To resolve the ongoing controversy surrounding the impact of teratoma (TER) in the primary among patients with metastatic testicular non-seminomatous germ-cell tumours (NSGCT).
Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method.
Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001).
Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.
European journal of cancer (Oxford, England : 1990). 2024 Mar 30 [Epub ahead of print]
Emanuel Bührer, David D'Haese, Gedske Daugaard, Ronald de Wit, Costantine Albany, Alexey Tryakin, Karim Fizazi, Olof Stahl, Jourik A Gietema, Ugo De Giorgi, Fay H Cafferty, Aaron R Hansen, Torgrim Tandstad, Robert A Huddart, Andrea Necchi, Christopher J Sweeney, Xavier Garcia-Del-Muro, Daniel Y C Heng, Anja Lorch, Michal Chovanec, Eric Winquist, Peter Grimison, Darren R Feldman, Angelika Terbuch, Marcus Hentrich, Carsten Bokemeyer, Helene Negaard, Christian Fankhauser, Jonathan Shamash, David J Vaughn, Cora N Sternberg, Axel Heidenreich, Laurence Collette, Silke Gillessen, Jörg Beyer
European Organisation for Research and Treatment of Cancer, Brussels, Belgium., Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Horizon Oncology Research, 1345 Unity PI Ste 345, Lafayette, IN, United States of America., N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation., Institut Gustave Roussy, University of Paris Saclay, Villejuif, France., Department of Oncology, Skåne University Hospital, Lund, Sweden., University Medical Centre Groningen, Groningen, the Netherlands., IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Italy and the Italian Germ Cell Cancer Group (IGG), Italy., Medical Research Council Clinical Trials Unit, University College London (UCL), London, United Kingdom; Institute of Cancer Research Clinical Trials and Statistics Unit, Sutton, United Kingdom., Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., The Cancer Clinic, St Olavs University Hospital and Department of Clinical and Molecular Medicine, The Norwegian University of Science and Technology, Trondheim, Norway., Institute of Cancer Research, Sutton, United Kingdom., Vita-Salute San Raffaele University, Milan, Italy; Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy., South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia., Catalan Institute of Oncology, IDIBELL Institute of Research, University of Barcelona, Barcelona, Spain., Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada., Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland; Department of Urology, University Hospital Dusseldorf, Dusseldorf, Germany., 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia; Cancer Research Institute, Biomedical Center, Slovak Academy of Sciences, Bratislava, Slovakia., Division of Medical Oncology, Western University and London Health Sciences Centre, London, Ontario, Canada., Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, Australia., Memorial Sloan Kettering Cancer Centre, New York, NY, United States of America; Weill Medical College of Cornell University, New York, NY, United States of America., Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria., Department of Hematology and Oncology, Red Cross Hospital, University of Munich, Munich, Germany., Department of Oncology, Hematology and BMT with Section Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Department of Oncology, Oslo University Hospital, Oslo, Norway., University of Zurich, Zurich, Switzerland., St Bartholomew's Hospital, London, United Kingdom., University of Pennsylvania, Philadelphia, PA, United States of America., Medical Oncology, San Camillo Forlanini Hospital, Rome, Italy., Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Austria., Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland; Universita della Svizzera Italiana (USI), Lugano, Switzerland., University Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland. Electronic address: .