Long-term outcomes of regressed or “burnt out” primary testicular germ cell tumors Journal Article
| Authors: | Baky, F. J.; Liso, N.; Williams, B.; Reuter, V. E.; Tickoo, S. K.; Feldman, D. R.; Funt, S. A.; Carver, B. S.; Sheinfeld, J.; Matulewicz, R. S. |
| Article Title: | Long-term outcomes of regressed or “burnt out” primary testicular germ cell tumors |
| Abstract: | Objective: To review the presentation and long-term oncologic outcomes of patients with regressed (“burnt out”) primary testicular germ cell tumors (GCT). Certain testicular GCT can present with complete regression of the primary tumor. It is not well established if this is associated with more aggressive disease or worse oncologic outcomes. Methods: We queried our prospectively maintained testicular cancer clinical database at a tertiary cancer center and identified patients without prior chemotherapy who had regressed primary GCT at radical orchiectomy from 1990 to 2023. All specimens were reviewed by a genitourinary pathologist at diagnosis. Long-term clinical outcomes were reported by Kaplan-Meier method. Results: Fifty-six patients met inclusion criteria; at diagnosis, 17 had no evidence of extra-testicular disease and 39 had advanced (clinical stage [CS] II+) GCT. All CSx (no viable disease or germ cell neoplasia in situ at orchiectomy, and no evidence of advanced disease) and CS0 patients were managed with surveillance and had 5-year recurrence-free survival (RFS) of 88% (95% CI: 39%, 98%). All patients with CS II+ disease underwent primary treatment with surgery (n = 5) or first-line chemotherapy (n = 34). Two- and 5-year RFS for patients with CSII+ disease was 94% (95% CI: 78%, 98%) and 90% (95% CI: 72%, 97%), respectively. Conclusion: Patients with regressed primary testicular GCT often present with advanced disease, possibly due to lack of early clinical signs from the primary tumor. Our analysis shows excellent long-term oncologic outcomes similar to those reported in the literature for patients with viable primary testicular GCT. © 2024 Elsevier Inc. |
| Keywords: | adult; controlled study; treatment outcome; middle aged; primary tumor; retrospective studies; young adult; major clinical study; mortality; cisplatin; paclitaxel; cancer staging; outcome assessment; follow up; neoplasm staging; monitoring; multiple cycle treatment; nausea; vomiting; cohort analysis; pathology; retrospective study; ifosfamide; time factors; abdominal pain; flank pain; burn; testis tumor; testicular neoplasms; long term care; surgery; neoplasms, germ cell and embryonal; orchiectomy; gynecomastia; seminoma; therapy; lymphadenopathy; retroperitoneum; alpha fetoprotein; chorionic gonadotropin; recurrence free survival; retroperitoneal disease; clinical outcome; time factor; neck tumor; intratubular germ cell neoplasia; humans; human; male; article; testicular germ cell tumor; germ cell and embryonal neoplasms; radical orchiectomy |
| Journal Title: | Urology |
| Volume: | 193 |
| ISSN: | 0090-4295 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-11-01 |
| Start Page: | 174 |
| End Page: | 179 |
| Language: | English |
| DOI: | 10.1016/j.urology.2024.07.049 |
| PUBMED: | 39128634 |
| PROVIDER: | scopus |
| PMCID: | PMC11560521 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Richard S. Matulewicz -- Source: Scopus |
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