Extragonadal Germ Cell Tumors: Prognostic Factors and Long-Term Follow-Up

1995 ◽  
Vol 28 (1) ◽  
pp. 19-24 ◽  
Author(s):  
J. Aparicio ◽  
J. Montalar ◽  
E.B. Munárriz ◽  
G. Reynés ◽  
J. Gómez-Codina ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Long Term Follow Up ◽  
Extragonadal Germ Cell Tumors

Adult primary extragonadal germ cell tumors: Treatment results and long-term follow-up

2003 ◽  
Vol 41 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Argon Andac ◽  
Basaran Mert ◽  
Bavbek Sevil ◽  
Sakar Burak ◽  
Onat Haluk
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Results ◽  
Long Term Follow Up ◽  
Extragonadal Germ Cell Tumors

Adjuvant therapy of ovarian germ cell tumors with cisplatin, etoposide, and bleomycin: a trial of the Gynecologic Oncology Group.

1994 ◽  
Vol 12 (4) ◽  
pp. 701-706 ◽  
Author(s):  
S Williams ◽  
J A Blessing ◽  
S Y Liao ◽  
H Ball ◽  
P Hanjani
Keyword(s):  
Germ Cell ◽  
Gynecologic Oncology ◽  
Cell Cancer ◽  
Germ Cell Tumors ◽  
Germ Cell Cancer ◽  
Gynecologic Oncology Group ◽  
Long Term Follow Up ◽  
Acute Myelomonocytic Leukemia

PURPOSE This study was performed to determine the effectiveness of postoperative adjuvant chemotherapy in patients with surgically resected ovarian germ cell tumors. PATIENTS AND METHODS After tumor removal and thorough surgical staging, patients were enrolled on this study and treated with three courses of cisplatin, etoposide, and bleomycin (BEP). Reassessment laparotomy was required of consenting, appropriate patients initially, but became an optional procedure in 1989. RESULTS Of 93 patients assessable on this trial, 89 are continuously free of germ cell cancer. At second-look laparotomy, two other patients were found to have small foci of immature teratoma; both remain clinically free of recurrence. One received subsequent alternate chemotherapy and one did not. Thus, 91 of 93 patients are currently free of germ cell cancer. Follow-up duration ranges from 4.0 to 90.3 months, with 67 patients monitored for longer than 2 years. Acute toxicity was moderate. One patient developed acute myelomonocytic leukemia 22 months after diagnosis. Another patient was noted to have a malignant lymphoma 69 months after protocol treatment. CONCLUSION Three courses of BEP will nearly always prevent recurrence in well-staged patients with completely resected ovarian germ cell tumors and should be given to all such patients. The development of acute leukemia as a complication of treatment is disturbing and mandates careful long-term follow-up, but is unusual and does not alter the risk-to-benefit ratio of treatment.

Long-term follow-up of chemotherapy-induced remissions in patients with disseminated nonseminomatous germ cell tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5029-5029
Author(s):  
Y. Ehrlich ◽  
M. J. Brames ◽  
S. D. Beck ◽  
R. S. Foster ◽  
L. H. Einhorn
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Free Survival ◽  
Nonseminomatous Germ Cell Tumor ◽  
Long Term Follow Up ◽  
Prospective Trials ◽  
Lymph Nodes Dissection ◽  
Lost To Follow Up

