RESULT OF TREATMENT FOR ADVANCED GERM CELL TUMOR IN THE LAST DECADE
(Purpose) We retrospectively analyzed our therapeutic results of advanced male germ cell tumors in terms of efficacy and feasibility of our treatment strategy. (Patients and methods) Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged fro...
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| creator | Ishioka, Jun-Ichiro Kageyama, Yukio Inoue, Masaharu Fukui, Naotaka Numao, Noboru Saito, Kazutaka Ichiyanagi, Nobutaka Tanaka, Masaki Hyochi, Nobuhiko Fukuda, Hiroshi Higashi, Yotsuo |
| description | (Purpose) We retrospectively analyzed our therapeutic results of advanced male germ cell tumors in terms of efficacy and feasibility of our treatment strategy. (Patients and methods) Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged from 16 to 58 (median 33). Primary site of the tumor was testis in 41 (80%) patients, retroperitneum in 6 (12%), and mediastinum in 4 (8%). Histology of the primary germ cell tumor was pure seminoma in 14 (27%), and non-seminoma in 30 (59%). Twenty (39%), 14 (27%) and 17 (33%) were classified as good-, intermediate-, and poor-risk, retrospectively, based on The International Germ Cell Consensus Classification (IGCCC) criteria. The initial treatment for good-risk patients was BEP×3. Intermediate- or poor-risk patients were treated by VIP from 1997 to 2000, VIPVB from 2001 to 2004, and BEP from 2005 to 2007. Second line salvage treatments were high-dose VIP or ICE from 1997 to 2000. TIP×4 has been employed since. Marker-negative cases with residual tumors underwent surgical resection of the mass lesion. (Results) Five-year survival rate was 100%, 74%, and 76% in patients with good-, intermediate- and poor-risk characteristics, respectively. After two courses of initial chemotherapy, tumor marker decline was satisfactory in 37 patients (73%) and unsatisfactory in 14 (27%). Of these 14 patients, 12 (86%) had unsatisfactory hCG decline, 4 (29%) had unsatisfactory AFP decline, and 2 (14%) had unsatisfactory decline in both markers. Five-year overall survival was 94% in cases with satisfactory maker decline and 71% in those with unsatisfactory marker decline (p=0.03). (Conclusions) In this IGCCCG era, 5 year survival rates of the advanced germ cell tumors have improved by the earlier administration of second line chemotherapies based on both the prognostic factor-based staging system and the tumor marker decline in initial chemotherapy. Development of effective treatment for cases with unfavorable tumor maker decline is the most challenging issue to be addressed. |
| doi_str_mv | 10.5980/jpnjurol.101.539 |
| format | Article |
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(Patients and methods) Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged from 16 to 58 (median 33). Primary site of the tumor was testis in 41 (80%) patients, retroperitneum in 6 (12%), and mediastinum in 4 (8%). Histology of the primary germ cell tumor was pure seminoma in 14 (27%), and non-seminoma in 30 (59%). Twenty (39%), 14 (27%) and 17 (33%) were classified as good-, intermediate-, and poor-risk, retrospectively, based on The International Germ Cell Consensus Classification (IGCCC) criteria. The initial treatment for good-risk patients was BEP×3. Intermediate- or poor-risk patients were treated by VIP from 1997 to 2000, VIPVB from 2001 to 2004, and BEP from 2005 to 2007. Second line salvage treatments were high-dose VIP or ICE from 1997 to 2000. TIP×4 has been employed since. Marker-negative cases with residual tumors underwent surgical resection of the mass lesion. (Results) Five-year survival rate was 100%, 74%, and 76% in patients with good-, intermediate- and poor-risk characteristics, respectively. After two courses of initial chemotherapy, tumor marker decline was satisfactory in 37 patients (73%) and unsatisfactory in 14 (27%). Of these 14 patients, 12 (86%) had unsatisfactory hCG decline, 4 (29%) had unsatisfactory AFP decline, and 2 (14%) had unsatisfactory decline in both markers. Five-year overall survival was 94% in cases with satisfactory maker decline and 71% in those with unsatisfactory marker decline (p=0.03). (Conclusions) In this IGCCCG era, 5 year survival rates of the advanced germ cell tumors have improved by the earlier administration of second line chemotherapies based on both the prognostic factor-based staging system and the tumor marker decline in initial chemotherapy. Development of effective treatment for cases with unfavorable tumor maker decline is the most challenging issue to be addressed.