Very Late Recurrence in Germ Cell Tumor of the Testis: Lessons and Implications

Joseph A. Moore, Rebecca S. Slack, Michael J. Lehner, Matthew T. Campbell, Amishi Y. Shah, Miao Zhang, Charles C. Guo, John F. Ward, Jose A. Karam, Christopher G. Wood, Louis L. Pisters, Shi Ming Tu

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background. Very late recurrence (LR), i.e., >5 years after initial presentation, occurs in about 1% of patients with germ cell tumors of the testis (TGCT) and is associated with poor prognosis. Methods. We retrospectively reviewed the records of patients at the M. D. Anderson Cancer Center who developed LR > 5 years after their initial diagnosis of TGCT. Results. We identified 25 patients who developed LR between July 2007 and August 2020. The median age at the time of LR was 46 years (range, 29–61). Pathology of LR: somatic transformation to carcinoma or sarcoma—11, nonseminoma with yolk sac tumor or teratoma—11, nonseminoma without yolk sac tumor or teratoma—2, not available—1. With a median follow-up of 3.5 years, 68% of patients are alive 3 years after LR. Patients with prior post-chemotherapy consolidation surgery do not have statistically significant longer survival compared to patients who did not receive post-chemotherapy consolidation surgery, 83.3% vs. 60.8% at 3 years, respectively, p = 0.50. Conclusions. Patients with LR > 5 years tend to harbor nonseminoma (with yolk sac tumor and or teratoma). Among these patients, a majority who did not undergo surgery to remove residual disease after chemotherapy developed somatic transformation and succumbed to their LR.

Original languageEnglish (US)
Article number1127
JournalCancers
Volume14
Issue number5
DOIs
StatePublished - Mar 1 2022

Keywords

  • Germ cell tumor
  • Late recurrence
  • Nonseminoma
  • Testicular cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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