²,

Schmeller³

et al. 1995

Br J Cancer

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Section: Survivalsupporting

confidence: 79%

Section: Survivalsupporting

confidence: 59%

See 1 more Smart Citation

Prognosis after salvage treatment for unselected male patients with germ cell tumours

Gerl¹,

Clemm²,

Schmeller³

et al. 1995

Br J Cancer

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“…This percentage is comparable to other reports (Motzer et al, 1991;Horwich et al, 1993;Josefsen et al, 1993;Gerl et al, 1995). Although about 70% of the cases of progression occurred within the first year after the start of induction treatment, reactivation of the disease was observed in 23% patients after 2 years.…”

Section: Progressive Germ Cell Malignancysupporting

confidence: 75%

“…Few series have been published dealing with prognostic factors in patients with recurrent malignant germ cell tumours, and most are based on the experience of specialized institutions (Motzer et al, 1991;Horwich et al, 1993;Josefsen et al, 1993;Ledermann et al, 1994;Gerl et al, 1995). The aim of the present study was to establish prognostic factors based on a series of patients presenting to unselected oncological units.…”

mentioning

confidence: 99%

Prognostic factors in patients progressing after cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumours

Fosså

Stenning²,

Gerl³

et al. 1999

Br J Cancer

132

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The aim of this study was to define prognostic parameters for survival in patients with malignant germ cell tumours progressing after platinum-based induction chemotherapy with or without surgery. A total of 164 progressing patients (testicular: 83%, extragonadal: 17%) were identified out of 795 patients treated with platinum-based induction chemotherapy for metastatic germ cell malignancy with or without surgery. ‘Progressive disease’ included patients who had progressed after a previous partial or complete remission as well as patients who failed primary therapy. Salvage chemotherapy consisted of ‘conventional’ platinum-based chemotherapy. Prognostic factors for survival were assessed by uni- and multivariate analyses. The resulting prognostic model was validated in an independent data set of 66 similar patients. For all 164 patients the median time from start of induction chemotherapy to progression was 10 months (range: 0–99). Thirty-eight (23%) patients relapsed after 2 years. The 5-year survival rate for all progressing patients was 30% (95% confidence interval 23–38%). In the univariate analysis the following factors most importantly predicted a poor prognosis: progression-free interval < 2 years: initial poor prognosis category (MRC criteria), < CR to induction chemotherapy, initial treatment early in the 1980s and treatment given at a ‘small’ centre. Three prognostic factors remained in the multivariate analysis: progression-free interval, response to induction treatment and the level of serum human chronic gonadotrophin (hCG) and alpha fetoprotein (AFP) at relapse. One hundred and twenty-four patients could be classified on the basis of these characteristics, Those patients with progression-free interval < 2 years, < CR to induction chemotherapy and high markers at relapse (AFP >100 kU l −1 or hCG >100 IU l −1 ) formed a poor prognosis group of 30 patients, none of whom survived after 3 years. Patients with at most two of these three risk factors formed a good prognosis group of 94 patients (76%) with a 47% (37–56%) 5-year survival. Thirty-eight patients from the good prognosis group with a progression-free interval of >2 years had a 2-year survival of 74% (60–88%) and 5-year survival of 61%. These prognostic groups were validated in the independent data set, in which 5-year survival rates in the good and poor risk groups were 51% and 0% respectively. One-third of patients progressing during or after platinum-based induction chemotherapy for metastatic germ cell malignancy may be cured by repeated ‘conventional’ platinum-based chemotherapy. Good prognosis parameters are: progression-free interval of > 2 years, CR to induction treatment and normal or low serum markers at relapse (hCG < 100 IU l −1 and AFP < 100 kU l −1 ). The results of high-dose salvage chemotherapy should be interpreted on the background of these prognostic factors. © 1999 Cancer Research Campaign

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Germ‐cell Testis Tumors

Schmoll¹,

Rie²

2014

TNM Online

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Prognostic factors are of major importance for the treatment and cure of patients with testicular cancer. The histologic type, seminoma versus nonseminomatous germ‐cell tumors (NSGCT) and the (TNM) stage constitute the fundamental prognostic factors that govern clinical practice. For early stages, prognostic factors are the critical determinants for the decisions about treatment. They don't necessarily predict the survival, which is greater than 98% independent of treatment strategy, but for the risk of relapse with different treatment options. In advanced stages, prognostic factors indicate the chance of survival following chemotherapy, either first‐line or salvage. In this chapter, the different prognostic factors, relevant for decision making in early and late stage germ‐cell testis tumors, are discussed.

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Salvage treatment in male patients with germ cell tumours

Cited by 34 publications

References 18 publications

Prognosis after salvage treatment for unselected male patients with germ cell tumours

Prognosis after salvage treatment for unselected male patients with germ cell tumours

Prognostic factors in patients progressing after cisplatin-based chemotherapy for malignant non-seminomatous germ cell tumours

Germ‐cell Testis Tumors

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