</description><identifier>ISSN: 0021-5287</identifier><identifier>EISSN: 1884-7110</identifier><identifier>DOI: 10.5980/jpnjurol.101.539</identifier><identifier>PMID: 20387513</identifier><language>jpn</language><publisher>Japan: THE JAPANESE UROLOGICAL ASSOCIATION</publisher><subject>Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - classification ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biomarkers, Tumor ; Bleomycin - administration & dosage ; Cisplatin - administration & dosage ; Etoposide - administration & dosage ; Female ; Germ cell tumor ; Humans ; Ifosfamide - administration & dosage ; International Germ Cell Consensus Classification ; Male ; Mediastinal Neoplasms - classification ; Mediastinal Neoplasms - diagnosis ; Mediastinal Neoplasms - drug therapy ; Middle Aged ; Neoplasms, Germ Cell and Embryonal - classification ; Neoplasms, Germ Cell and Embryonal - diagnosis ; Neoplasms, Germ Cell and Embryonal - drug therapy ; Prognosis ; Retroperitoneal Neoplasms - classification ; Retroperitoneal Neoplasms - diagnosis ; Retroperitoneal Neoplasms - drug therapy ; Retrospective Studies ; Salvage Therapy ; Testicular Neoplasms - classification ; Testicular Neoplasms - diagnosis ; Testicular Neoplasms - drug therapy ; tumor marker ; Young Adult</subject><ispartof>The Japanese Journal of Urology, 2010, Vol.101(3), pp.539-546</ispartof><rights>2010 Japanese Urological Association</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c229t-45b923e3d27e7bfa8938cffa3c6bd64f79bcd538e3e329c1af9b706a8734cdcb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,1879,4012,27906,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20387513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishioka, Jun-Ichiro</creatorcontrib><creatorcontrib>Kageyama, Yukio</creatorcontrib><creatorcontrib>Inoue, Masaharu</creatorcontrib><creatorcontrib>Fukui, Naotaka</creatorcontrib><creatorcontrib>Numao, Noboru</creatorcontrib><creatorcontrib>Saito, Kazutaka</creatorcontrib><creatorcontrib>Ichiyanagi, Nobutaka</creatorcontrib><creatorcontrib>Tanaka, Masaki</creatorcontrib><creatorcontrib>Hyochi, Nobuhiko</creatorcontrib><creatorcontrib>Fukuda, Hiroshi</creatorcontrib><creatorcontrib>Higashi, Yotsuo</creatorcontrib><title>RESULT OF TREATMENT FOR ADVANCED GERM CELL TUMOR IN THE LAST DECADE</title><title>Nippon Hinyokika Gakkai zasshi</title><addtitle>Jpn. j. urol</addtitle><description>(Purpose) We retrospectively analyzed our therapeutic results of advanced male germ cell tumors in terms of efficacy and feasibility of our treatment strategy. (Patients and methods) Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged from 16 to 58 (median 33). Primary site of the tumor was testis in 41 (80%) patients, retroperitneum in 6 (12%), and mediastinum in 4 (8%). Histology of the primary germ cell tumor was pure seminoma in 14 (27%), and non-seminoma in 30 (59%). Twenty (39%), 14 (27%) and 17 (33%) were classified as good-, intermediate-, and poor-risk, retrospectively, based on The International Germ Cell Consensus Classification (IGCCC) criteria. The initial treatment for good-risk patients was BEP×3. Intermediate- or poor-risk patients were treated by VIP from 1997 to 2000, VIPVB from 2001 to 2004, and BEP from 2005 to 2007. Second line salvage treatments were high-dose VIP or ICE from 1997 to 2000. TIP×4 has been employed since. Marker-negative cases with residual tumors underwent surgical resection of the mass lesion. (Results) Five-year survival rate was 100%, 74%, and 76% in patients with good-, intermediate- and poor-risk characteristics, respectively. After two courses of initial chemotherapy, tumor marker decline was satisfactory in 37 patients (73%) and unsatisfactory in 14 (27%). Of these 14 patients, 12 (86%) had unsatisfactory hCG decline, 4 (29%) had unsatisfactory AFP decline, and 2 (14%) had unsatisfactory decline in both markers. Five-year overall survival was 94% in cases with satisfactory maker decline and 71% in those with unsatisfactory marker decline (p=0.03). (Conclusions) In this IGCCCG era, 5 year survival rates of the advanced germ cell tumors have improved by the earlier administration of second line chemotherapies based on both the prognostic factor-based staging system and the tumor marker decline in initial chemotherapy. Development of effective treatment for cases with unfavorable tumor maker decline is the most challenging issue to be addressed.