title: Resection of residual masses after chemotherapy for advanced non-seminomatous germ cell tumours, a monocentric analysis of pre-operative prognosticators.
abstract: Removal of residual masses after chemotherapy in non-seminomatous germ cell tumours (NSGCTs) remains the standard of care. We evaluated in a retrospective and monocentric study potential prognostic factors. Fifty-one patients underwent surgery after chemotherapy for NSGCT. We estimated event-free survival with Kaplan-Meier method and used Cox proportional hazards regression analysis to assess the prognostic significance of risk factors. Histology of residual masses revealed fibrosis in 25 (49%), mature teratoma in 18 (35%) and viable germ cells in 8 (16%). Alpha-fetoprotein mean level at diagnosis was higher in patients with residual masses showing mature teratoma and/or viable malignant cells (P = 0.036). In multivariate analysis, poor prognosis group according to International Germ Cell Cancer Collaborative Group was associated with worse outcome compared with good and intermediate prognosis groups (hazard ratio for events = 26.4; 95% confidence interval 2.46-283.9; P = 0.006) and primary testicular NSGCT was associated with better event-free survival than extragonadal NSGCTs (hazard ratio for events = 0.04; 95% confidence interval 0.004-0.48; P = 0.01). Resection of residual masses after chemotherapy in NSGCT results in favourable long-term survival in most patients. Our results compared favourably with those reported from higher volume centres.
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France. jldeville@infonie.fr
authors.forename: J-L
authors.initials: JL
authors.lastname: Deville
authors.forename: G
authors.initials: G
authors.lastname: Gravis
authors.forename: N
authors.initials: N
authors.lastname: Salem
authors.forename: P-H
authors.initials: PH
authors.lastname: Savoie
authors.forename: B
authors.initials: B
authors.lastname: Esterni
authors.forename: J
authors.initials: J
authors.lastname: Walz
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Goncalves
authors.forename: P
authors.initials: P
authors.lastname: Viens
authors.forename: F
authors.initials: F
authors.lastname: Bladou
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018365:Neoplasm, Residual; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents