Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database

Jakob Lauritsen; Nicolas Sauvé; Alexey Tryakin; Di Maria Jiang; Robert Huddart; Daniel Y C Heng; Angelika Terbuch; Eric Winquist; Michal Chovanec; Marcus Hentrich; Christian D Fankhauser; Jonathan Shamash; Xavier Garcia Del Muro; David Vaughn; Axel Heidenreich; Cora N Sternberg; Christopher Sweeney; Andrea Necchi; Carsten Bokemeyer; Mikkel Bandak; Abolghassem Jandari; Laurence Collette; Silke Gillessen; Joerg Beyer; Gedske Daugaard

doi:10.1038/s41416-023-02443-3

Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database

Jakob Lauritsen, Nicolas Sauvé, Alexey Tryakin, Di Maria Jiang, Robert Huddart, Daniel Y C Heng, Angelika Terbuch, Eric Winquist, Michal Chovanec, Marcus Hentrich, Christian D Fankhauser, Jonathan Shamash, Xavier Garcia Del Muro, David Vaughn, Axel Heidenreich, Cora N Sternberg, Christopher Sweeney, Andrea Necchi, Carsten Bokemeyer, Mikkel BandakAbolghassem Jandari, Laurence Collette, Silke Gillessen, Joerg Beyer^*, Gedske Daugaard

^*Corresponding author for this work

Department of Oncology

5 Citations (Scopus)

Abstract

BACKGROUND: Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.

PATIENTS AND METHODS: In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.

RESULTS: A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem.

CONCLUSION: Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.

Original language	English
Journal	British Journal of Cancer
Volume	129
Issue number	11
Pages (from-to)	1759-1765
Number of pages	7
ISSN	0007-0920
DOIs	https://doi.org/10.1038/s41416-023-02443-3
Publication status	Published - Nov 2023

Keywords

Humans
Male
Neoplasms, Germ Cell and Embryonal
Neoplasms, Second Primary
Prognosis
Progression-Free Survival
Recurrence
Seminoma/surgery
Testicular Neoplasms/surgery

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10.1038/s41416-023-02443-3

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Lauritsen, J., Sauvé, N., Tryakin, A., Jiang, D. M., Huddart, R., Heng, D. Y. C., Terbuch, A., Winquist, E., Chovanec, M., Hentrich, M., Fankhauser, C. D., Shamash, J., Del Muro, X. G., Vaughn, D., Heidenreich, A., Sternberg, C. N., Sweeney, C., Necchi, A., Bokemeyer, C., ... Daugaard, G. (2023). Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database. British Journal of Cancer, 129(11), 1759-1765. https://doi.org/10.1038/s41416-023-02443-3

Lauritsen, J, Sauvé, N, Tryakin, A, Jiang, DM, Huddart, R, Heng, DYC, Terbuch, A, Winquist, E, Chovanec, M, Hentrich, M, Fankhauser, CD, Shamash, J, Del Muro, XG, Vaughn, D, Heidenreich, A, Sternberg, CN, Sweeney, C, Necchi, A, Bokemeyer, C, Bandak, M, Jandari, A, Collette, L, Gillessen, S, Beyer, J & Daugaard, G 2023, 'Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database', British Journal of Cancer, vol. 129, no. 11, pp. 1759-1765. https://doi.org/10.1038/s41416-023-02443-3

@article{dd134abdd2b849009acee933b4431dc4,

title = "Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database",

abstract = "BACKGROUND: Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30\% relapse rate.PATIENTS AND METHODS: In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.RESULTS: A total of 1014 seminoma (Sem) [298 (29.4\%) relapsed from CSI, 716 (70.6\%) de novo] and 3103 non-seminoma (NSem) [626 (20.2\%) relapsed from CSI, 2477 (79.8\%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6\% versus 88.5\%; 5-year overall survival (5y-OS) 93.2\% versus 96.1\%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6\% versus 80.0\%; 5y-OS 93.3\% versus 88.7\%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95\% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4\%) Sem and 112/626 (18\%) NSem.CONCLUSION: Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.",

keywords = "Humans, Male, Neoplasms, Germ Cell and Embryonal, Neoplasms, Second Primary, Prognosis, Progression-Free Survival, Recurrence, Seminoma/surgery, Testicular Neoplasms/surgery",

author = "Jakob Lauritsen and Nicolas Sauv{\'e} and Alexey Tryakin and Jiang, \{Di Maria\} and Robert Huddart and Heng, \{Daniel Y C\} and Angelika Terbuch and Eric Winquist and Michal Chovanec and Marcus Hentrich and Fankhauser, \{Christian D\} and Jonathan Shamash and \{Del Muro\}, \{Xavier Garcia\} and David Vaughn and Axel Heidenreich and Sternberg, \{Cora N\} and Christopher Sweeney and Andrea Necchi and Carsten Bokemeyer and Mikkel Bandak and Abolghassem Jandari and Laurence Collette and Silke Gillessen and Joerg Beyer and Gedske Daugaard",

note = "{\textcopyright} 2023. The Author(s).",

year = "2023",

month = nov,

doi = "10.1038/s41416-023-02443-3",

language = "English",

volume = "129",

pages = "1759--1765",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Nature Publishing Group",

number = "11",

}

TY - JOUR

T1 - Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients

T2 - an analysis of the IGCCCG Update database

AU - Lauritsen, Jakob

AU - Sauvé, Nicolas

AU - Tryakin, Alexey

AU - Jiang, Di Maria

AU - Huddart, Robert

AU - Heng, Daniel Y C

AU - Terbuch, Angelika

AU - Winquist, Eric

AU - Chovanec, Michal

AU - Hentrich, Marcus

AU - Fankhauser, Christian D

AU - Shamash, Jonathan

AU - Del Muro, Xavier Garcia

AU - Vaughn, David

AU - Heidenreich, Axel

AU - Sternberg, Cora N

AU - Sweeney, Christopher

AU - Necchi, Andrea

AU - Bokemeyer, Carsten

AU - Bandak, Mikkel

AU - Jandari, Abolghassem

AU - Collette, Laurence

AU - Gillessen, Silke

AU - Beyer, Joerg

AU - Daugaard, Gedske

PY - 2023/11

Y1 - 2023/11

N2 - BACKGROUND: Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.PATIENTS AND METHODS: In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.RESULTS: A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem.CONCLUSION: Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.

AB - BACKGROUND: Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate.PATIENTS AND METHODS: In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT.RESULTS: A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem.CONCLUSION: Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments.

KW - Humans

KW - Male

KW - Neoplasms, Germ Cell and Embryonal

KW - Neoplasms, Second Primary

KW - Prognosis

KW - Progression-Free Survival

KW - Recurrence

KW - Seminoma/surgery

KW - Testicular Neoplasms/surgery

UR - https://www.scopus.com/pages/publications/85173045178

U2 - 10.1038/s41416-023-02443-3

DO - 10.1038/s41416-023-02443-3

M3 - Journal article

C2 - 37777577

SN - 0007-0920

VL - 129

SP - 1759

EP - 1765

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 11

ER -

Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database

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Keywords

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