5029 Background: There is controversy concerning management of patients (pts) with nonseminomatous germ cell tumor (NSGCT) who obtain a chemotherapy-induced complete radiographic (<1cm node diameter) and serologic remission (CR). It has been our policy not to recommend retroperitoneal lymph nodes dissection (RPLND). Proponents of mandatory RPLND cite a 20% to 30% rate of residual microscopic tumor, mostly teratoma, despite achieving CR. Methods: Retrospective analysis of 141 patients with metastatic NSGCT who obtained CR to cisplatin-based first-line chemotherapy. All were observed without RPLND. Included were 78 consecutive pts treated between Jan 1987 and Sept 1994. Additionally included were 63 pts recruited in 4 prospective trials between Oct 1984 and Apr 2005. Seven pts were lost to follow-up (FU) after <2 year. Results: At a median a FU of 15 years (range 3 months to 23.8 years), 12 pts recurred and 4 are dead of disease (DOD). The estimated 15 year recurrence free and disease specific survival was 90% and 97% respectively. The estimated 15 years recurrence free survival for 109 pts with good risk and 32 pts with intermediate or poor risk was 95% and 73% respectively (p = 0.001). Five pts recurred >2 years (range 3–13 years). All 5 are currently disease free. Six pts recurred in the RP and 2 are DOD. Six pts recurred outside the RP. Two of these 6 are DOD. Conclusions: Pts obtaining CR after primary chemotherapy can be safely observed without RPLND. Relapses are rare and potentially curable with further treatment. No significant financial relationships to disclose.

Cyclin-dependent kinase 4/6 inhibition for the treatment of mature teratoma germ cell tumor: Long-term follow-up of a phase II study.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 474-474
Author(s):  
Vivek Narayan ◽  
Wei-Ting Hwang ◽  
Priti Lal ◽  
Mark Alan Rosen ◽  
Maryann Gallagher ◽  
...  
Keyword(s):  
Germ Cell ◽  
Phase Ii ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Progression Free Survival ◽  
Clinical Event ◽  
Free Survival ◽  
Long Term Follow Up

474 Background: We have previously reported the results of a phase II clinical trial evaluating the safety and efficacy of palbociclib for the treatment of patients with unresectable germ cell tumors, including mature teratoma, teratoma with malignant transformation, and non-teratomatous tumors. In an effort to better assess the efficacy of palbociclib, we now report long-term follow-up of a more homogeneous population of patients with unresectable mature teratoma treated on the phase II clinical trial, with an emphasis on clinically-relevant endpoints for this incurable patient population. Methods: This was a retrospective analysis with long-term follow-up of the patient cohort with mature teratoma treated on the phase II study of palbociclib for the treatment of retinoblastoma protein-expressing germ cell tumors. Patient clinical data was obtained from the medical records and from communication with the enrolled patients and referring medical providers. Major medical events for the treatment of germ cell tumor, including before, during, and after study treatment, were recorded. Clinical events of interest included the initiation of systemic therapy, radiation therapy, surgical debulking, or other invasive procedures. Study endpoints included pre-study and post-study clinical event rates, event-free survival, and radiographic progression-free survival. Results: Long-term follow-up was obtained for 12 patients with mature teratoma. The median pre-study follow-up time was 19.7 months, and the median post-study follow-up time was 38.0 months. The median number of palbociclib treatment cycles was 11. The pre-study clinical event rate was 2.27 events/year (95% CI 1.66 – 3.13), and the post-study event rate was 0.62 events/year (95% CI 0.36 – 1.09). The median progression-free survival was 5.3 months (95% CI 1.8 – 22.6), and the median event-free survival was 16.2 months (95% CI 3.0 – 24.3). Conclusions: The initiation of palbociclib resulted in a clinically-meaningful delay in disease-related major clinical events and radiographic progression. These findings lend further support to the therapeutic activity of CDK4/6 inhibition in this incurable patient population.

Long-term follow-up of a phase III study of three versus four cycles of bleomycin, etoposide, and cisplatin in favorable-prognosis germ-cell tumors: the Indian University experience.

1998 ◽  
Vol 16 (2) ◽  
pp. 702-706 ◽  
Author(s):  
S B Saxman ◽  
D Finch ◽  
R Gonin ◽  
L H Einhorn
Keyword(s):  
Germ Cell ◽  
Univariate Analysis ◽  
Germ Cell Tumors ◽  
Phase Iii ◽  
Term Survival ◽  
Favorable Prognosis ◽  
Significant Difference ◽  
Long Term Follow Up

