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Teratoma Not A Prognostic Factor in Metastatic Testicular Germ Cell Tumors
Findings from a large retrospective study suggest that the presence of teratoma is not a prognostic factor in patients with metastatic testicular germ cell tumors (GCT; J Clin Oncol. 2020 Apr 20. Epub ahead of print).
“Presence of teratoma in patients with metastatic testicular [GCT] is of unknown prognostic significance,” explained Fadi Taza, MD, Division of Hematology and Medical Oncology, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, and colleagues, who conducted this research.
A total of 1224 patients (median age, 27 years) with metastatic nonseminomatous GCT (NSGCT) who had primary testicular tumor specimen from orchiectomy between 1990 and 2016 were enrolled in the study. All patients were divided into arms based on the presence or absence of teratoma in their orchiectomy specimens and given cisplatin-based combination chemotherapy.
The primary end points were differences in progression-free survival (PFS) and overall survival (OS), which were measured using log-rank tests and Cox proportional hazards models.
Ultimately, 689 patients had teratoma in their orchiectomy specimens whereas 535 did not. The median follow-up time was 2.3 years.
In the teratoma arm, 5-year PFS was 61.9% versus 63.1% in the nonteratoma arm; the 5-year OS in these arms was 82.2% versus 81.4%, respectively.
Among 473 patients who had retroperitoneal lymph node dissection (PC-RPLND) after chemotherapy, the 5-year PFS for patients with pure teratoma versus necrosis only in their PC-RPLND specimens was 65.9% and 79.1%, respectively. The 5-year OS for these patients was 90.3% and 93.4%, respectively.
“Presence of teratoma in [orchiectomy] and PC-RPLND specimens was not a prognostic factor in this large retrospective study of patients with NSGCT,” concluded Dr Taza and co-investigators.—Kaitlyn Manasterski
