Survival of metastatic germ cell cancer patients assessed by international germ cell consensus classification in Japan.
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.
Shintaku
Ichiro
I
Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
Satoh
Makoto
M
Okajima
Eijiro
E
Fujimoto
Hiroyuki
H
Kamoto
Toshiyuki
T
Ogawa
Osamu
O
Kawai
Koji
K
Akaza
Hideyuki
H
Tsukamoto
Taiji
T
Naito
Seiji
S
Miki
Tsuneharu
T
Arai
Yoichi
Y
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