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - classification</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biomarkers, Tumor</subject><subject>Bleomycin - administration & dosage</subject><subject>Cisplatin - administration & dosage</subject><subject>Etoposide - administration & dosage</subject><subject>Female</subject><subject>Germ cell tumor</subject><subject>Humans</subject><subject>Ifosfamide - administration & dosage</subject><subject>International Germ Cell Consensus Classification</subject><subject>Male</subject><subject>Mediastinal Neoplasms - classification</subject><subject>Mediastinal Neoplasms - diagnosis</subject><subject>Mediastinal Neoplasms - drug therapy</subject><subject>Middle Aged</subject><subject>Neoplasms, Germ Cell and Embryonal - classification</subject><subject>Neoplasms, Germ Cell and Embryonal - diagnosis</subject><subject>Neoplasms, Germ Cell and Embryonal - drug therapy</subject><subject>Prognosis</subject><subject>Retroperitoneal Neoplasms - classification</subject><subject>Retroperitoneal Neoplasms - diagnosis</subject><subject>Retroperitoneal Neoplasms - drug therapy</subject><subject>Retrospective Studies</subject><subject>Salvage Therapy</subject><subject>Testicular Neoplasms - classification</subject><subject>Testicular Neoplasms - diagnosis</subject><subject>Testicular Neoplasms - drug therapy</subject><subject>tumor marker</subject><subject>Young Adult</subject><issn>0021-5287</issn><issn>1884-7110</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkD1vwjAQhq2qVYsoe6fKW6dQ25fEzhgF8yEFkCB0jRzHaYMCoTEM_fd1xYfU5U66e95neBF6oWQYRIK8bw_77alrmyEldBhAdId6VAjf45SSe9QjhFEvYII_oYG1dUGAcsEEwCN6YgQEDyj0ULKS602a4eUYZysZZ3O5yPB4ucLx6CNeJHKEJ3I1x4lMU5xt5u4xW-BsKnEarzM8kkk8ks_ooVKNNYPL7qPNWGbJ1EuXk1kSp55mLDp6flBEDAyUjBteVEpEIHRVKdBhUYZ-xaNClwEI4xgWaaqqqOAkVIKDr0tdQB-9nb2Hrv0-GXvMd7XVpmnU3rQnm3MASjkLhSPJmdRda21nqvzQ1TvV_eSU5H_l5dfy3IHmrjwXeb3IT8XOlLfAtSoHjM_A1h7Vp7kBqjvWujH_jXCZznwD9JfqcrOHXzMjf9I</recordid><startdate>2010</startdate><enddate>2010</enddate><creator>Ishioka, Jun-Ichiro</creator><creator>Kageyama, Yukio</creator><creator>Inoue, Masaharu</creator><creator>Fukui, Naotaka</creator><creator>Numao, Noboru</creator><creator>Saito, Kazutaka</creator><creator>Ichiyanagi, Nobutaka</creator><creator>Tanaka, Masaki</creator><creator>Hyochi, Nobuhiko</creator><creator>Fukuda, Hiroshi</creator><creator>Higashi, Yotsuo</creator><general>THE JAPANESE UROLOGICAL ASSOCIATION</general><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>2010</creationdate><title>RESULT OF TREATMENT FOR ADVANCED GERM CELL TUMOR IN THE LAST DECADE</title><author>Ishioka, Jun-Ichiro ; Kageyama, Yukio ; Inoue, Masaharu ; Fukui, Naotaka ; Numao, Noboru ; Saito, Kazutaka ; Ichiyanagi, Nobutaka ; Tanaka, Masaki ; Hyochi, Nobuhiko ; Fukuda, Hiroshi ; Higashi, Yotsuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c229t-45b923e3d27e7bfa8938cffa3c6bd64f79bcd538e3e329c1af9b706a8734cdcb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>jpn</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - classification</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biomarkers, Tumor</topic><topic>Bleomycin - administration & dosage</topic><topic>Cisplatin - administration & dosage</topic><topic>Etoposide - administration & dosage</topic><topic>Female</topic><topic>Germ cell tumor</topic><topic>Humans</topic><topic>Ifosfamide - administration & dosage</topic><topic>International Germ Cell Consensus Classification</topic><topic>Male</topic><topic>Mediastinal Neoplasms - classification</topic><topic>Mediastinal Neoplasms - diagnosis</topic><topic>Mediastinal Neoplasms - drug therapy</topic><topic>Middle Aged</topic><topic>Neoplasms, Germ Cell and Embryonal - classification</topic><topic>Neoplasms, Germ Cell and Embryonal - diagnosis</topic><topic>Neoplasms, Germ Cell and Embryonal - drug therapy</topic><topic>Prognosis</topic><topic>Retroperitoneal Neoplasms - classification</topic><topic>Retroperitoneal Neoplasms - diagnosis</topic><topic>Retroperitoneal Neoplasms - drug therapy</topic><topic>Retrospective Studies</topic><topic>Salvage Therapy</topic><topic>Testicular Neoplasms - classification</topic><topic>Testicular Neoplasms - diagnosis</topic><topic>Testicular Neoplasms - drug therapy</topic><topic>tumor