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

Figures & data

Table I.  Patient characteristics of 132 patients treated for NSGCT.

	N	%
Age (years)
Median	28
Range	15–72
Histology
Embryonal carcinoma	54	41
Choriocarcinoma	1	1
Teratoma	15	11
Mixed non-seminoma	61	46
Seminoma with AFP	1	1
Vascular invasion
Present	43	43
Not present	56	57
Not described^1	33
Stage
I	70	53
I Mk +	4	3
IIA	14	11
IIB	17	13
IIC	5	4
IID	4	3
III	5	4
IV	13	10
AFP^2 (ng/mL)
≥ 10	84	66
< 10	44	34
Missing	4
HCG^3 (U/L)
≥ 5	68	53
< 5	60	47
Missing	4
LD^4 (U/L)
≥ 450	35	42
< 450	49	58
Missing	48

¹ Vascular invasion was not routinely described by the pathologist until 1991.

² Alpha-fetoprotein, measured prior to orchiectomy.

³ Human choriogonadotropin, measured prior to orchiectomy.

⁴ Lactate dehydrogenase, measured prior to orchiectomy.

Table II.  Treatment and relapse among 70 patients with stage I non-seminomatous germ cell tumours.

	Treatment		Relapse
	N	%	N	%
RPLND^1	24	34.3	7	29.2
Chemotherapy	10	14.3	0	0
Surveillance	36	51.4	8	22.2
Total	70	100.0	15	21.4

¹ Standard staging procedure until 1991. Also part of a three-armed risk assessed protocol from 1991 to 1994.

Table III.  Distribution of 62 patients with metastatic germ cell cancers (stages IMk+ to IV) according to the International Germ Cell Consensus Classification [12].

Prognostic group	N	%	Determining variables
Good	39	63
Intermediate	13	21	AFP ≥ 1000, N = 5
			HCG ≥ 5000, N = 2
			LD ≥ 1.5×N, N = 8
Poor	10	16	Non-pulmonary visceral metastasis, N = 6
			AFP ≥ 10,000, N = 5
			HCG ≥ 50,000, N = 1

Figure 1. Overall and disease-specific survival in 132 patients with NSGCT (p = 0.20).

Figure 2. Disease-specific survival of patients with NSGCT according to clinical stage (RMH staging system). Stage I, N = 70; stage IMk + /II, N = 44; stage III, N = 5; stage IV, N = 13 (p < 0.0001). Graphs for stage I and stage III are superimposed.

Figure 3. Disease-specific survival of patients with metastatic (Stage I Mk+ to stage IV) NSGCT according to the International Germ Cell Consensus Classification (IGCCC). Good prognosis, N = 39; intermediate prognosis, N = 13; poor prognosis, N = 10 (p = 0.0001).

International Germ Cell Consensus Classification. A prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15: 594–603

 PubMed Web of Science ®Google Scholar