Synchronous versus metachronous brain metastasis from testicular germ cell tumors (TGCT): an analysis from the Spanish Germ Cell Cancer Group data base
Por:
Girones, R, Aparicio, J, Roure, P, Germa-Lluch, JR, del Muro, XG, Vazquez-Estevez, S, Saenz, A, Sastre, J, Arija, JA, Gallardo, E, Gonzalez-Billalabeitia, E, Sanchez-Hernandez, A, Terrasa, J, Hernandez, A, Santander, C, Cillan, E, Sagastibelza, N, Almenar-Cubells, D, Brea, ML, Maroto, J
Publicada:
1 nov 2014
Resumen:
Brain metastases of testicular germ cell tumor (TGCT) are a rare event. Prognostic is poor and there is not much evidence on optimal management of these patients.
A review of case records of germ cell tumor patients within the Spanish Germ Cell Cancer Group data base from 1994 to 2012 was conducted.
Thirty-three out of 6,200 cases (0.5 %). Nineteen patients (57 %) group 1: synchronous, 13 (40 %) group 2: metachronous and only one developed brain metastasis during cisplatin-based chemotherapy (excluded from the analysis). Median serum BHCG levels at initial diagnosis was higher in group 1, whereas elevated AFP serum levels were more common in group 2. Histology in the primary tumor: chorionic carcinoma for group 1 versus embryonal carcinoma for group 2. Mainly solitary brain metastasis in group 2 (54 versus 21 %, respectively). The median overall survival from the diagnosis of central nervous system involvement was 16 months for group 1 (CI 95 % 13.9-18) and 23 months (95 % CI 0-165) for group 2 (log rank p = 0.84). Long-term survivors were practically identical in the two groups (38.9 % group 1 versus 38.5 % group 2). Regardless of the timing of brain metastasis, those patients that achieved complete response to the treatment had better survival (log rank p 0.003).
Although some distinctive clinical characteristics have been found between patients with synchronous versus metachronous brain metastasis from TGCT, the timing of brain metastasis did not seem to have prognostic influence, but due to the retrospective nature of the analysis and the results should be interpreted with caution.
Filiaciones:
Girones, R:
Hosp Lluis Alcanyis Xativa, Valencia, Spain
Aparicio, J:
Hosp La Fe, E-46009 Valencia, Spain
Roure, P:
Hosp Vic, Barcelona, Spain
Germa-Lluch, JR:
Inst Catala Oncol, Barcelona, Spain
del Muro, XG:
Inst Catala Oncol, Barcelona, Spain
Vazquez-Estevez, S:
Hosp Lucus Augusti Lugo, Lugo, Spain
Saenz, A:
Hosp Clin Zaragoza, Zaragoza, Spain
Sastre, J:
Hosp Clin San Carlos Madrid, Madrid, Spain
Arija, JA:
Hosp Gen Gregorio Maranon, Madrid, Spain
Gallardo, E:
Hosp Parc Tauli, Sabadell, Spain
Gonzalez-Billalabeitia, E:
Hosp Morales Meseguer, Murcia, Spain
Sanchez-Hernandez, A:
Hosp Prov Castellon, Castellon de La Plana, Spain
Terrasa, J:
Hosp Son Espases, Palma De Mallorca, Spain
Hernandez, A:
Hosp Prov Castellon, Castellon de La Plana, Spain
Inst Oncol Guipuzcoa San Sebastian, San Sebastian, Spain
Santander, C:
Hosp St Pau Barcelona, Barcelona, Spain
Cillan, E:
Hosp Servet Zaragoza, Zaragoza, Spain
Sagastibelza, N:
Hosp Donostia, San Sebastian, Spain
Almenar-Cubells, D:
Hosp Doctor Peset Valencia, Valencia, Spain
Brea, ML:
Hosp Marques Valdecilla, Santander, Spain
Maroto, J:
Hosp St Pau Barcelona, Barcelona, Spain
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