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Gille R, Allignet B, Izarn F, Peyrat P, Boyle H, Fléchon A. Bone Metastases in Non-Seminomatous Germ Cell Tumors: A 20-Year Retrospective Analysis. J Clin Med 2024; 13:3280. [PMID: 38892991 PMCID: PMC11172778 DOI: 10.3390/jcm13113280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/26/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Non-seminomatous germ cell tumors (NSGCTs) represent a rare yet the most prevalent malignancy among young men. Bone metastases (BMs) are exceedingly uncommon in this neoplasm, and available data regarding the initial disease presentation, survival outcomes, and prognostic significance of BMs are limited. Methods: We conducted a retrospective analysis of 40 NSGCT patients with BMs treated between 2001 and 2021 in our tertiary care center. The cohort was stratified into synchronous (n = 29) and metachronous (n = 11) groups based on the presence of BM at diagnosis or only at relapse, respectively. We assessed overall survival (OS), progression-free survival (PFS), disease presentation, and treatments. Results: After a median follow-up of 93 months, the 5-year PFS and OS rates were 37.6% and 53.9% in the synchronous group and 18.2% and 36.4% in the metachronous group, respectively. At the initial diagnosis, most patients were classified into the IGCCCG poor prognostic group (n = 34, 85%). BMs were mostly asymptomatic (n = 23, 57.5%), involved the spine (n = 37, 92.5%), and could become visible only after disease response (n = 4, 10%). A pathological examination of resected bone lesions after first-line treatment revealed necrosis (n = 5, 71.4%), teratoma, or seminoma (both n = 1, 14.3%). At first relapse, eight patients in the synchronous group did not experience bone recurrence, while eight patients experienced recurrence at the initial affected bone site. Conclusions: In NSGCT patients, BMs often present asymptomatically and may initially be unnoticed. However, these patients may have a poorer prognosis compared to those in the IGCCCG poor prognostic group. Further studies including control groups are needed to assess the independent prognostic significance of BMs.
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Affiliation(s)
- Romane Gille
- Campus Lyon Sud Charles Mérieux, University Claude-Bernard Lyon 1, 69921 Oullins-Pierre-Bénite, France;
- Department of Medical Oncology, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France; (H.B.); (A.F.)
| | - Benoît Allignet
- Department of Radiation Oncology, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France;
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1 , CNRS, Inserm, CREATIS UMR 5220, U1294, 69621 Lyon, France
| | - Floriane Izarn
- Campus Lyon Sud Charles Mérieux, University Claude-Bernard Lyon 1, 69921 Oullins-Pierre-Bénite, France;
- Department of Medical Oncology, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France; (H.B.); (A.F.)
| | - Patrice Peyrat
- Department of Surgery, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France;
| | - Helen Boyle
- Department of Medical Oncology, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France; (H.B.); (A.F.)
| | - Aude Fléchon
- Department of Medical Oncology, Centre Léon Bérard, 28 rue Laennec, 69673 Lyon Cedex, France; (H.B.); (A.F.)
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2
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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. Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database. Br J Cancer 2023; 129:1759-1765. [PMID: 37777577 PMCID: PMC10667594 DOI: 10.1038/s41416-023-02443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 08/07/2023] [Accepted: 09/14/2023] [Indexed: 10/02/2023] Open
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.
