Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Immunol. 2022 Jan 10;12:720359. doi: 10.3389/fimmu.2021.720359. eCollection 2021.
Testicular sex cord stromal tumours (TSCSTs) are rare, with few studies focusing on the metastatic TSCST prognosis. The value of treatments, including radical orchiectomy (RO) and retroperitoneal lymph node dissection (RPLND), in preventing metastasis is controversial. Additionally, metastatic TSCSTs are resistant to chemotherapy. We aimed to assess the effectiveness and safety of immunotherapy in metastatic TSCSTs after first-line chemotherapy.
We retrospectively screened patients with testicular tumours undergoing testis surgery between January 2005 and January 2019. Patients with TSCSTs who had undergone testis-sparing surgery (TSS) or RO were identified. The malignant type was defined as metastasis confirmed by pathology. Treatment responses, progression-free survival (PFS), overall survival (OS) and safety were analysed.
Among the 494 testicular tumour patients who received TSS or RO, 11 (2.2%) patients with histologically proven TSCSTs were identified. At the last follow-up, 7 patients survived without tumours, and 4 patients developed metastasis and received first-line cisplatin-based chemotherapy, with 1 of them achieving an objective response. Their PFS times were 1.5, 2.2, 9.0, and 17.0 months, respectively. Two patients received immune checkpoint inhibitors (ICIs) after developing chemotherapy resistance and achieved a partial response up to the last follow-up; one of them experienced Grade 1 adverse events, and the other experienced Grade 2 adverse events during immunotherapy. The median OS time of the 4 patients with metastatic TSCSTs was 32 months.
TSCSTs are rare, and most are benign with a good prognosis. ICIs represent a promising option for improving clinical outcomes in metastatic TSCSTs.
睾丸性索间质肿瘤（TSCST）较为罕见，鲜有研究关注转移性 TSCST 的预后。根治性睾丸切除术（RO）和腹膜后淋巴结清扫术（RPLND）在预防转移方面的价值存在争议。此外，转移性 TSCST 对化疗具有耐药性。我们旨在评估转移性 TSCST 患者在一线化疗后免疫治疗的有效性和安全性。
我们回顾性筛选了 2005 年 1 月至 2019 年 1 月期间接受睾丸手术的睾丸肿瘤患者。识别出接受保留睾丸手术（TSS）或 RO 的 TSCST 患者。恶性类型定义为病理证实的转移。分析治疗反应、无进展生存期（PFS）、总生存期（OS）和安全性。
在接受 TSS 或 RO 的 494 例睾丸肿瘤患者中，有 11 例（2.2%）患者经组织学证实为 TSCST。在最后一次随访时，7 例患者无肿瘤存活，4 例患者发生转移并接受了一线顺铂为基础的化疗，其中 1 例患者获得了客观缓解。他们的 PFS 时间分别为 1.5、2.2、9.0 和 17.0 个月。2 例患者在发生化疗耐药后接受了免疫检查点抑制剂（ICIs）治疗，并在最后一次随访时达到部分缓解；其中 1 例发生 1 级不良事件，另 1 例在免疫治疗期间发生 2 级不良事件。4 例转移性 TSCST 患者的中位 OS 时间为 32 个月。
TSCST 较为罕见，大多数为良性，预后良好。ICIs 为改善转移性 TSCST 的临床结局提供了一种有前途的选择。
Zotero 插件
