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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Fischer, S; Tandstad, T; Cohn-Cedermark, G; Thibault, C; Vincenzi, B; Klingbiel, D; Albany, C; Necchi, A; Terbuch, A; Lorch, A; Aparicio, J; Heidenreich, A; Hentrich, M; Wheater, M; Langberg, CW; Ståhl, O; Fankhauser, CD; Hamid, AA; Koutsoukos, K; Shamash, J; White, J; Bokemeyer, C; Beyer, J; Gillessen, S, , Global, Germ-Cell, Cancer, Group.
Outcome of Men With Relapses After Adjuvant Bleomycin, Etoposide, and Cisplatin for Clinical Stage I Nonseminoma.
J Clin Oncol. 2020; 38(12):1322-1331 Doi: 10.1200/JCO.19.01876 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Terbuch Angelika

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PURPOSE: Clinical stage I (CSI) nonseminoma (NS) is a disease limited to the testis without metastases. One treatment strategy after orchiectomy is adjuvant chemotherapy. Little is known about the outcome of patients who experience relapse after such treatment. PATIENTS AND METHODS: Data from 51 patients with CSI NS who experienced a relapse after adjuvant bleomycin, etoposide, and cisplatin (BEP) from 18 centers/11 countries were collected and retrospectively analyzed. Primary outcomes were overall and progression-free survivals calculated from day 1 of treatment at first relapse. Secondary outcomes were time to, stage at, and treatment of relapse and rate of subsequent relapses. RESULTS: Median time to relapse was 13 months, with the earliest relapse 2 months after start of adjuvant treatment and the latest after 25 years. With a median follow-up of 96 months, the 5-year PFS was 67% (95% CI, 54% to 82%) and the 5-year OS was 81% (95% CI, 70% to 94%). Overall, 19 (37%) of 51 relapses occurred later than 2 years. Late relapses were associated with a significantly higher risk of death from NS (hazard ratio, 1.10 per year; P = .01). Treatment upon relapse was diverse: the majority of patients received a combination of chemotherapy and surgery. Twenty-nine percent of patients experienced a subsequent relapse. At last follow-up, 41 patients (80%) were alive and disease-free, eight (16%) had died of progressive disease, and one patient (2%) each had died from therapy-related or other causes. CONCLUSION: Outcomes of patients with relapse after adjuvant BEP seem better compared with patients who experience relapse after treatment of metastatic disease but worse compared with those who have de-novo metastatic disease. We found a substantial rate of late and subsequent relapses. There seem to be three patterns of relapse with different outcomes: pure teratoma, early viable NS relapse (< 2 years), and late viable NS relapse (> 2 years).
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - administration & dosage, therapeutic use
Bleomycin - administration & dosage
Chemotherapy, Adjuvant - administration & dosage
Cisplatin - administration & dosage
Etoposide - administration & dosage
Humans - administration & dosage
Male - administration & dosage
Neoplasm Staging - administration & dosage
Neoplasms, Germ Cell and Embryonal - drug therapy, surgery
Orchiectomy - administration & dosage
Progression-Free Survival - administration & dosage
Retrospective Studies - administration & dosage
Survival Rate - administration & dosage
Testicular Neoplasms - drug therapy, pathology, surgery
Treatment Outcome - administration & dosage

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