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Affiliation(s)
- Jakob Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Nicolas Sauvé
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Alexey Tryakin
- Department of Chemotherapy, N.N.Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Di Maria Jiang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Robert Huddart
- Institute of Cancer Research and Royal Marsden Hospital, Downs Road, Sutton, Surrey, UK
| | - Daniel Y C Heng
- Division of Medical Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | | | - Eric Winquist
- Department of Oncology, University of Western Ontario and London Health Sciences Centre, London, ON, Canada
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, National Cancer Institute, Bratislava, Slovakia
| | - Marcus Hentrich
- Department of Hematology/Oncology, Red Cross Hospital, Munich, Germany
| | | | | | | | - David Vaughn
- Division of Hematology/Oncology, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA, USA
| | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York-Presbyterian, New York, NY, USA
| | | | - Andrea Necchi
- Vita-Salute San Raffaele University, Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and BMT with section Pneumonology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Mikkel Bandak
- Department of Consulting and Research, International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - Abolghassem Jandari
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
- University of Southern Switzerland, Lugano, Switzerland
| | - Joerg Beyer
- Department of Medical Onccology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Gedske Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark
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3
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Gillessen S, Sauvé N, Collette L, Daugaard G, de Wit R, Albany C, Tryakin A, Fizazi K, Stahl O, Gietema JA, De Giorgi U, Cafferty FH, Hansen AR, Tandstad T, Huddart RA, Necchi A, Sweeney CJ, Garcia-Del-Muro X, Heng DYC, Lorch A, Chovanec M, Winquist E, Grimison P, Feldman DR, Terbuch A, Hentrich M, Bokemeyer C, Negaard H, Fankhauser C, Shamash J, Vaughn DJ, Sternberg CN, Heidenreich A, Beyer J. Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium. J Clin Oncol 2021; 39:1563-1574. [PMID: 33822655 PMCID: PMC8099402 DOI: 10.1200/jco.20.03296] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The classification of the International Germ Cell Cancer Collaborative Group (IGCCCG) plays a pivotal role in the management of metastatic germ cell tumors but relies on data of patients treated between 1975 and 1990.
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Affiliation(s)
- Silke Gillessen
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.,Universita della Svizzera Italiana, Lugano, Switzerland.,University of Manchester, Manchester, United Kingdom
| | - Nicolas Sauvé
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Gedske Daugaard
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ronald de Wit
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Costantine Albany
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | - Alexey Tryakin
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation.,Research Institute of Oncology at Bashkir State Medical University, Ufa, Russian Federation
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Olof Stahl
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | | | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy and the Italian Germ Cell Cancer Group (IGG)
| | - Fay H Cafferty
- Medical Research Council Clinical Trials Unit, University College London (UCL), London, United Kingdom
| | - Aaron R Hansen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Torgrim Tandstad
- The Cancer Clinic, St Olavs University Hospital and Department of Clinical and Molecular Medicine, The Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Andrea Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Current Affiliation: Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | | | - Xavier Garcia-Del-Muro
- Catalan Institute of Oncology, IDIBELL Institute of Research, University of Barcelona, Barcelona, Spain
| | - Daniel Y C Heng
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Anja Lorch
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.,Department of Urology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Eric Winquist
- Division of Medical Oncology, Western University and London Health Sciences Centre, London, Ontario, Canada
| | - Peter Grimison
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, Australia
| | - Darren R Feldman
- Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Medical College of Cornell University, New York, NY
| | - Angelika Terbuch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital, University of Munich, Munich, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helene Negaard
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | | | | | - Cora N Sternberg
- Medical Oncology, San Camillo Forlanini Hospital, Rome, Italy. Current Affiliation: Englander Institute for Precision Medicine, Weill Cornell Medicine, New York-Presbyterian, NY
| | - Axel Heidenreich
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Jörg Beyer
- University Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
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Glycan Analysis as Biomarkers for Testicular Cancer. Diagnostics (Basel) 2019; 9:diagnostics9040156. [PMID: 31652641 PMCID: PMC6963830 DOI: 10.3390/diagnostics9040156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/13/2019] [Accepted: 10/19/2019] [Indexed: 12/24/2022] Open
Abstract
The U.S. Preventive Services Task Force does not recommend routine screening for testicular cancer (TC) in asymptomatic men, essentially because serological testicular cancer (TC) biomarkers are not reliable. The main reason is that two of the most important TC biomarkers, α-fetoprotein (AFP) and human chorionic gonadotropin (hCG), are not produced solely due to TC. Moreover, up to 40% of patients with TC do not have elevated serological biomarkers, which is why serial imaging with CT is the chief means of monitoring progress. On the other hand, exposure to radiation can lead to an increased risk of secondary malignancies. This review provides the first comprehensive account of the applicability of protein glycoprofiling as a promising biomarker for TC with applications in disease diagnostics, monitoring and recurrence evaluation. The review first deals with the description and classification of TC. Secondly, the limitations of current TC biomarkers such as hCG, AFP and lactate dehydrogenase are provided together with an extensive overview of the glycosylation of hCG and AFP related to TC. The final part of the review summarises the potential of glycan changes on either hCG and AFP as TC biomarkers for diagnostics and prognostics purposes, and for disease recurrence evaluation. Finally, an analysis of glycans in serum and tissues as TC biomarkers is also provided.
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