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Authors: Brandt, Maximilian Peter
Ruf, Christian
Dieckmann, Klaus Peter
Syring, Isabella
Ruckes, Christian
Nestler, Tim
Schmelz, H. U.
Dotzauer, Robert
Hiester, Andreas
Albers, Pete
Nettersheim, Daniel
Bolenz, Christian
Loosen, Sven H.
Heidenreich, Axel
Pfister, Darren
Haferkamp, Axel
Zengerling, Friedemann
Paffenholz, Pia
Title: Clinical characteristics, treatment patterns and relapse in patients with clinical stage IS testicular cancer
Online publication date: 29-Aug-2022
Year of first publication: 2022
Language: english
Abstract: Purpose Clinical stage I (CSI) testicular germ cell tumors (TGCT) represents disease confined to the testis without metastasis and CSIS is defined as persistently elevated tumor markers (TM) after orchiectomy, indicating subclinical metastatic disease. This study aims at assessing clinical characteristics and oncological outcome in CSIS. Methods Data from five tertiary referring centers in Germany were screened. We defined correct classification of CSIS according to EAU guidelines. TM levels, treatment and relapse-free survival were assessed and differences between predefined groups (chemotherapy, correct/incorrect CSIS) were analyzed with Fisher’s exact and Chi-square test. Results Out of 2616 TGCT patients, 43 (1.6%) were CSIS. Thereof, 27 were correctly classified (cCSIS, 1.03%) and 16 incorrectly classified (iCSIS). TMs that defined cCSIS were in 12 (44.4%), 10 (37%), 3 (11.1%) and 2 (7.4%) patients AFP, ß-HCG, AFP plus ß-HCG and LDH, respectively. In the cCSIS group, six patients were seminoma and 21 non-seminoma. Treatment consisted of active surveillance, carboplatin-mono AUC7 and BEP (bleomycin, etoposide and cisplatin). No difference between cCSIS and iCSIS with respect to applied chemotherapy was found (p = 0.830). 5-year relapse-free survival was 88.9% and three patients (11%) in the cCSIS group relapsed. All underwent salvage treatment (3xBEP) with no documented death. Conclusion Around 1% of all TGCT were classified as cCSIS patients. Identification of cCSIS is of critical importance to avoid disease progression and relapses by adequate treatment. We report a high heterogeneity of treatment patterns, associated with excellent long-term survival irrespective of the initial treatment approach.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
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Journal: World journal of urology
Pages or article number: 327
Publisher: Springer
Publisher place: Berlin u.a.
Issue date: 2022
ISSN: 1433-8726
Publisher DOI: 10.1007/s00345-021-03889-x
Appears in collections:JGU-Publikationen

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