Universität zu Köln

Brandt, Maximilian Peter, Ruf, C., Dieckmann, K. P., Syring, I, Ruckes, C., Nestler, T., Schmelz, H. U., Dotzauer, R., Hiester, A., Albers, P., Nettersheim, D., Bolenz, C., Loosen, S. H., Heidenreich, A., Pfister, D., Haferkamp, A., Zengerling, F. and Paffenholz, P. (2022). Clinical characteristics, treatment patterns and relapse in patients with clinical stage IS testicular cancer. World J. Urol., 40 (2). S. 327 - 335. NEW YORK: SPRINGER. ISSN 1433-8726

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Abstract

Purpose Clinical stage I (CSI) testicular germ cell tumors (TGCT) represents disease confined to the testis without metastasis and CSIS is defined as persistently elevated tumor markers (TM) after orchiectomy, indicating subclinical metastatic disease. This study aims at assessing clinical characteristics and oncological outcome in CSIS. Methods Data from five tertiary referring centers in Germany were screened. We defined correct classification of CSIS according to EAU guidelines. TM levels, treatment and relapse-free survival were assessed and differences between predefined groups (chemotherapy, correct/incorrect CSIS) were analyzed with Fisher's exact and Chi-square test. Results Out of 2616 TGCT patients, 43 (1.6%) were CSIS. Thereof, 27 were correctly classified (cCSIS, 1.03%) and 16 incorrectly classified (iCSIS). TMs that defined cCSIS were in 12 (44.4%), 10 (37%), 3 (11.1%) and 2 (7.4%) patients AFP, ss-HCG, AFP plus ss-HCG and LDH, respectively. In the cCSIS group, six patients were seminoma and 21 non-seminoma. Treatment consisted of active surveillance, carboplatin-mono AUC7 and BEP (bleomycin, etoposide and cisplatin). No difference between cCSIS and iCSIS with respect to applied chemotherapy was found (p = 0.830). 5-year relapse-free survival was 88.9% and three patients (11%) in the cCSIS group relapsed. All underwent salvage treatment (3xBEP) with no documented death. Conclusion Around 1% of all TGCT were classified as cCSIS patients. Identification of cCSIS is of critical importance to avoid disease progression and relapses by adequate treatment. We report a high heterogeneity of treatment patterns, associated with excellent long-term survival irrespective of the initial treatment approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brandt, Maximilian Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruf, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dieckmann, K. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Syring, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruckes, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nestler, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmelz, H. U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dotzauer, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hiester, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Albers, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nettersheim, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bolenz, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loosen, S. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haferkamp, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zengerling, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Paffenholz, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-598676
DOI:	10.1007/s00345-021-03889-x
Journal or Publication Title:	World J. Urol.
Volume:	40
Number:	2
Page Range:	S. 327 - 335
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-8726
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GERM-CELL TUMORS; RISK-ADAPTED TREATMENT; LACTATE-DEHYDROGENASE; ALPHA-FETOPROTEIN; SURVEILLANCE; SEMINOMA; CHEMOTHERAPY; MANAGEMENT; OUTCOMES; DISEASE Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59867