Background To report our experience utilizing a multidisciplinary clinic (MDC) at Indiana University (IU) since the publication of the International Germ Cell Cancer Collaborative Group (IGCCCG), and to compare our overall survival (OS) to that of the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program. Patients and methods We conducted a retrospective analysis of all patients with metastatic germ-cell tumor (GCT) seen at IU from 1998 to 2014. A total of 1611 consecutive patients were identified, of whom 704 patients received an initial evaluation by our MDC (including medical oncology, pathology, urology and thoracic surgery) and started first-line chemotherapy at IU. These 704 patients were eligible for analysis. All patients in this cohort were treated with cisplatin-etoposide-based combination chemotherapy. We compared the progression-free survival (PFS) and OS of patients treated at IU with that of the published IGCCCG cohort. OS of the IU testis cancer primary cohort (n = 622) was further compared with the SEER data of 1283 patients labeled with 'distant' disease. The Kaplan-Meier method was used to estimate PFS and OS. Results With a median follow-up of 4.4 years, patients with good, intermediate, and poor risk disease by IGCCCG criteria treated at IU had 5-year PFS of 90%, 84%, and 54% and 5-year OS of 97%, 92%, and 73%, respectively. The 5-year PFS for all patients in the IU cohort was 79% [95% confidence interval (CI) 76% to 82%]. The 5-year OS for the IU cohort was 90% (95% CI 87% to 92%). IU testis cohort had 5-year OS 94% (95% CI 91% to 96%) versus 75% (95% CI 73% to 78%) for the SEER 'distant' cohort between 2000 and 2014, P-value <0.0001. Conclusion The MDC approach to GCT at high-volume cancer center associated with improved OS outcomes in this contemporary dataset. OS is significantly higher in the IU cohort compared with the IGCCCG and SEER 'distant' cohort.

中文翻译：

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多学科临床方法可改善转移性生殖细胞肿瘤患者的总体生存结果。

背景自从国际生殖细胞癌合作小组（IGCCCG）出版以来，我们报告了我们在印第安纳大学（IU）使用多学科诊所（MDC）的经验，并将我们的总体生存率（OS）与美国国家癌症研究所（US）进行了比较（ NCI）监视，流行病学和最终结果（SEER）计划。患者和方法我们对1998年至2014年在IU观察到的所有转移性生殖细胞肿瘤（GCT）患者进行了回顾性分析。共鉴定出1611例连续患者，其中704例接受了MDC的初步评估（包括医学肿瘤学，病理学，泌尿科和胸外科），并在IU开始了一线化疗。这704位患者符合分析条件。该队列中的所有患者均接受了以顺铂-依托泊苷为基础的联合化疗。我们比较了在IU治疗的患者与已发表的IGCCCG队列的无进展生存期（PFS）和OS。IU睾丸癌原发队列（n = 622）的OS进一步与1283例标有“远处”疾病的患者的SEER数据进行了比较。Kaplan-Meier方法用于估计PFS和OS。结果根据IGCCCG标准，在IU治疗的具有良好，中度和低风险疾病的患者中位随访时间为4.4年，其5年PFS分别为90％，84％和54％，5年OS为97％ ，分别为92％和73％。IU队列中所有患者的5年PFS为79％[95％置信区间（CI）为76％至82％]。IU队列的5年OS为90％（95％CI为87％至92％）。IU睾丸队列的5年OS为94％（95％CI CI从91％到96％），而2000年至2014年间SEER``遥远''队列的75％（95％CI从73％到78％），P值<0.0001 。结论在这个当代数据集中，大剂量癌症中心的GDC的MDC方法改善了OS结局。与IGCCCG和SEER“遥远”队列相比，IU队列中的OS显着更高。