Single institutional experience with non‐seminomatous germ cell tumours of the testis: local perspectives on a curable cancer

Abstract

We have reviewed 77 patients with Non-seminomatous germ cell tumour of the testis (NSGCTT) treated at a single institution. A residual mass following definitive treatment occurred in 16 patients (35%), 13 of whom had a resection of the mass, yielding active tumour in only one patient. Nine patients (12%) relapsed including four of the 14 with Stage I disease who were treated by orchidectomy alone. Four relapses occurred at more than two and a half years after primary treatment. Relapse prior to the development of clinical symptoms or signs was evident in three of nine patients; in two patients by routine imaging and one with elevated routine serum markers. Three of the nine patients who relapsed had elevated serum markers. Two patients died from disease but there were four treatment-related deaths (7%). Overall, 64 patients (83%) remain disease free at the time of follow-up. A further seven (9%) have been lost to follow-up but were disease-free at a minimum of 26 months after diagnosis. This study confirms features of this disease including the excellent prognosis when adequately treated. However, it also reveals the problems of late or marker negative relapses, the implementation of an observation policy in Stage I disease and treatment related mortality in young men.

Patients with non-seminoma germ cell tumours treated in a minor oncology department: the importance of multi-institutional protocols and research collaboration

“…The grouping of histological subdiagnoses differs between reported series. However, our finding that the majority (87%) of patients had either pure embryonal carcinoma or mixed tumours, was consistent with previous reports [16,17]. Reported vascular invasion in 45 Á/50% of NSGCT [4,17], is in agreement with our data.…”

“…However, our finding that the majority (87%) of patients had either pure embryonal carcinoma or mixed tumours, was consistent with previous reports [16,17]. Reported vascular invasion in 45 Á/50% of NSGCT [4,17], is in agreement with our data. Concerning tumour markers, the majority of patients had elevated AFP or HCG and 74% had at least one of these markers elevated, corroborating other studies [16,17].…”

“…Reported vascular invasion in 45 Á/50% of NSGCT [4,17], is in agreement with our data. Concerning tumour markers, the majority of patients had elevated AFP or HCG and 74% had at least one of these markers elevated, corroborating other studies [16,17].…”

Nonseminomatous Germ Cell Tumour of Testis in Hong Kong Chinese Patients

“…In the 1990 Hong Kong Cancer Registry, the reported incidence of testicular germ cell tumour was 34 new cases per 5 million (0.68 per 100.000) [3], As a significant proportion of cases are looked after by private practitioners and reporting in general is low, this figure would suggest an incidence com parable to the American black population (0.9 in 100,000), but considerably less than the American white population (3.7 in 100.000) [1], The median age of 30 years at presentation and an age range of 16-62 is compa rable with Western series. In an Australian series of 77 patients, the median age was 29 years with an age range of 14-60 [12], 11% of the patients had a history of cryptor 233 chidism which is very close to the reported figure of 10% in the Western population [13]. Apart from the group of mixed N S G C T , the most common histological types in this series are, in order, embryonal carcinoma (23%).…”

An Unusual Late Relapse in Pathologic Stage I Non-Seminomatous Germ Cell Tumor: Case Report and Review of the Literature

“…Late relapses have been observed in patients with clini cal stage I NSGCT of the testis treated with inguinal orchiectomy and surveillance [10][11][12][13], inguinal orchiecto my and retroperitoneal lymph node irradiation [14,15], and inguinal orchiectomy and adjuvant chemotherapy [16], However, late relapses are particularly uncommon in patients with PSI NSGCT treated with inguinal or chiectomy and RPLND (table 1). Physicians must remain vigilant for such late recurrences since most can be sal vaged with chemotherapy.…”