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Journal of Cancer Research and Clinical Oncology

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01.07.2014 | Original Article – Clinical Oncology

First salvage treatment in patients with advanced germ cell cancer after cisplatin-based chemotherapy: analysis of a registry of the German Testicular Cancer Study Group (GTCSG)

verfasst von: Lars Arne Berger, Carsten Bokemeyer, Anja Lorch, Marcus Hentrich, Hans-Georg Kopp, Thomas Christoph Gauler, Jörg Beyer, Maike de Wit, Frank Mayer, Ina Boehlke, Christoph Oing, Friedemann Honecker, Karin Oechsle

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 7/2014

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Abstract

Purpose

We analyzed prognostic categories at first relapse according to the International Prognostic Factors Study Group (IPFSG) criteria as well as the efficacy of salvage treatment.

Methods

143 patients with relapsed or refractory germ cell cancer undergoing first salvage treatment with conventional-dose (CD-CX, n = 48) or high-dose chemotherapy with autologous stem cell support (HD-CX, n = 95) contributed by nine centers were retrospectively analyzed.

Results

Prognostic subgroups according to IPFSG criteria were: very low risk 13/143, low risk 36/143, intermediate risk 66/143, high risk 22/143, and very high risk 6/143 patients. The IPFSG categories significantly correlated with overall survival (OS) (p = 0.025) after 1st salvage treatment. After a median follow-up of 19 months, 55 % of all patients had relapsed and 33 % had died. For the entire cohort, progression-free survival (PFS) rate after 2 years was 43 %, and OS rate after 5 years was 52 %. Compared to the HD-CX group, vital carcinoma was found more often in secondarily resected lesions following CD-CX (22/29 vs. 22/45; p = 0.021). Second relapse rate was higher with 75 versus 44 %, resulting in a shorter median PFS with 8 versus 42 months (p < 0.001), but this did not translate into different OS (p = 0.931). At subsequent relapses, 26/36 patients received HD-CX as ≥2nd-salvage treatment.

Conclusion

This analysis confirms the prognostic value of the IPFSG prognostic score. HD-CX seemed superior to CD-CX as first salvage treatment with respect to PFS in this retrospective analysis.

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Titel: First salvage treatment in patients with advanced germ cell cancer after cisplatin-based chemotherapy: analysis of a registry of the German Testicular Cancer Study Group (GTCSG)
verfasst von: Lars Arne Berger
Carsten Bokemeyer
Anja Lorch
Marcus Hentrich
Hans-Georg Kopp
Thomas Christoph Gauler
Jörg Beyer
Maike de Wit
Frank Mayer
Ina Boehlke
Christoph Oing
Friedemann Honecker
Karin Oechsle
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 7/2014
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-014-1661-z

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First salvage treatment in patients with advanced germ cell cancer after cisplatin-based chemotherapy: analysis of a registry of the German Testicular Cancer Study Group (GTCSG)