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Tytuł:
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Human chorionic gonadotropin-positive seminoma patients: A registry compiled by the global germ cell tumor collaborative group (G3).
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Autorzy:
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Seidel C; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: .
Daugaard G; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Nestler T; Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany.
Tryakin A; Department of Clinical Pharmacology and Chemotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation.
Fedyanin M; Department of Clinical Pharmacology and Chemotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation.
Fankhauser C; Department of Urology, University Hospital Zürich, Zurich, Switzerland.
Hermanns T; Department of Urology, University Hospital Zürich, Zurich, Switzerland.
Aparicio J; Medical Oncology Department, Hospital La Fe, On behalf of the Spanish Germ Cell Cancer Group, Valencia, Spain.
Heinzelbecker J; Department of Urology, University Hospital Saarland, Homburg/Saar, Germany.
Paffenholz P; Department of Urology, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Austria.
Heidenreich A; Department of Urology, University Hospital Cologne, Cologne, Germany; Department of Urology, Medical University Vienna, Austria.
De Giorgi U; Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, On behalf of the Italian Germ Cell Cancer Group (IGG), Meldola, Italy.
Cathomas R; Department of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland.
Lorch A; Department of Oncology and Hematology, University Hospital Zürich, Zurich, Switzerland; Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany.
Fingerhut A; Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany.
Gayer F; Department of Pathology, University Clinic Göttingen, Göttingen, Germany.
Bremmer F; Department of Pathology, University Clinic Göttingen, Göttingen, Germany.
Giannatempo P; Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
Necchi A; Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
Aurilio G; Medical Division of Urogenital and Head & Neck Cancer, IEO European Institute of Oncology IRCCS, Milan, Italy.
Casadei C; Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, On behalf of the Italian Germ Cell Cancer Group (IGG), Meldola, Italy.
Tran B; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Dieckmann KP; Department of Urology, Asklepios Klinik Altona, Hodentumorzentrum, Germany.
Brito M; Instituto Português de Oncologia de Lisboa, Lisboa, Portugal.
Ruf C; Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany.
Oing C; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bokemeyer C; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Źródło:
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European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2020 Jun; Vol. 132, pp. 127-135. Date of Electronic Publication: 2020 Apr 29.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Oxford : Elsevier Science Ltd
Original Publication: Oxford ; New York : Pergamon Press, c1990-
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MeSH Terms:
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Chorionic Gonadotropin/*metabolism
Neoplasms, Germ Cell and Embryonal/*mortality
Orchiectomy/*mortality
Registries/*statistics & numerical data
Seminoma/*mortality
Testicular Neoplasms/*mortality
Adult ; Follow-Up Studies ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal/metabolism ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasms, Germ Cell and Embryonal/surgery ; Prognosis ; Retrospective Studies ; Seminoma/metabolism ; Seminoma/pathology ; Seminoma/surgery ; Survival Rate ; Testicular Neoplasms/metabolism ; Testicular Neoplasms/pathology ; Testicular Neoplasms/surgery
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Contributed Indexing:
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Keywords: Beta-hCG; Human chorionic gonadotropin; Lactate dehydrogenase; Prognostic factor; Seminoma
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Substance Nomenclature:
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0 (Chorionic Gonadotropin)
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Entry Date(s):
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Date Created: 20200504 Date Completed: 20201109 Latest Revision: 20201109
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Update Code:
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20240105
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DOI:
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10.1016/j.ejca.2020.03.022
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PMID:
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32361383
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Background: The prognostic role of human chorionic gonadotropin (hCG) and lactate dehydrogenase (LDH) serum levels in seminoma patients remains uncertain. This observational study evaluates the prognostic impact of tumour marker levels, and other clinicopathological findings, in hCG-positive seminoma patients.
Methods: Seminoma patients with serum hCG levels above normal at first diagnosis were eligible for recruitment. Statistical analysis, including multivariate regression, was performed to identify risk factors. Primary end-points were overall survival (OS) and recurrence-free survival (RFS).
Results: We recruited 1031 hCG-positive patients (stage I: n = 586; stage II + III: n = 427) diagnosed between 1981 and 2018. In metastatic disease, LDH levels ≥3 above upper normal limit (UNL) pre- (n = 109) or post-orchiectomy (n = 73) and patients aged ≥40 years (n = 187) were associated with poor prognosis: 5-year OS rates of 84% (LDH ≥3 UNL pre-orchiectomy) versus 92% (<3 UNL pre-orchiectomy) (hazard ratio [HR]: 3.155, [95% confidence interval {CI}: 1.28-7.75], P = 0.012), 82% (≥3 UNL post-orchiectomy) versus 92% (<3 UNL post-orchiectomy) (HR: 6.877, [95% CI: 1.61-29.34]; P = 0.009) and 86% (≥40 years) versus 91% (<40 years) (HR: 6.870, [95% CI: 1.45-13.37], P = 0.009), respectively. A subset of patients with hCG levels ≥2000 IU/l pre-orchiectomy (n = 17) exhibited a poor prognosis, with 5-year OS rates of 73% (≥2000 IU/l) versus 94% (<2000 IU/l) (HR: 3.936, [95% CI: 1.02-12.61], P = 0.047).
Conclusions: Age and LDH levels are significantly associated with poor prognosis in hCG-positive seminoma patients. A small number of patients, with levels of hCG ≥2000 IU/l, may represent a separate prognostic subgroup associated with impaired survival rates.
Competing Interests: Conflict of interest statement None declared.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
