Retrospective Analysis of Testicular Germ Cell Tumor Patients with Brain Metastases: A Single-Center Experience
Received Date : 05 Dec 2021
Accepted Date : 12 Mar 2022
Available Online : 31 Mar 2022
Doi: 10.37047/jos.2021-87403 - Article's Language: EN
J Oncol Sci. 2022;8(1):27-33
This is an open access article under the CC BY-NC-ND license
Objective: We evaluated the survival characteristics of testicular germ cell tumor (GCT) patients with brain metastases (BM). Material and Methods: In this retrospective cross-sectional study, patients with relapsed or refractory GCT and BM were evaluated. The characteristic clinical features of the patients, their systemic treatments, local treatments applied to BM, and follow-up periods were recorded. The primary endpoint was to assess survival after detection of synchronous and metachronous BM. The secondary endpoint was determined as overall survival (OS). Results: Twenty-five patients were included in this study with median age and interquartile range (IQR) of 30.24 and 7.92, respectively. Stage IIIC was detected at first diagnosis in 72% of the patients. The most commonly used local BM treatment was the combination of surgery and radiotherapy (60%). The objective response rate (complete response plus partial response) after local BM treatment was 60%. The median OS in the whole group was 24.75 (IQR: 25.97) months. The median OS (IQR) in the synchronous BM group was significantly different than that in the metachronous BM group [33.51 (18.13) vs. 9.97 (7.52), 95% confidence interval of 6.7 to 40.3 months, p=0.013]. There was no difference in the median OS between the groups [median (IQR)=36.39 (25.35) months vs. 23.70 (35.68) months, p=0.672]. Conclusion: The patients with GCTs presenting with BM during diagnosis were in a better condition than those who developed BM at relapse. However, no significant difference was found in OS. This may indicate shorter survival times for the patients who relapse, as the tumor is resistant to systemic therapy.
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