title: Survival of metastatic germ cell cancer patients assessed by international germ cell consensus classification in Japan.
abstract: BACKGROUND
  As a risk classification system of metastatic germ cell tumors, the International Germ Cell Consensus (IGCC) classification was proposed in 1997 and has received broad approval. Since the IGCC classification was based on patients treated between 1975 and 1990, we aimed to investigate whether survival has improved for more recently treated Japanese patients.
  
  
  METHODS
  We analyzed 296 patients with metastatic germ cell tumors treated at seven hospitals in Japan between 1990 and 2001. These cases are classified as good, intermediate or poor prognosis groups by the IGCC classification. The 5-year progression-free and the 5-year overall survivals were calculated for each prognosis group.
  
  
  RESULTS
  The median follow-up period of all patients was 53 months. In 227 non-seminomatous germ cell tumor cases, the 5-year progression-free survival (95% confidence interval) for good (n = 55), intermediate (n = 106) and poor (n = 66) prognosis was 96% (91-100), 71% (62-80) and 52% (39-65) (P < 0.001), respectively. The 5-year overall survival was 94% (88-100), 81% (73-89) and 61% (49-73) (P < 0.001), respectively. In 69 seminoma cases, the 5-year progression-free survival for good (n = 64) and intermediate (n = 5) prognosis was 78% (67-89) and 80% (45-100) (P = 0.98), respectively. The 5-year overall survival was 90% (82-99) and 80% (45-100) (P = 0.49), respectively.
  
  
  CONCLUSIONS
  There was a trend of increase in survival for any risk groups and, in particular, large increase in survival for patients with a poor prognosis. This increase is most likely attributed to more effective chemotherapy regimens and more extensive care in the experienced institutes.
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Shintaku
authors.forename: Makoto
authors.initials: M
authors.lastname: Satoh
authors.forename: Eijiro
authors.initials: E
authors.lastname: Okajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002822:Choriocarcinoma / Q000175:diagnosis / Q000453:epidemiology; D018572:Disease-Free Survival; D018240:Endodermal Sinus Tumor / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000145:classification / Q000175:diagnosis* / Q000401:mortality* / Q000556:secondary; D011379:Prognosis; D018239:Seminoma / Q000175:diagnosis / Q000453:epidemiology; D015996:Survival Rate; D013724:Teratoma / Q000175:diagnosis / Q000453:epidemiology; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology