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Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications

SIMPLE SUMMARY: Very late recurrence of testicular germ cell tumors, i.e., greater than 5 years after initial presentation, is a rare event occurring in about 1% of patients and is associated with poor prognosis. Our study sought to add to the available data and characterize patients with late recur...

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Autores principales: Moore, Joseph A., Slack, Rebecca S., Lehner, Michael J., Campbell, Matthew T., Shah, Amishi Y., Zhang, Miao, Guo, Charles C., Ward, John F., Karam, Jose A., Wood, Christopher G., Pisters, Louis L., Tu, Shi-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909729/
https://www.ncbi.nlm.nih.gov/pubmed/35267435
http://dx.doi.org/10.3390/cancers14051127
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author Moore, Joseph A.
Slack, Rebecca S.
Lehner, Michael J.
Campbell, Matthew T.
Shah, Amishi Y.
Zhang, Miao
Guo, Charles C.
Ward, John F.
Karam, Jose A.
Wood, Christopher G.
Pisters, Louis L.
Tu, Shi-Ming
author_facet Moore, Joseph A.
Slack, Rebecca S.
Lehner, Michael J.
Campbell, Matthew T.
Shah, Amishi Y.
Zhang, Miao
Guo, Charles C.
Ward, John F.
Karam, Jose A.
Wood, Christopher G.
Pisters, Louis L.
Tu, Shi-Ming
author_sort Moore, Joseph A.
collection PubMed
description SIMPLE SUMMARY: Very late recurrence of testicular germ cell tumors, i.e., greater than 5 years after initial presentation, is a rare event occurring in about 1% of patients and is associated with poor prognosis. Our study sought to add to the available data and characterize patients with late recurrence. Patients with late recurrence > 5 years after initial presentation tend to harbor nonseminomatous germ cell tumors (with yolk sac tumor and or teratoma). Among these patients, a majority who did not undergo surgery to remove residual disease after chemotherapy developed somatic transformation and succumbed to their late recurrence. Further investigation into rates of late recurrence among all patients may be warranted given the poor survival after late recurrence. ABSTRACT: Background. Very late recurrence (LR), i.e., >5 years after initial presentation, occurs in about 1% of patients with germ cell tumors of the testis (TGCT) and is associated with poor prognosis. Methods. We retrospectively reviewed the records of patients at the M. D. Anderson Cancer Center who developed LR > 5 years after their initial diagnosis of TGCT. Results. We identified 25 patients who developed LR between July 2007 and August 2020. The median age at the time of LR was 46 years (range, 29–61). Pathology of LR: somatic transformation to carcinoma or sarcoma—11, nonseminoma with yolk sac tumor or teratoma—11, nonseminoma without yolk sac tumor or teratoma—2, not available—1. With a median follow-up of 3.5 years, 68% of patients are alive 3 years after LR. Patients with prior post-chemotherapy consolidation surgery do not have statistically significant longer survival compared to patients who did not receive post-chemotherapy consolidation surgery, 83.3% vs. 60.8% at 3 years, respectively, p = 0.50. Conclusions. Patients with LR > 5 years tend to harbor nonseminoma (with yolk sac tumor and or teratoma). Among these patients, a majority who did not undergo surgery to remove residual disease after chemotherapy developed somatic transformation and succumbed to their LR.
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spelling pubmed-89097292022-03-11 Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications Moore, Joseph A. Slack, Rebecca S. Lehner, Michael J. Campbell, Matthew T. Shah, Amishi Y. Zhang, Miao Guo, Charles C. Ward, John F. Karam, Jose A. Wood, Christopher G. Pisters, Louis L. Tu, Shi-Ming Cancers (Basel) Article SIMPLE SUMMARY: Very late recurrence of testicular germ cell tumors, i.e., greater than 5 years after initial presentation, is a rare event occurring in about 1% of patients and is associated with poor prognosis. Our study sought to add to the available data and characterize patients with late recurrence. Patients with late recurrence > 5 years after initial presentation tend to harbor nonseminomatous germ cell tumors (with yolk sac tumor and or teratoma). Among these patients, a majority who did not undergo surgery to remove residual disease after chemotherapy developed somatic transformation and succumbed to their late recurrence. Further investigation into rates of late recurrence among all patients may be warranted given the poor survival after late recurrence. ABSTRACT: Background. Very late recurrence (LR), i.e., >5 years after initial presentation, occurs in about 1% of patients with germ cell tumors of the testis (TGCT) and is associated with poor prognosis. Methods. We retrospectively reviewed the records of patients at the M. D. Anderson Cancer Center who developed LR > 5 years after their initial diagnosis of TGCT. Results. We identified 25 patients who developed LR between July 2007 and August 2020. The median age at the time of LR was 46 years (range, 29–61). Pathology of LR: somatic transformation to carcinoma or sarcoma—11, nonseminoma with yolk sac tumor or teratoma—11, nonseminoma without yolk sac tumor or teratoma—2, not available—1. With a median follow-up of 3.5 years, 68% of patients are alive 3 years after LR. Patients with prior post-chemotherapy consolidation surgery do not have statistically significant longer survival compared to patients who did not receive post-chemotherapy consolidation surgery, 83.3% vs. 60.8% at 3 years, respectively, p = 0.50. Conclusions. Patients with LR > 5 years tend to harbor nonseminoma (with yolk sac tumor and or teratoma). Among these patients, a majority who did not undergo surgery to remove residual disease after chemotherapy developed somatic transformation and succumbed to their LR. MDPI 2022-02-23 /pmc/articles/PMC8909729/ /pubmed/35267435 http://dx.doi.org/10.3390/cancers14051127 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Moore, Joseph A.
Slack, Rebecca S.
Lehner, Michael J.
Campbell, Matthew T.
Shah, Amishi Y.
Zhang, Miao
Guo, Charles C.
Ward, John F.
Karam, Jose A.
Wood, Christopher G.
Pisters, Louis L.
Tu, Shi-Ming
Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title_full Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title_fullStr Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title_full_unstemmed Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title_short Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications
title_sort very late recurrence in germ cell tumor of the testis: lessons and implications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8909729/
https://www.ncbi.nlm.nih.gov/pubmed/35267435
http://dx.doi.org/10.3390/cancers14051127
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