Incidence of late-relapse germ cell tumor and outcome to salvage chemotherapy Journal Article

Authors: Ronnen, E. A.; Kondagunta, G. V.; Bacik, J.; Marion, S.; Bajorin, D. F.; Sheinfeld, J.; Bosl, G. J.; Motzer, R. J.
Article Title: Incidence of late-relapse germ cell tumor and outcome to salvage chemotherapy
Abstract: Purpose: To define the incidence, clinical features, and outcome to salvage chemotherapy in patients with late-relapse germ cell tumor (GCT) after a complete response to first-line chemotherapy. Patients and Methods: Two patient populations were examined. First, retrospective analysis of 246 patients treated on a clinical trial with salvage chemotherapy was performed; 29 patients with late-relapse GCT were identified and evaluated for treatment outcome and survival. Salvage regimens included paclitaxel, ifosfamide, and cisplatin, single agents, or a high-dose chemotherapy program. Second, the incidence of late relapse was assessed by retrospective analysis of 551 patients after a complete response (CR) to first-line chemotherapy. Results: Twenty-nine patients received salvage chemotherapy on a clinical trial for late relapse GCT. The median survival was 23.9 months. At a median follow-up of 50.6 months, there were nine survivors. The chemotherapy regimens varied, but the only CRs were observed in patients treated with paclitaxel, ifosfamide, and cisplatin. Seven (50%) of 14 patients treated with paclitaxel, ifosfamide, and cisplatin achieved a continuous CR. Among the second population of 551 patients who had previously achieved a CR to a first-line chemotherapy trial, 17 were identified as having a late relapse (3%). The median time to relapse for these 17 patients was 7.8 years. Conclusion: Late-relapse GCT is uncommon and is associated with a poor prognosis resulting from a high degree of resistance to chemotherapy. Chemotherapy with paclitaxel, ifosfamide, and cisplatin followed by surgery may be effective in patients with late-relapse GCT who are not considered candidates for primary surgery. © 2005 by American Society of Clinical Oncology.
Keywords: survival; adult; cancer survival; clinical article; controlled study; treatment outcome; treatment response; survival analysis; retrospective studies; clinical feature; clinical trial; salvage therapy; cisplatin; cancer combination chemotherapy; bone metastasis; paclitaxel; drug megadose; antineoplastic agent; cancer incidence; lymph node dissection; carboplatin; controlled clinical trial; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; incidence; cyclophosphamide; pathology; retrospective study; ifosfamide; liver metastasis; lung metastasis; tumor recurrence; brain metastasis; testis tumor; testicular neoplasms; cancer relapse; orchiectomy; mesna; germ cell tumor; retroperitoneal cancer; mediastinum metastasis; germinoma
Journal Title: Journal of Clinical Oncology
Volume: 23
Issue: 28
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2005-10-01
Start Page: 6999
End Page: 7004
Language: English
DOI: 10.1200/jco.2005.21.956
PUBMED: 16192587
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 37" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Ellen Arielle Ronnen
    11 Ronnen
  2. Dean Bajorin
    416 Bajorin
  3. Robert Motzer
    769 Motzer
  4. Joel Sheinfeld
    197 Sheinfeld
  5. George Bosl
    270 Bosl
  6. Jennifer M Bacik
    46 Bacik
  7. Stephanie Marion
    8 Marion