PURPOSE: To retrospectively analyze clinical characteristics, prognostic factors, and optimal treatment of patients with bone metastases (BM) of germ cell tumors (GCT) at first relapse. METHODS: One hundred and four GCT patients with BM were identified from the IPFSG database containing 1,594 patients at first relapse. Within this database, all patients experienced unequivocal relapse/progression after cisplatin-based chemotherapy and had received either conventional (CD-CTX) or high-dose chemotherapy (HD-CTX) as first salvage treatment. RESULTS: At relapse, eight patients (8 %) had BM only, concomitant relapse with lung, brain, liver and/or nodal metastases were present in 40 (39 %), 6 (6 %), 27 (26 %), and 69 (66 %) pts, respectively. Patients clustered over all IPFSG subgroups, and the IPFSG score could be confirmed. Salvage treatment was CD-CTX in 35 and HD-CTX in 69 patients. Overall response (CR, PR) rate to salvage chemotherapy was 81 % (HD-CTX) versus 43 % (CD-CTX; p < 0.001). Median follow-up was 14 months (mos; range 1-161). Both, median PFS and OS, were higher after HD-CTX compared to CD-CTX [PFS 9 (95 % CI 6-12) vs. 5 (3-7) mos (p < 0.01); OS 18 (12-24) vs. 13 (8-18) mos (p = 0.078)]. CONCLUSIONS: GCT patients relapsing with BM have a dismal outcome. Retrospectively, first salvage HD-CTX seems to improve treatment response and outcome. Further evaluation of characteristics and treatment of GCT patients with BM is warranted.
PURPOSE: To retrospectively analyze clinical characteristics, prognostic factors, and optimal treatment of patients with bone metastases (BM) of germ cell tumors (GCT) at first relapse. METHODS: One hundred and four GCT patients with BM were identified from the IPFSG database containing 1,594 patients at first relapse. Within this database, all patients experienced unequivocal relapse/progression after cisplatin-based chemotherapy and had received either conventional (CD-CTX) or high-dose chemotherapy (HD-CTX) as first salvage treatment. RESULTS: At relapse, eight patients (8 %) had BM only, concomitant relapse with lung, brain, liver and/or nodal metastases were present in 40 (39 %), 6 (6 %), 27 (26 %), and 69 (66 %) pts, respectively. Patients clustered over all IPFSG subgroups, and the IPFSG score could be confirmed. Salvage treatment was CD-CTX in 35 and HD-CTX in 69 patients. Overall response (CR, PR) rate to salvage chemotherapy was 81 % (HD-CTX) versus 43 % (CD-CTX; p < 0.001). Median follow-up was 14 months (mos; range 1-161). Both, median PFS and OS, were higher after HD-CTX compared to CD-CTX [PFS 9 (95 % CI 6-12) vs. 5 (3-7) mos (p < 0.01); OS 18 (12-24) vs. 13 (8-18) mos (p = 0.078)]. CONCLUSIONS: GCT patients relapsing with BM have a dismal outcome. Retrospectively, first salvage HD-CTX seems to improve treatment response and outcome. Further evaluation of characteristics and treatment of GCT patients with BM is warranted.
Authors: J-L Pico; G Rosti; A Kramar; H Wandt; V Koza; R Salvioni; C Theodore; G Lelli; W Siegert; A Horwich; M Marangolo; W Linkesch; G Pizzocaro; H-J Schmoll; J Bouzy; J-P Droz; P Biron Journal: Ann Oncol Date: 2005-05-31 Impact factor: 32.976
Authors: Karin Oechsle; Carsten Bokemeyer; Christian Kollmannsberger; Frank Mayer; Lars Arne Berger; Christoph Oing; Friedemann Honecker Journal: J Cancer Res Clin Oncol Date: 2012-02-21 Impact factor: 4.553
Authors: K Fizazi; G Gravis; A Flechon; L Geoffrois; C Chevreau; B Laguerre; R Delva; J C Eymard; F Rolland; N Houede; A Laplanche; D Burcoveanu; S Culine Journal: Ann Oncol Date: 2014-03-04 Impact factor: 32.976
Authors: Susanne Krege; Jörg Beyer; Rainer Souchon; Peter Albers; Walter Albrecht; Ferran Algaba; Michael Bamberg; István Bodrogi; Carsten Bokemeyer; Eva Cavallin-Ståhl; Johannes Classen; Christoph Clemm; Gabriella Cohn-Cedermark; Stéphane Culine; Gedske Daugaard; Pieter H M De Mulder; Maria De Santis; Maike de Wit; Ronald de Wit; Hans Günter Derigs; Klaus-Peter Dieckmann; Annette Dieing; Jean-Pierre Droz; Martin Fenner; Karim Fizazi; Aude Flechon; Sophie D Fosså; Xavier Garcia del Muro; Thomas Gauler; Lajos Geczi; Arthur Gerl; Jose Ramon Germa-Lluch; Silke Gillessen; Jörg T Hartmann; Michael Hartmann; Axel Heidenreich; Wolfgang Hoeltl; Alan Horwich; Robert Huddart; Michael Jewett; Johnathan Joffe; William G Jones; László Kisbenedek; Olbjørn Klepp; Sabine Kliesch; Kai Uwe Koehrmann; Christian Kollmannsberger; Markus Kuczyk; Pilar Laguna; Oscar Leiva Galvis; Volker Loy; Malcolm D Mason; Graham M Mead; Rolf Mueller; Craig Nichols; Nicola Nicolai; Tim Oliver; Dalibor Ondrus; Gosse O N Oosterhof; Luis Paz-Ares; Giorgio Pizzocaro; Jörg Pont; Tobias Pottek; Tom Powles; Oliver Rick; Giovanni Rosti; Roberto Salvioni; Jutta Scheiderbauer; Hans-Ulrich Schmelz; Heinz Schmidberger; Hans-Joachim Schmoll; Mark Schrader; Felix Sedlmayer; Niels E Skakkebaek; Aslam Sohaib; Sergei Tjulandin; Padraig Warde; Stefan Weinknecht; Lothar Weissbach; Christian Wittekind; Eva Winter; Lori Wood; Hans von der Maase Journal: Eur Urol Date: 2007-12-26 Impact factor: 20.096