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Improved survival in metastatic germ-cell cancer.
Annals of Oncology ( IF 50.5 ) Pub Date : 2018-02-01 , DOI: 10.1093/annonc/mdx741
C D Fankhauser 1 , S Sander 1 , L Roth 1 , J Beyer 2 , T Hermanns 1
Affiliation  

Background The prognostic score of the International Germ-Cell Cancer Collaborative Group (IGCCCG) in metastatic germ-cell cancers (mGCC) relies on treatments delivered before 1990. It is unclear, if this score is still relevant to contemporary cohorts of patients who receive modern-type chemotherapy and supportive care. Patients and methods All patients who underwent cisplatin/etoposide-based first-line chemotherapy for mGCC at the University Hospital Zurich (USZ) between 1991 and 2016 were identified retrospectively. Clinical characteristics were extracted from medical charts and patients classified according to the IGCCCG score. International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997; 15: 594-603.). Progression-free survival (PFS) and overall survival (OS) probabilities at 5 years served as outcome parameters. Results The study cohort consisted of 204 patients at a median age of 32 years and a median follow-up of 4.2 years. According to the IGCCCG score, PFS in the contemporary USZ cohort was 71% overall: 83% for good-risk, 69% for intermediate-risk and 30% for poor-risk patients, P < 0.001. OS for the entire cohort was 88%. In respect to OS, we observed no difference between good- and intermediate-risk patients (94% versus 91%, P = 0.62), but a statistically significant difference between those two risk groups and poor-risk patients, who had an OS of only 65%, P < 0.001. Conclusions Within the contemporary USZ cohort of mGCC patients no improvements in PFS probabilities were observed compared with the ones predicted by the IGCCCG score for any prognostic category, but marked improvements in OS probabilities for intermediate- and poor-risk patients, possibly due to better salvage treatments.

中文翻译:

转移性生殖细胞癌的生存改善。

背景国际生殖细胞癌合作组织(IGCCCG)对转移性生殖细胞癌(mGCC)的预后评分取决于1990年之前进行的治疗。目前尚不清楚该评分是否仍与当代接受现代疗法的患者群体有关型化学疗法和支持治疗。患者和方法回顾性分析1991年至2016年在苏黎世大学医院(USZ)接受过顺铂/依托泊苷基于一线化疗的mGCC的所有患者。从医学图表中提取临床特征,并根据IGCCCG评分对患者进行分类。国际生殖细胞共识分类:一种基于预后因素的转移性生殖细胞癌分期系统。J Clin Oncol 1997;15:594-603。)。5年时无进展生存率(PFS)和总体生存率(OS)用作结果参数。结果该研究队列由204位患者组成,中位年龄为32岁,中位随访时间为4.2年。根据IGCCCG评分,当代USZ队列中的PFS总体为71%:高危人群为83%,中危人群为69%,低危人群为30%,P <0.001。整个队列的OS为88%。在OS方面,我们观察到高风险和中风险患者之间没有差异(94%对91%,P = 0.62),但是这两个风险组与OS为的低风险患者之间存在统计学上的显着差异。只有65%,P <0.001。
更新日期:2017-11-17
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