Outcomes of active surveillance of clinical stage I non-seminomatous germ cell tumors

Sub-analysis of the multi-institutional nationwide case series of the Japanese Urological Association

the Cancer Registration Committee of the Japanese Urological Association

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the survival rate and risk factors of distant metastasis in stage I nonseminomatous germ cell tumor (NSGCT) cases without adjuvant treatments. Methods: A national testicular cancer survey of cases newly diagnosed in 2005 and 2008 was conducted by the Japanese Urological Association in 2011. In 159 stage I NSGCT cases, 132 were followed by active surveillance after high orchiectomy. Their recurrence-free survival rate (RFS) was compared with 27 cases that received adjuvant treatments, and clinical and pathological parameters were explored to identify significant risk factors of recurrence. Results: Within a median follow-up period of 30.3 months (range: 0.3-65.6 months), 16 (12.1%) of the 132 surveillance cases relapsed at 2.8-51.2 months after high orchiectomy (median: 8.35 months). The 2-year RFS rate was 90%. Eleven (68.8%) cases relapsed within 1 year, and five (31.3%) cases relapsed in 3 years or more. Half (50%) of the recurrences were detected by imaging studies alone, 37.5% by imaging combined with tumor markers, and 12.5% by tumor marker elevation alone. The only significant risk factor of recurrence was the existence of embryonal carcinoma elements in the primary testicular tumor (P = 0.0068). There was no significant difference in RFS between cases with active surveillance and adjuvant treatments. Conclusions: The present report is the first large scale study of clinical stage I NSGCTs in Japan. Active surveillance appears to be an effective treatment option for patients with clinical stage I NSGCTs.

Original languageEnglish
Pages (from-to)565-569
Number of pages5
JournalJapanese journal of clinical oncology
Volume48
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

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Recurrence
Orchiectomy
Survival Rate
Testicular Neoplasms
Tumor Biomarkers
Embryonal Carcinoma
Therapeutics
Nonseminomatous germ cell tumor
Japan
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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Outcomes of active surveillance of clinical stage I non-seminomatous germ cell tumors : Sub-analysis of the multi-institutional nationwide case series of the Japanese Urological Association. / the Cancer Registration Committee of the Japanese Urological Association.

In: Japanese journal of clinical oncology, Vol. 48, No. 6, 01.06.2018, p. 565-569.

Research output: Contribution to journalArticle

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title = "Outcomes of active surveillance of clinical stage I non-seminomatous germ cell tumors: Sub-analysis of the multi-institutional nationwide case series of the Japanese Urological Association",
abstract = "Objective: To evaluate the survival rate and risk factors of distant metastasis in stage I nonseminomatous germ cell tumor (NSGCT) cases without adjuvant treatments. Methods: A national testicular cancer survey of cases newly diagnosed in 2005 and 2008 was conducted by the Japanese Urological Association in 2011. In 159 stage I NSGCT cases, 132 were followed by active surveillance after high orchiectomy. Their recurrence-free survival rate (RFS) was compared with 27 cases that received adjuvant treatments, and clinical and pathological parameters were explored to identify significant risk factors of recurrence. Results: Within a median follow-up period of 30.3 months (range: 0.3-65.6 months), 16 (12.1{\%}) of the 132 surveillance cases relapsed at 2.8-51.2 months after high orchiectomy (median: 8.35 months). The 2-year RFS rate was 90{\%}. Eleven (68.8{\%}) cases relapsed within 1 year, and five (31.3{\%}) cases relapsed in 3 years or more. Half (50{\%}) of the recurrences were detected by imaging studies alone, 37.5{\%} by imaging combined with tumor markers, and 12.5{\%} by tumor marker elevation alone. The only significant risk factor of recurrence was the existence of embryonal carcinoma elements in the primary testicular tumor (P = 0.0068). There was no significant difference in RFS between cases with active surveillance and adjuvant treatments. Conclusions: The present report is the first large scale study of clinical stage I NSGCTs in Japan. Active surveillance appears to be an effective treatment option for patients with clinical stage I NSGCTs.",
author = "{the Cancer Registration Committee of the Japanese Urological Association} and Yasuo Shinoda and Yoshiyuki Matsui and Hiroyuki Fujimoto and Chikara Ohyama and Hiroomi Kanayama and Tsuneharu Miki and Hiroyuki Nishiyama and Kazuhiro Suzuki and Masatoshi Eto and Masatoshi Eto and Tomoharu Fukumori and Seiji Naito",
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T1 - Outcomes of active surveillance of clinical stage I non-seminomatous germ cell tumors

T2 - Sub-analysis of the multi-institutional nationwide case series of the Japanese Urological Association

AU - the Cancer Registration Committee of the Japanese Urological Association

AU - Shinoda, Yasuo

AU - Matsui, Yoshiyuki

AU - Fujimoto, Hiroyuki

AU - Ohyama, Chikara

AU - Kanayama, Hiroomi

AU - Miki, Tsuneharu

AU - Nishiyama, Hiroyuki

AU - Suzuki, Kazuhiro

AU - Eto, Masatoshi

AU - Eto, Masatoshi

AU - Fukumori, Tomoharu

AU - Naito, Seiji

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N2 - Objective: To evaluate the survival rate and risk factors of distant metastasis in stage I nonseminomatous germ cell tumor (NSGCT) cases without adjuvant treatments. Methods: A national testicular cancer survey of cases newly diagnosed in 2005 and 2008 was conducted by the Japanese Urological Association in 2011. In 159 stage I NSGCT cases, 132 were followed by active surveillance after high orchiectomy. Their recurrence-free survival rate (RFS) was compared with 27 cases that received adjuvant treatments, and clinical and pathological parameters were explored to identify significant risk factors of recurrence. Results: Within a median follow-up period of 30.3 months (range: 0.3-65.6 months), 16 (12.1%) of the 132 surveillance cases relapsed at 2.8-51.2 months after high orchiectomy (median: 8.35 months). The 2-year RFS rate was 90%. Eleven (68.8%) cases relapsed within 1 year, and five (31.3%) cases relapsed in 3 years or more. Half (50%) of the recurrences were detected by imaging studies alone, 37.5% by imaging combined with tumor markers, and 12.5% by tumor marker elevation alone. The only significant risk factor of recurrence was the existence of embryonal carcinoma elements in the primary testicular tumor (P = 0.0068). There was no significant difference in RFS between cases with active surveillance and adjuvant treatments. Conclusions: The present report is the first large scale study of clinical stage I NSGCTs in Japan. Active surveillance appears to be an effective treatment option for patients with clinical stage I NSGCTs.

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