Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy
With treatment leading to nearly uniform cure in clinical stage I nonseminomatous testicular cancer (CSI-NSGCT), diminishing treatment-related morbidity has become the primary concern. This study examined feasibility and outcome of active surveillance as treatment in an unselected CSI patient popula...
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| Veröffentlicht in: | Annals of oncology 2010-06, Vol.21 (6), p.1296-1301 |
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| container_title | Annals of oncology |
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| creator | Kollmannsberger, C. Moore, C. Chi, K.N. Murray, N. Daneshmand, S. Gleave, M. Hayes-Lattin, B. Nichols, C.R. |
| description | With treatment leading to nearly uniform cure in clinical stage I nonseminomatous testicular cancer (CSI-NSGCT), diminishing treatment-related morbidity has become the primary concern. This study examined feasibility and outcome of active surveillance as treatment in an unselected CSI patient population.
All patients with CSI-NSGCT referred from 1998 to 2007 to the British Columbia Cancer Agency and the Oregon Testis Cancer Program were retrospectively reviewed. A total of 233 patients were identified, of which 223 chose active surveillance.
Vascular invasion (VI) was absent, present and unknown in 66%, 27% and 7% of cases, respectively. Overall, 49% of patients had embryonal predominant disease. Fifty-nine patients (26%) relapsed, all but one with good prognosis disease. VI was present in 30 relapsed patients. Most patients relapsed within 2 years (88%). Only 7 of 223 patients (3%) relapsed beyond 2 years. All relapses were in long-term remission following chemotherapy with or without retroperitoneal lymph node dissection (RPLND). Only 17 of 223 patients (8%) required postorchiectomy surgery. Disease-specific survival is 100% after a median follow-up of 52 months (3–136). No patient has required second-line chemotherapy.
Active surveillance for all CSI-NSGCT patients is associated with excellent outcomes comparable with the best results reported with primary RPLND or adjuvant chemotherapy. Nearly 75% of patients are spared any therapy after orchiectomy. |
| doi_str_mv | 10.1093/annonc/mdp473 |
| format | Article |
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All patients with CSI-NSGCT referred from 1998 to 2007 to the British Columbia Cancer Agency and the Oregon Testis Cancer Program were retrospectively reviewed. A total of 233 patients were identified, of which 223 chose active surveillance.
Vascular invasion (VI) was absent, present and unknown in 66%, 27% and 7% of cases, respectively. Overall, 49% of patients had embryonal predominant disease. Fifty-nine patients (26%) relapsed, all but one with good prognosis disease. VI was present in 30 relapsed patients. Most patients relapsed within 2 years (88%). Only 7 of 223 patients (3%) relapsed beyond 2 years. All relapses were in long-term remission following chemotherapy with or without retroperitoneal lymph node dissection (RPLND). Only 17 of 223 patients (8%) required postorchiectomy surgery. Disease-specific survival is 100% after a median follow-up of 52 months (3–136). No patient has required second-line chemotherapy.
Active surveillance for all CSI-NSGCT patients is associated with excellent outcomes comparable with the best results reported with primary RPLND or adjuvant chemotherapy. Nearly 75% of patients are spared any therapy after orchiectomy.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1093/annonc/mdp473</identifier><identifier>PMID: 19875756</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Antineoplastic agents ; Biological and medical sciences ; Chemotherapy, Adjuvant - statistics & numerical data ; Comorbidity ; Follow-Up Studies ; Gynecology. Andrology. Obstetrics ; Humans ; Male ; Male genital diseases ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal - drug therapy ; Neoplasms, Germ Cell and Embryonal - epidemiology ; Neoplasms, Germ Cell and Embryonal - mortality ; Neoplasms, Germ Cell and Embryonal - surgery ; nonseminomatous testicular cancer ; Orchiectomy - adverse effects ; Orchiectomy - rehabilitation ; Orchiectomy - statistics & numerical data ; Pharmacology. Drug treatments ; Population Surveillance - methods ; Postoperative Complications - drug therapy ; Postoperative Complications - epidemiology ; Recurrence ; Retrospective Studies ; Risk ; stage I ; surveillance ; Testicular Neoplasms - drug therapy ; Testicular Neoplasms - epidemiology ; Testicular Neoplasms - mortality ; Testicular Neoplasms - surgery ; testis cancer ; Treatment Outcome ; Tumors ; Young Adult</subject><ispartof>Annals of oncology, 2010-06, Vol.21 (6), p.1296-1301</ispartof><rights>2009 European Society for Medical Oncology</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-c60cea6b65a09497b7d329b435da7eb8851703dd82672e66ac73032413c4f6ac3</citedby><cites>FETCH-LOGICAL-c377t-c60cea6b65a09497b7d329b435da7eb8851703dd82672e66ac73032413c4f6ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22838396$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19875756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kollmannsberger, C.</creatorcontrib><creatorcontrib>Moore, C.</creatorcontrib><creatorcontrib>Chi, K.N.</creatorcontrib><creatorcontrib>Murray, N.</creatorcontrib><creatorcontrib>Daneshmand, S.</creatorcontrib><creatorcontrib>Gleave, M.</creatorcontrib><creatorcontrib>Hayes-Lattin, B.</creatorcontrib><creatorcontrib>Nichols, C.R.</creatorcontrib><title>Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>With treatment leading to nearly uniform cure in clinical stage I nonseminomatous testicular cancer (CSI-NSGCT), diminishing treatment-related morbidity has become the primary concern. This study examined feasibility and outcome of active surveillance as treatment in an unselected CSI patient population.
