Biswas Bivas, Dabkara Deepak, Ganguly Sandip, Ghosh Joydeep, Gupta Sujoy, Sen Saugata, Chatterjee Meheli, Basu Archisman, Mukherjee Satyadip
Department of Medical Oncology, Tata Medical Center, 14 MAR (EW), New Town, Rajarhat, Kolkata 700160, India.
Department of Urosurgery, Tata Medical Center, 14 MAR (EW), New Town, Rajarhat, Kolkata 700160, India.
Ecancermedicalscience. 2021 Mar 11;15:1204. doi: 10.3332/ecancer.2021.1204. eCollection 2021.
Non-seminomatous germ cell tumour (NSGCT) is a rare but highly curable malignancy. The literature on the management and outcomes of NSGCT is scarce from India. Here, we report the demography and treatment outcomes of NSGCT treated at our centre. This is a retrospective analysis of testicular and retroperitoneal NSGCT patients treated from March 2011 to December 2019. Patients were staged appropriately with imaging, pre- and post-operative tumour marker. Patients received stage adjusted adjuvant treatment after high inguinal orchiectomy. Patients with advanced disease were risk stratified as per International Germ Cell Cancer Collaborative Group (IGCCCG) classification. A total of 100 patients were treated with a median age of 28 years (Range: 18-51). Primary site was testis in 92 and retroperitoneum in 8 patients. Testicular violation was present in 17 (18%) patients. The stage of the disease was I in 32, II in 19 and III in 49 patients, respectively. IGCCCG risk groups were good in 29 (46%), intermediate in 13 (21%) and poor in 21 (33%) patients. Eleven patients (24%) underwent retroperitoneal lymph node dissection amongst 45 with post-chemotherapy residual disease. After a median follow-up of 26.6 months (range: 2.2-100.7), 3-year event-free survival and overall survival (OS) were 70.7% ± 5.6% and 78.2% ± 5.4%, respectively. S3 tumour marker ( = 0.01) and non-pulmonary visceral metastasis ( < 0.001) emerged as independent poor prognostic factors for OS in multivariate analysis. To conclude, testicular NSGCT has very high cure rate. Two-third patients present with advanced disease and one-third of them had poor risk disease. S3 tumour marker and non-pulmonary visceral metastasis are poor risk factors for OS.
非精原细胞瘤性生殖细胞肿瘤(NSGCT)是一种罕见但治愈率很高的恶性肿瘤。来自印度的关于NSGCT治疗及预后的文献很少。在此,我们报告在我们中心接受治疗的NSGCT患者的人口统计学特征及治疗结果。这是一项对2011年3月至2019年12月期间接受治疗的睾丸及腹膜后NSGCT患者的回顾性分析。通过影像学检查、术前和术后肿瘤标志物对患者进行恰当分期。患者在高位腹股沟睾丸切除术后接受分期调整辅助治疗。晚期疾病患者根据国际生殖细胞癌症协作组(IGCCCG)分类进行风险分层。共有100例患者接受治疗,中位年龄为28岁(范围:18 - 51岁)。原发部位为睾丸的有92例,腹膜后的有8例。17例(18%)患者存在睾丸侵犯。疾病分期分别为I期32例、II期19例和III期49例。IGCCCG风险组中,良好风险的有29例(46%),中等风险的有13例(21%),不良风险的有21例(33%)。45例化疗后有残留病灶的患者中,11例(24%)接受了腹膜后淋巴结清扫术。中位随访26.6个月(范围:2.2 - 100.7个月)后,3年无事件生存率和总生存率(OS)分别为70.7%±5.6%和78.2%±5.4%。在多因素分析中,S3肿瘤标志物(P = 0.01)和非肺内脏转移(P < 0.001)成为OS的独立不良预后因素。总之,睾丸NSGCT治愈率非常高。三分之二的患者为晚期疾病,其中三分之一为不良风险疾病。S3肿瘤标志物和非肺内脏转移是OS的不良风险因素。