Teratomatous Elements in Orchiectomy Specimens Are Associated with a Reduced Relapse-Free Survival in Metastasized Testicular Germ Cell Tumors

Paffenholz, Pia, Nestler, Tim, Maatoug, Yasmine, von Brandenstein, Melanie, Koeditz, Barbara, Loosen, Sven H., Fischer, Nicolas, Pfister, David and Heidenreich, Axel . Teratomatous Elements in Orchiectomy Specimens Are Associated with a Reduced Relapse-Free Survival in Metastasized Testicular Germ Cell Tumors. Urol.Int.. BASEL: KARGER. ISSN 1423-0399

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DOI:10.1159/000515715

Abstract

Introduction: The impact of teratomatous elements in orchiectomy specimens of metastasized testicular germ cell tumors (TGCT) regarding oncological outcome is still unclear. Methods: We performed a retrospective analysis including 146 patients with metastasized TGCT analysing patient characteristics. Results: Twenty-six (18%) of all patients showed teratomatous elements in the orchiectomy specimens. TGCT with teratomatous elements showed a significantly higher frequency of clinical-stage 2C-3 disease (73 vs. 49%, p = 0.031), visceral metastases (58 vs. 32%, p = 0.015), and poor prognosis (p = 0.011) than TGCT without teratomatous elements. Teratoma-containing TGCT revealed a significantly higher rate of post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND, 54 vs. 32%, p = 0.041), with teratomatous elements being more often present in the PC-RPLND specimens (43 vs. 11%, p = 0.020) than nonteratoma-containing primaries. In the Kaplan-Meier estimates, the presence of teratomatous elements in orchiectomy specimens was associated with a significantly reduced relapse-free survival (RFS) (p = 0.049) during a median follow-up of 36 months (10-115.5). Conclusions: The presence of teratomatous elements in orchiectomy specimens is associated with an advanced tumor stage, worse treatment response as well as a reduced RFS in metastasized TGCT. Consequently, the presence of teratomatous elements might act as a reliable stratification tool for treatment decision in TGCT patients.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Paffenholz, Pia	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Nestler, Tim	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Maatoug, Yasmine	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
von Brandenstein, Melanie	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Koeditz, Barbara	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Loosen, Sven H.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Fischer, Nicolas	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Pfister, David	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Heidenreich, Axel	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED