scholarly journals GC-03 * INTRACRANIAL NONGERMINOMATOUS GERM CELL TUMORS: TREATMENT STRATEGIES AND OUTCOMES

2015 ◽  
Vol 17 (suppl 3) ◽  
pp. iii10-iii10 ◽  
Author(s):  
B. Imber ◽  
S. Braunstein ◽  
A. Banerjee ◽  
T. Tihan ◽  
A. Bollen ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Strategies

scholarly journals Clinical interpretation of residual uptake in 11C-methionine positron emission tomography after treatment of basal ganglia germ cell tumors: report of 3 cases

2015 ◽  
Vol 16 (4) ◽  
pp. 367-371
Author(s):  
Kohei Fukuoka ◽  
Takaaki Yanagisawa ◽  
Yuko Watanabe ◽  
Tomonari Suzuki ◽  
Masao Matsutani ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
Additional Treatment ◽  
Free Survival ◽  
Posterior Limb ◽  
Met Pet

Although 11C-methionine (MET)-PET has been used to diagnose intracranial germ cell tumors (GCTs) arising in the basal ganglia, whether this imaging technique is useful in assessing treatment response and residual tumor is still unclear. The authors report 3 cases of basal ganglia GCTs in which the residual MET uptake at the end of treatment did not develop into a relapse, even without additional treatment. Case 1 is a 22-year-old man who had a second relapse of a left basal ganglia germinoma with diffuse dissemination on the walls of both of his lateral ventricles. MET-PET revealed high MET accumulation around tumors and their surroundings (maximum standardized uptake value [SUVmax] 3.3). After all treatments, MET-PET demonstrated mild tracer accumulation in both basal ganglia (SUVmax 2.2). Progression-free survival was 56 months from the second relapse without any further treatment. Case 2 is a 17-year-old boy with a left basal ganglia germinoma that showed increased MET uptake (SUVmax 4.2). After treatment, MET-PET revealed residual MET uptake (SUVmax 2.4) along the left posterior limb of the internal capsule. Progression-free survival was 52 months from the start of treatment. Case 3 is a 7-year-old boy with a left basal ganglia choriocarcinoma with increased tumor MET uptake (SUVmax 2.5). A minor enhanced mass remained on MRI after treatment with residual MET accumulation (SUVmax 1.4). Progression-free survival was 44 months. Treatment strategies based on MET uptake on PET should be carefully designed in patients with basal ganglia GCTs to avoid overtreatment and complications.

Extragonadal Germ Cell Tumors of the Mediastinum and Retroperitoneum: Results From an International Analysis

2002 ◽  
Vol 20 (7) ◽  
pp. 1864-1873 ◽  
Author(s):  
Carsten Bokemeyer ◽  
Craig R. Nichols ◽  
Jean-P. Droz ◽  
Hans-J. Schmoll ◽  
Alan Horwich ◽  
...  
Keyword(s):  
Survival Rate ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Cell Tumor ◽  
Primary Tumor Site ◽  
Primary Tumors ◽  
Platinum Based Chemotherapy

PURPOSE: To characterize the clinical and biologic features of extragonadal germ cell tumor (EGCT) and to determine the overall outcome with currently available treatment strategies.PATIENTS AND METHODS: Of an unselected population of 635 consecutive patients treated from 1975 through 1996 at 11 cancer centers, 341 patients (54%) had primary mediastinal EGCT, and 283 patients (45%) had retroperitoneal EGCT. Five hundred twenty-four patients (83%) had a nonseminomatous germ cell tumor (GCT), and 104 patients (16%) had a seminomatous histology.RESULTS: After platinum-based induction chemotherapy with or without secondary surgery, 141 patients (49%) with mediastinal nonseminomas (median follow-up, 19 months; range, 1 to 178 months) and 144 patients (63%) with retroperitoneal nonseminoma (median follow-up, 29 months; range, 1 to 203 months) are alive (P = .0006). In contrast, the overall survival rate for patients with a seminomatous EGCT is 88%, with no difference between patients with mediastinal or retroperitoneal tumor location (median follow-up, 49 months; range, 4 to 193 months; respective 70 months; range, 1 to 211 months). A significantly lower progression-free survival rate was found in seminoma patients treated with initial radiotherapy alone compared with chemotherapy. Nonseminomatous histology, presence of nonpulmonary visceral metastases, primary mediastinal GCT location, and elevated beta-human chorionic gonadotropin were independent prognostic factors for shorter survival. Hematologic malignancies (n = 17) occurred without exception in patients with primary mediastinal nonseminoma. Sixteen patients developed a metachronous testicular cancer despite the use of platinum-based chemotherapy.CONCLUSION: Whereas patients with pure seminomatous EGCT histology have a long-term chance of cure of almost 90% irrespective of the primary tumor site, 45% of patients with mediastinal nonseminomas are alive at 5 years. This outcome is clearly inferior compared with patients with nonseminomatous retroperitoneal primary tumors.

The Treatment of Early-Stage Germ Cell Tumors of the Testis (GCTT)

2012 ◽  
Vol 79 (2) ◽  
pp. 81-88
Author(s):  
Roberto Salvioni ◽  
Nicola Nicolai ◽  
Andrea Necchi ◽  
Tullio Torelli ◽  
Luigi Piva ◽  
...  
Keyword(s):  
Germ Cell ◽  
Early Stage ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Diagnostic Techniques ◽  
High Tech ◽  
Early Stage Disease ◽  
Appropriateness Of Care ◽  
Stage Disease

The treatment of tumors of the testis represents an ideal model of care for cancer. Many different, intersecting strategies are available for managing germ-cell cancers, particularly in the early-stage disease. Which is ‘right’ remains a matter of debate, and requires balancing efficacy against late effects, bearing in mind the complexity of treatment strategies and the available expertise. The cornerstone of this model of success is linked to the quality and appropriateness of care. The current therapeutic strategy is very complex (Fig. 1). High-tech surgery, medical oncology and radiotherapy are involved at various levels of diagnostic techniques of the latest generation. The choice of therapy, alone or integrated, is often influenced by prognostic factors. In this article we will examine the important points and sometimes the subject of controversy in both diagnosis and treatment of these early-stage tumors (Clinical Stage I: disease confined to the testis; Clinical Stage IIA: retroperitoneal lymph nodes <2 cm).

scholarly journals Treatment strategies and prognostic factors of patients with primary germ cell tumors in the mediastinum

2011 ◽  
Vol 137 (11) ◽  
pp. 1607-1612 ◽  
Author(s):  
Ting Zhi Liu ◽  
Dong Sheng Zhang ◽  
Ying Liang ◽  
Ning Ning Zhou ◽  
Hong Fei Gao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Strategies

Pathobiological Basis of Treatment Strategies of Germ Cell Tumors

2006 ◽  
pp. 252-271
Author(s):  
J. Wolter Oosterhuis ◽  
Friedemann Honecker ◽  
Frank Mayer ◽  
Carsten Bokemeyer ◽  
L. H. J. Looijenga
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Strategies

Improved outcomes in testicular germ cell tumor patients treated at the referral center in Slovakia in the last decade.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16059-e16059
Author(s):  
Michal Chovanec ◽  
Katarina Rejlekova ◽  
Zuzana Sycova-Mila ◽  
Jana Obertova ◽  
Patrik Palacka ◽  
...  
Keyword(s):  
Germ Cell ◽  
National Cancer Institute ◽  
Cell Cancer ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Collaborative Group ◽  
Rank Test ◽  
Poor Risk ◽  
Before And After ◽  
Group 2

e16059 Background: Treatment at expert centers results in superior survival in patients with germ cell tumors (GCTs). This study evaluated outcomes in patients treated at National Cancer Institute in Slovakia before and after the year 2008 after refining the treatment strategies. Methods: Our institutional database was searched for GCT patients treated at National Cancer Institute in Slovakia between 1992 and 2016. A year of 2008 was selected for cutoff to compare changes in outcomes before and after this time-point due to refining treatment strategies such as centralization of post-chemotherapy surgery and incorporation of granulocyte-colony stimulating factor (G-CSF) for routine prophylaxis of febrile neutropenia. Kaplan-Meier product limit and log-rank test were used for statistical analysis. Results: This retrospective study included 485 patients treated for metastatic GCT. Two hundred and sixty-three patients (54%) were treated before 2008 (group 1) and 222 patients (46%) were treated after 2008, including (group 2). Progression-free survival (PFS) and overall survival (OS) was significantly improved in group 2 vs 1 (HR = 0.63, 95% CI 0.46-0.87; P= 0.0039 for PFS and HR = 0.44, 95% CI 0.30-0.65; P = 0.0003 for OS, respectively). In a subgroup analysis of International Germ Cell Cancer Collaborative Group criteria, favorable change in survival was observed in good-risk GCTs (HR = 0.40, 95% CI 0.24-0.67; P = 0.0009 for PFS, and HR = 0.20, 95% CI 0.10-0.38; P = 0.0002 for OS), but nor in intermediate or poor risk group. Conclusions: Treatment outcomes of GCTs have significantly improved in the last decade at our institution. We hypothesize that changes in treatment approach contributed to this improvement including centralization of post-chemotherapy retroperitoneal lymph-node dissections and routine use of granulocyte-colony stimulating factors that have been implemented in 2007. Referral bias for extremely poor risk patients in recent years may be an accounting factor for lack of improvement in this subgroup.

Recent advances in molecular biology and treatment strategies for intracranial germ cell tumors

2016 ◽  
Vol 12 (3) ◽  
pp. 275-282 ◽  
Author(s):  
Xiang Huang ◽  
Rong Zhang ◽  
Ying Mao ◽  
Liang-Fu Zhou ◽  
Chao Zhang
Keyword(s):  
Molecular Biology ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Recent Advances ◽  
Intracranial Germ Cell Tumors

Serum Tumor Marker Half-Life during Chemotherapy in Patients with Germ Cell Tumors

1994 ◽  
Vol 9 (1) ◽  
pp. 25-28 ◽  
Author(s):  
G.J. Bosl ◽  
M.D. Head
Keyword(s):  
Germ Cell ◽  
Half Life ◽  
Germ Cell Tumors ◽  
Treatment Strategies ◽  
Predictor Variable ◽  
Serum Levels ◽  
Poor Risk ◽  
Risk Patients ◽  
Pre Treatment ◽  
Rate Of Decline

Approximately 80% of previously untreated men with metastatic germ cell tumors will be cured with cisplatin-based chemotherapy. Serum levels of alpha fetoprotein (AFP) or human chorionic gonadotropin (HCG) or both are increased in most of these patients. Pre-treatment clinical characteristics can be used to distinguish between “good” and “poor” risk patients who are either highly likely or unlikely to achieve a complete remission, respectively. A slow rate of decline of either AFP or HCG or both has been associated with an inferior survival in both good and poor risk patients. In multivariate analysis, the pre-treatment risk status and the post-treatment clearance of markers were independent and equal prognostic variables. Similarly, in patients receiving cisplatin + ifosfamide-based salvage chemotherapy, the rate of decline of HCG was an independent predictor variable in addition to the primary site and pre-treatment HCG levels for both overall and event-free survival. Prolonged half-life clearance of serum tumor markers is an important prognostic variable in both previously untreated as well as previously treated germ cel tumor patients. Treatment strategies can be based on marker clearance and prospective clinical trials are warranted.

Sign in / Sign up

Export Citation Format

Share Document