PURPOSE In a previously reported randomized Southeastern Cancer Study Group (SECSG) trial, three cycles of chemotherapy were found to be equivalent to four cycles in patients with favorable-prognosis germ-cell cancer. We have conducted a follow-up analysis of patients treated at Indiana University (Indianapolis, IN) to compare long-term survival between the two groups and to examine factors associated with survival. PATIENTS AND METHODS Sixty-nine patients with minimal-stage and 49 patients with moderate-stage disseminated germ-cell tumors were randomized to either three or four courses of bleomycin, etoposide, and cisplatin (BEP) administered every 3 weeks. Median follow-up time is 10.1 years (range, 7 months to 12.6 years). Ninety-two percent of patients have an actual follow-up time of > 5 years, and 97.5% of patients have an actual follow-up time of > 3 years. RESULTS Survival analysis shows no significant difference between the two treatment groups in terms of overall (P = .80) or disease-free (P = .93) survival. Several clinical variables were examined by univariate analysis; only serum human chorionic gonadotropin (HCG) had an impact on survival. There were two disease-related deaths in 104 patients with HCG < or = 1,000 mIU/mL and five disease-related deaths in 14 patients with HCG greater than 1,000 mIU/mL (P < .001). Ninety-eight percent (95% CI, 95.2 to 100) of patients with favorable prognosis germ-cell tumor with an initial HCG of < or = 1,000 mIU/mL are alive without evidence of disease at 5+ years. CONCLUSION With long-term follow-up, there is no statistically significant difference in survival between three or four cycles of BEP chemotherapy in patients with favorable prognosis germ-cell carcinoma. Serum HCG elevation of greater than 1,000 mIU/mL is a significant predictor of poor outcome in patients with otherwise good-risk disease.

Cisplatin-Based Combination Chemotherapy for Disseminated Germ Cell Tumors: Long-Term Follow-Up

1989 ◽  
Vol 141 (6) ◽  
pp. 1499-1499
Author(s):  
B.J. Roth ◽  
A. Greist ◽  
P.S. Kubilis ◽  
S.D. Williams ◽  
L.H. Einhorn
Keyword(s):  
Germ Cell ◽  
Combination Chemotherapy ◽  
Germ Cell Tumors ◽  
Long Term Follow Up

Second neoplasm and cerebrovascular disease in over five-year survivors with CNS germ cell tumor

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9046-9046
Author(s):  
K. Sugiyama ◽  
K. Arita ◽  
K. Kurisu ◽  
Y. Sawamura
Keyword(s):  
Cerebrovascular Disease ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Malignant Neoplasm ◽  
Long Term Effects ◽  
Second Neoplasm ◽  
Cavernous Angiomas ◽  
Long Term Follow Up

9046 Background: Survivors of childhood and adolescent brain tumors are at risk for long-term effects of treatment (Tx). This study investigates details on second neoplasm and cerebrovascular disease of long-term survivors with CNS germ cell tumors (CNSGCTs). Methods: The authors reviewed clinical data on 203 institutional patients (pts) who had a CNSGCT and survived more than 5 years. Median age of initial Tx was 15.0 years and median follow-up period was 168 months (60–448 months). Results: Among these pts, 32 pts (15.4%) suffered from second neoplasm and/or cerebrovascular disease. Median age of 32 pts was 14.6 years at the initial Tx. Median interval to event was 151 months (24–456 months). The secondary events, therefore, occurred at the third decade of age. The second neoplasm included 8 cavernous angiomas, 7 GBMs, 3 meningiomas, 2 G-III glioma, 1 hemangiopericytoma, and 1 leukemia. Four cavernous angiomas caused a hematoma. The cerebrovascular disease included 14 steno-occlusive diseases of circle of Willis, 1 aneurysm, and 1 dural AVF. Four pts sufferred from both neoplasum and cerebrovascular disease. All 32 pts had previously received radiotherapy and 6 pts had undergone chemotherapy. Radiation field included whole ventricle system or whole brain involving basal cistern with the dose of more than 40 Gy, except for one who received 24 Gy followed by P-E chemotherapy. Eight of 32 pts died and 14 pts had additional sequelae due to these secondary events. Conclusions: The risk of lethal malignant neoplasm and disabling cerebarovascular disease after Tx for CNSGCTs is extremely large. Long-term follow-up system to monitor and prevent late sequelae should be established. No significant financial relationships to disclose.

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