Universität zu Köln

Paffenholz, Pia ORCID: 0000-0002-8209-7795, Seelemeyer, F. ORCID: 0000-0001-8411-8353, Gößmann, Ruben, von Brandenstein, Melanie ORCID: 0000-0002-1499-7644, Pfister, David ORCID: 0000-0002-2109-3221 and Heidenreich, Axel ORCID: 0000-0002-2511-3664 (2025). Very Early Relapse (< 1 year) in de novo Metastatic Seminoma is Associated With Reduced Overall Survival. Clinical Genitourinary Cancer, 23 (4). pp. 1-7. Elsevier. ISSN 15587673

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Abstract

[Artikel-Nr.: 102347] Characteristics and outcome associated with relapse in seminomatous testicular germ cell tumors (STGCT) are still unclear. We aim at evaluating the differences between very early relapse (VER, tumour recurrence < 12 months after successful treatment) and later relapse (LR) in a cohort of 459 patients with STGCT. 20 % of all seminoma relapsed. In the initial metastatic stage, VER was associated with a higher metastatic burden at diagnosis compared to LR, leading to a reduced overall survival in VER. Introduction: As the characteristics and outcome associated with relapse in seminomatous testicular germ cell tumors (STGCT) are still unclear, this study aims at evaluating the differences between very early relapse (VER) and later relapse (LR) in this cohort of patients. Material and methods: This retrospective analysis included 459 patients with STGCT treated from 2000 to 2024, analysing patient characteristics with nonparametric statistics as well as follow- up using Kaplan Meier analyses. VER was defined as tumour recurrence < 12 months after successful treatment. Results and limitations: About 94 (20%) patients relapsed during a median follow-up of 19 months [IQR 2-68]. De novo metastatic patients with VER (n = 38, 40%) showed a significantly higher number of clinical stages 2C-3 disease (21% vs. 4%, P = .007), M-stage (P = .009) at diagnosis as well as a higher HCG level (P = .030) and LDH levels (P < .001; >2x ULN P = .039) at start of chemotherapy compared to patients with LR (n = 56; 60%). Initial treatment did not significantly differ between VER and LR (P = .199). VER after initial metastatic disease was associated with a significantly reduced overall survival compared to LR (P = .046), however not after de novo stage I. Our study is limited by its retrospective design. Conclusion: Relapse in seminoma occurred in 20% of all patients. In the initial metastatic stage, VER was associated with a higher metastatic burden at diagnosis compared to LR, leading to a reduced overall survival in VER. Consequently, treating physicians should be aware of these patients portending a worse prognosis, potentially discussing an early intensification of systemic treatment.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Paffenholz, Pia UNSPECIFIED https://orcid.org/0000-0002-8209-7795 UNSPECIFIED Seelemeyer, F. UNSPECIFIED https://orcid.org/0000-0001-8411-8353 UNSPECIFIED Gößmann, Ruben UNSPECIFIED UNSPECIFIED UNSPECIFIED von Brandenstein, Melanie UNSPECIFIED https://orcid.org/0000-0002-1499-7644 UNSPECIFIED Pfister, David UNSPECIFIED https://orcid.org/0000-0002-2109-3221 UNSPECIFIED Heidenreich, Axel UNSPECIFIED https://orcid.org/0000-0002-2511-3664 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-802791
Identification Number:	10.1016/j.clgc.2025.102347
Journal or Publication Title:	Clinical Genitourinary Cancer
Volume:	23
Number:	4
Page Range:	pp. 1-7
Number of Pages:	7
Date:	August 2025
Publisher:	Elsevier
ISSN:	15587673
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Urologie > Klinik und Poliklinik für Urologie Faculty of Medicine > Weitere > Centrum für integrierte Onkologie (CIO)
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Germ cell tumor ; Overall survival ; Seminoma, Testicular cancer ; Systemic treatment English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80279