Department of Urology, N.N. Alexandrov National Cancer Centre, Minsk, Belarus.
Department of Chemotherapy, N.N. Alexandrov National Cancer Centre, Minsk, Belarus.
JCO Glob Oncol. 2021 Jan;7:63-71. doi: 10.1200/GO.20.00473.
Since the development of the International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification in a 1997 study, high-income countries have reported a significant increase in survival for poor prognosis patients. There are scant data on IGCCCG risk-stratified survival from low- and middle-income countries. We assessed the progression-free survival (PFS) and overall survival (OS) rates in a contemporary cohort of Belarusian patients with advanced germ cell cancer (GCC) stratified by the IGCCCG prognostic classification and analyzed prognostic factors for survival.
The consecutive cohort of patients with clinical stage IIb-III testicular GCC or extragonadal germ cell tumors who received treatment or consultation in our two centers between 2010 and 2015 was included. All patients underwent primary chemotherapy. The patients were divided into seminoma and nonseminomatous germ cell carcinoma (NSGCC) subgroups. The Kaplan-Meier method was used to estimate 5-year PFS and OS.
This study included 111 patients with a median age of 32 years, 95% of whom were diagnosed with testicular cancer. Seminoma and NSGCC were identified in 32 (29%) and 79 (71%) patients, respectively. The median follow-up was 6.1 years. The 5-year PFS and OS rates for the entire cohort were 70% and 77%, respectively. In patients with good prognosis seminoma and good, intermediate, and poor prognosis NSGCC, the estimated PFS rates were 76%, 88%, 74%, and 39% and those for OS were 83%, 97%, 83%, and 38%, respectively.
In our cohort of Belarusian patients with advanced germ cell tumors, we failed to demonstrate an improvement in PFS and OS compared with the 1997 IGCCCG study. Moreover, survival in poor prognosis group is inferior to that in IGCCCG and all contemporary series from high-income countries.
自 1997 年国际生殖细胞癌协作组（IGCCCG）风险分类发展以来，高收入国家报告称预后不良患者的生存率显著提高。来自低收入和中等收入国家的 IGCCCG 风险分层生存数据很少。我们评估了白俄罗斯患者的无进展生存期（PFS）和总生存期（OS）率，这些患者的临床表现为 IIb-III 期睾丸生殖细胞癌（GCC）或性腺外生殖细胞肿瘤，根据 IGCCCG 预后分类进行分层，并分析了生存的预后因素。
连续队列的患者患有临床 IIb-III 期睾丸 GCC 或性腺外生殖细胞肿瘤，他们在我们的两个中心接受治疗或咨询，在 2010 年至 2015 年之间。所有患者均接受了初始化疗。将患者分为精原细胞瘤和非精原细胞瘤生殖细胞癌（NSGCC）亚组。使用 Kaplan-Meier 方法估计 5 年 PFS 和 OS。
这项研究包括 111 名中位年龄为 32 岁的患者，其中 95%的患者被诊断为睾丸癌。32 名（29%）和 79 名（71%）患者分别诊断为精原细胞瘤和 NSGCC。中位随访时间为 6.1 年。整个队列的 5 年 PFS 和 OS 率分别为 70%和 77%。在预后良好的精原细胞瘤和预后良好、中等和差的 NSGCC 患者中，估计的 PFS 率分别为 76%、88%、74%和 39%，OS 率分别为 83%、97%、83%和 38%。
在我们的白俄罗斯晚期生殖细胞肿瘤患者队列中，与 1997 年的 IGCCCG 研究相比，我们未能证明 PFS 和 OS 的改善。此外，预后不良组的生存情况不如 IGCCCG 和所有高收入国家的当代系列。
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