marker</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Ishioka, Jun-Ichiro</creatorcontrib><creatorcontrib>Kageyama, Yukio</creatorcontrib><creatorcontrib>Inoue, Masaharu</creatorcontrib><creatorcontrib>Fukui, Naotaka</creatorcontrib><creatorcontrib>Numao, Noboru</creatorcontrib><creatorcontrib>Saito, Kazutaka</creatorcontrib><creatorcontrib>Ichiyanagi, Nobutaka</creatorcontrib><creatorcontrib>Tanaka, Masaki</creatorcontrib><creatorcontrib>Hyochi, Nobuhiko</creatorcontrib><creatorcontrib>Fukuda, Hiroshi</creatorcontrib><creatorcontrib>Higashi, Yotsuo</creatorcontrib><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>Nippon Hinyokika Gakkai zasshi</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishioka, Jun-Ichiro</au><au>Kageyama, Yukio</au><au>Inoue, Masaharu</au><au>Fukui, Naotaka</au><au>Numao, Noboru</au><au>Saito, Kazutaka</au><au>Ichiyanagi, Nobutaka</au><au>Tanaka, Masaki</au><au>Hyochi, Nobuhiko</au><au>Fukuda, Hiroshi</au><au>Higashi, Yotsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>RESULT OF TREATMENT FOR ADVANCED GERM CELL TUMOR IN THE LAST DECADE</atitle><jtitle>Nippon Hinyokika Gakkai zasshi</jtitle><addtitle>Jpn. j. urol</addtitle><date>2010</date><risdate>2010</risdate><volume>101</volume><issue>3</issue><spage>539</spage><epage>546</epage><pages>539-546</pages><issn>0021-5287</issn><eissn>1884-7110</eissn><abstract>(Purpose) We retrospectively analyzed our therapeutic results of advanced male germ cell tumors in terms of efficacy and feasibility of our treatment strategy. (Patients and methods) Fifty-one new cases were treated in Saitama Cancer Center between April 1997 and August 2007. Patients age ranged from 16 to 58 (median 33). Primary site of the tumor was testis in 41 (80%) patients, retroperitneum in 6 (12%), and mediastinum in 4 (8%). Histology of the primary germ cell tumor was pure seminoma in 14 (27%), and non-seminoma in 30 (59%). Twenty (39%), 14 (27%) and 17 (33%) were classified as good-, intermediate-, and poor-risk, retrospectively, based on The International Germ Cell Consensus Classification (IGCCC) criteria. The initial treatment for good-risk patients was BEP×3. Intermediate- or poor-risk patients were treated by VIP from 1997 to 2000, VIPVB from 2001 to 2004, and BEP from 2005 to 2007. Second line salvage treatments were high-dose VIP or ICE from 1997 to 2000. TIP×4 has been employed since. Marker-negative cases with residual tumors underwent surgical resection of the mass lesion. (Results) Five-year survival rate was 100%, 74%, and 76% in patients with good-, intermediate- and poor-risk characteristics, respectively. After two courses of initial chemotherapy, tumor marker decline was satisfactory in 37 patients (73%) and unsatisfactory in 14 (27%). Of these 14 patients, 12 (86%) had unsatisfactory hCG decline, 4 (29%) had unsatisfactory AFP decline, and 2 (14%) had unsatisfactory decline in both markers. Five-year overall survival was 94% in cases with satisfactory maker decline and 71% in those with unsatisfactory marker decline (p=0.03). (Conclusions) In this IGCCCG era, 5 year survival rates of the advanced germ cell tumors have improved by the earlier administration of second line chemotherapies based on both the prognostic factor-based staging system and the tumor marker decline in initial chemotherapy. Development of effective treatment for cases with unfavorable tumor maker decline is the most challenging issue to be addressed.</abstract><cop>Japan</cop><pub>THE JAPANESE UROLOGICAL ASSOCIATION</pub><pmid>20387513</pmid><doi>10.5980/jpnjurol.101.539</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - classification Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor Bleomycin - administration & dosage Cisplatin - administration & dosage Etoposide - administration & dosage Female Germ cell tumor Humans Ifosfamide - administration & dosage International Germ Cell Consensus Classification Male Mediastinal Neoplasms - classification Mediastinal Neoplasms - diagnosis Mediastinal Neoplasms - drug therapy Middle Aged Neoplasms, Germ Cell and Embryonal - classification Neoplasms, Germ Cell and Embryonal - diagnosis Neoplasms, Germ Cell and Embryonal - drug therapy Prognosis Retroperitoneal Neoplasms - classification Retroperitoneal Neoplasms - diagnosis Retroperitoneal Neoplasms - drug therapy Retrospective Studies Salvage Therapy Testicular Neoplasms - classification Testicular Neoplasms - diagnosis Testicular Neoplasms - drug therapy tumor marker Young Adult |
| title | RESULT OF TREATMENT FOR ADVANCED GERM CELL TUMOR IN THE LAST DECADE |
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