All patients with CSI-NSGCT referred from 1998 to 2007 to the British Columbia Cancer Agency and the Oregon Testis Cancer Program were retrospectively reviewed. A total of 233 patients were identified, of which 223 chose active surveillance.
Vascular invasion (VI) was absent, present and unknown in 66%, 27% and 7% of cases, respectively. Overall, 49% of patients had embryonal predominant disease. Fifty-nine patients (26%) relapsed, all but one with good prognosis disease. VI was present in 30 relapsed patients. Most patients relapsed within 2 years (88%). Only 7 of 223 patients (3%) relapsed beyond 2 years. All relapses were in long-term remission following chemotherapy with or without retroperitoneal lymph node dissection (RPLND). Only 17 of 223 patients (8%) required postorchiectomy surgery. Disease-specific survival is 100% after a median follow-up of 52 months (3–136). No patient has required second-line chemotherapy.
Active surveillance for all CSI-NSGCT patients is associated with excellent outcomes comparable with the best results reported with primary RPLND or adjuvant chemotherapy. Nearly 75% of patients are spared any therapy after orchiectomy.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy, Adjuvant - statistics & numerical data</subject><subject>Comorbidity</subject><subject>Follow-Up Studies</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Germ Cell and Embryonal - drug therapy</subject><subject>Neoplasms, Germ Cell and Embryonal - epidemiology</subject><subject>Neoplasms, Germ Cell and Embryonal - mortality</subject><subject>Neoplasms, Germ Cell and Embryonal - surgery</subject><subject>nonseminomatous testicular cancer</subject><subject>Orchiectomy - adverse effects</subject><subject>Orchiectomy - rehabilitation</subject><subject>Orchiectomy - statistics & numerical data</subject><subject>Pharmacology. Drug treatments</subject><subject>Population Surveillance - methods</subject><subject>Postoperative Complications - drug therapy</subject><subject>Postoperative Complications - epidemiology</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>stage I</subject><subject>surveillance</subject><subject>Testicular Neoplasms - drug therapy</subject><subject>Testicular Neoplasms - epidemiology</subject><subject>Testicular Neoplasms - mortality</subject><subject>Testicular Neoplasms - surgery</subject><subject>testis cancer</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxSMEokvhyBX5gji5deLETrhBBbRSBRxAQnuxJvZkd2j-LLbTsp-Ir1mvsmpPHCzL8k_vzZuXZa9zcZaLRp7DOE6jPR_crtTySbbKK9XwWpT502wlmkJyXcnyJHsRwm8hhGqK5nl2kje1rnSlVtm_r9PIPYUbDg52ER0Ls79F6nsYLbJu8mwHkXCMgd1R3LIQYYPsiiXXgAON0wBxmgOLGCLZuQfPNugHbrHvWZyHyYf3zFEiKWxp3LDoEeKQBLnHHg6OiWnJUdyzuy31yAagMaZzoLHryILdv8yeddAHfHW8T7Ofnz_9uLjk19--XF18uOZWah25VcIiqFZVIJqy0a12smjaUlYONLZ1XeVaSOfqQukClQKrpZBFmUtbduklT7N3i-7OT3_mlMkMFA5ZYMQU02gpc6HS7hLJF9L6KQSPndl5GsDvTS7MoRqzVGOWahL_5qg8twO6R_rYRQLeHgEIFvrOpwYoPHBFUctaNurRmELEvw__4G-M0lJX5vLX2qhKfV9XH4VZJ14vPKa93RJ6E2wq1KIjjzYaN9F_Rr4HJnnBQA</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Kollmannsberger, C.</creator><creator>Moore, C.</creator><creator>Chi, K.N.</creator><creator>Murray, N.</creator><creator>Daneshmand, S.</creator><creator>Gleave, M.</creator><creator>Hayes-Lattin, B.</creator><creator>Nichols, C.R.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy</title><author>Kollmannsberger, C. ; Moore, C. ; Chi, K.N. ; Murray, N. ; Daneshmand, S. ; Gleave, M. ; Hayes-Lattin, B. ; Nichols, C.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-c60cea6b65a09497b7d329b435da7eb8851703dd82672e66ac73032413c4f6ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy, Adjuvant - statistics & numerical data</topic><topic>Comorbidity</topic><topic>Follow-Up Studies</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Germ Cell and Embryonal - drug therapy</topic><topic>Neoplasms, Germ Cell and Embryonal - epidemiology</topic><topic>Neoplasms, Germ Cell and Embryonal - mortality</topic><topic>Neoplasms, Germ Cell and Embryonal - surgery</topic><topic>nonseminomatous testicular cancer</topic><topic>Orchiectomy - adverse