Seidel, Christoph, Daugaard, Gedske, Nestler, Tim, Tryakin, Alexey ORCID: 0000-0003-2245-214X, Fedyanin, Mikhail, Fankhauser, Christian, Hermanns, Thomas, Aparicio, Jorge, Heinzelbecker, Julia, Paffenholz, Pia, Heidenreich, Axel, De Giorgi, Ugo, Cathomas, Richard, Lorch, Anja, Fingerhut, Anna, Gayer, Fabian, Bremmer, Felix, Giannatempo, Patrizia, Necchi, Andrea, Aurilio, Gaetano, Casadei, Chiara ORCID: 0000-0003-2467-749X, Dieckmann, Klaus-Peter, Brito, Margarida, Ruf, Christian, Oing, Christoph and Bokemeyer, Carsten (2020). Human chorionic gonadotropin-positive seminoma patients: A registry compiled by the global germ cell tumor collaborative group (G3). Eur. J. Cancer, 132. S. 127 - 136. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0852

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Abstract

Background: The prognostic role of human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH) serum levels in seminoma patients remains uncertain. This observational study evaluates the prognostic impact of tumour marker levels, and other clinicopathological findings, in hCG-positive seminoma patients. Methods: Seminoma patients with serum hCG levels above normal at first diagnosis were eligible for recruitment. Statistical analysis, including multivariate regression, was performed to identify risk factors. Primary end-points were overall survival (OS) and recurrence-free survival (RFS). Results: We recruited 1031 hCG-positive patients (stage I: n = 586; stage II + III: n = 427) diagnosed between 1981 and 2018. In metastatic disease, LDH levels >= 3 above upper normal limit (UNL) pre- (n = 109) or post-orchiectomy (n = 73) and patients aged >= 40 years (n = 187) were associated with poor prognosis: 5-year OS rates of 84% (LDH >= 3 UNL pre-orchiectomy) versus 92% (<3 UNL pre-orchiectomy) (hazard ratio [HR]: 3.155, [95% confidence interval {CI}: 1.28-7.75], P = 0.012), 82% (>= 3 UNL post-orchiectomy) versus 92% (<3 UNL post-orchiectomy) (HR: 6.877, [95% CI: 1.61-29.34]; P = 0.009) and 86% (>= 40 years) versus 91% (<40 years) (HR: 6.870, [95% CI: 1.45-13.37], P = 0.009), respectively. A subset of patients with hCG levels >= 2000 IU/l pre-orchiectomy (n = 17) exhibited a poor prognosis, with 5-year OS rates of 73% (>= 2000 IU/ l) versus 94% (<2000 IU/l) (HR: 3.936, [95% CI: 1.02-12.61], P = 0.047). Conclusions: Age and LDH levels are significantly associated with poor prognosis in hCG-positive seminoma patients. A small number of patients, with levels of hCG >= 2000 IU/l, may represent a separate prognostic subgroup associated with impaired survival rates. (C) 2020 Elsevier Ltd. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seidel, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Daugaard, GedskeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nestler, TimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tryakin, AlexeyUNSPECIFIEDorcid.org/0000-0003-2245-214XUNSPECIFIED
Fedyanin, MikhailUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fankhauser, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hermanns, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aparicio, JorgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinzelbecker, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paffenholz, PiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidenreich, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Giorgi, UgoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cathomas, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lorch, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fingerhut, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gayer, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bremmer, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giannatempo, PatriziaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Necchi, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aurilio, GaetanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Casadei, ChiaraUNSPECIFIEDorcid.org/0000-0003-2467-749XUNSPECIFIED
Dieckmann, Klaus-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brito, MargaridaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruf, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oing, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bokemeyer, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-332218
DOI: 10.1016/j.ejca.2020.03.022
Journal or Publication Title: Eur. J. Cancer
Volume: 132
Page Range: S. 127 - 136
Date: 2020
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1879-0852
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MARKERS; HCGMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33221

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