effects</topic><topic>Orchiectomy - rehabilitation</topic><topic>Orchiectomy - statistics & numerical data</topic><topic>Pharmacology. Drug treatments</topic><topic>Population Surveillance - methods</topic><topic>Postoperative Complications - drug therapy</topic><topic>Postoperative Complications - epidemiology</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>stage I</topic><topic>surveillance</topic><topic>Testicular Neoplasms - drug therapy</topic><topic>Testicular Neoplasms - epidemiology</topic><topic>Testicular Neoplasms - mortality</topic><topic>Testicular Neoplasms - surgery</topic><topic>testis cancer</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kollmannsberger, C.</creatorcontrib><creatorcontrib>Moore, C.</creatorcontrib><creatorcontrib>Chi, K.N.</creatorcontrib><creatorcontrib>Murray, N.</creatorcontrib><creatorcontrib>Daneshmand, S.</creatorcontrib><creatorcontrib>Gleave, M.</creatorcontrib><creatorcontrib>Hayes-Lattin, B.</creatorcontrib><creatorcontrib>Nichols, C.R.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kollmannsberger, C.</au><au>Moore, C.</au><au>Chi, K.N.</au><au>Murray, N.</au><au>Daneshmand, S.</au><au>Gleave, M.</au><au>Hayes-Lattin, B.</au><au>Nichols, C.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>21</volume><issue>6</issue><spage>1296</spage><epage>1301</epage><pages>1296-1301</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>With treatment leading to nearly uniform cure in clinical stage I nonseminomatous testicular cancer (CSI-NSGCT), diminishing treatment-related morbidity has become the primary concern. This study examined feasibility and outcome of active surveillance as treatment in an unselected CSI patient population.
All patients with CSI-NSGCT referred from 1998 to 2007 to the British Columbia Cancer Agency and the Oregon Testis Cancer Program were retrospectively reviewed. A total of 233 patients were identified, of which 223 chose active surveillance.
Vascular invasion (VI) was absent, present and unknown in 66%, 27% and 7% of cases, respectively. Overall, 49% of patients had embryonal predominant disease. Fifty-nine patients (26%) relapsed, all but one with good prognosis disease. VI was present in 30 relapsed patients. Most patients relapsed within 2 years (88%). Only 7 of 223 patients (3%) relapsed beyond 2 years. All relapses were in long-term remission following chemotherapy with or without retroperitoneal lymph node dissection (RPLND). Only 17 of 223 patients (8%) required postorchiectomy surgery. Disease-specific survival is 100% after a median follow-up of 52 months (3–136). No patient has required second-line chemotherapy.
Active surveillance for all CSI-NSGCT patients is associated with excellent outcomes comparable with the best results reported with primary RPLND or adjuvant chemotherapy. Nearly 75% of patients are spared any therapy after orchiectomy.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>19875756</pmid><doi>10.1093/annonc/mdp473</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Antineoplastic agents Biological and medical sciences Chemotherapy, Adjuvant - statistics & numerical data Comorbidity Follow-Up Studies Gynecology. Andrology. Obstetrics Humans Male Male genital diseases Medical sciences Middle Aged Neoplasm Staging Neoplasms, Germ Cell and Embryonal - drug therapy Neoplasms, Germ Cell and Embryonal - epidemiology Neoplasms, Germ Cell and Embryonal - mortality Neoplasms, Germ Cell and Embryonal - surgery nonseminomatous testicular cancer Orchiectomy - adverse effects Orchiectomy - rehabilitation Orchiectomy - statistics & numerical data Pharmacology. Drug treatments Population Surveillance - methods Postoperative Complications - drug therapy Postoperative Complications - epidemiology Recurrence Retrospective Studies Risk stage I surveillance Testicular Neoplasms - drug therapy Testicular Neoplasms - epidemiology Testicular Neoplasms - mortality Testicular Neoplasms - surgery testis cancer Treatment Outcome Tumors Young Adult |
| title | Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy |
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