Materiały źródłowe

• #1 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  A female-specific mIGCCCG risk model effectively stratifies patients and should be incorporated into clinical trials. […] Prognosis is excellent, and most GCTs are cured with etoposide and cisplatin-based chemotherapy. […] Accurate risk classification is important to select appropriate therapies to personalize treatment and maximize potential for cure, while minimizing side effects of treatment. […] The IGCCCG model is often extrapolated for female patients with GCT, although data in this setting are limited. […] Our earlier work proposed a modified IGCCCG (mIGCCCG) risk stratification system for female patients undergoing chemotherapy based on the male IGCCCG model but with modification to consider peritoneal spread as a favorable metastatic site given differences in anatomy. […] We found that 3-year PFS and OS were excellent, and histology, age, and stage at diagnosis were significant predictors of survival.

• #2 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. […] The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs. […] The usefulness of AFP as a prognostic factor was demonstrated by Frasier et al. […] According to the IGCCC classification, the initial AFP level is one of the factors considered in dividing patients into the following three risk groups, respectively: for the group with good prognosis, <1000 ng/mL; for the group with an intermediate prognosis, ≥1000 and ≤than 10,000 ng/mL; and for group with a poor prognosis, >10,000 ng/mL.

• #3

  https://link.springer.com/article/10.1007/s00432-020-03343-2

  Treatment of metastatic germ cell cancer (GCC) is based on the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic classification published in 1997. 5-year survival rates were reported to be 91%, 79%, and 48% for patients with good, intermediate and poor prognosis, respectively. […] Compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has considerably improved over time. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved. […] The 5-year-OS of our cohort was 98%, 96%, and 66%, for the good, intermediate and poor prognosis group, respectively. This compares favorably to the 5-year-OS of 91%, 79% and 48% predicted by the original IGCCCG score.

• #4

  https://link.springer.com/article/10.1007/s00432-020-03343-2

  Treatment of metastatic germ cell cancer (GCC) is based on the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic classification published in 1997. 5-year survival rates were reported to be 91%, 79%, and 48% for patients with good, intermediate and poor prognosis, respectively. […] Compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has considerably improved over time. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved. […] The 5-year-OS of our cohort was 98%, 96%, and 66%, for the good, intermediate and poor prognosis group, respectively. This compares favorably to the 5-year-OS of 91%, 79% and 48% predicted by the original IGCCCG score.

• #5

  https://link.springer.com/article/10.1007/s00432-020-03343-2

  Treatment of metastatic germ cell cancer (GCC) is based on the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic classification published in 1997. 5-year survival rates were reported to be 91%, 79%, and 48% for patients with good, intermediate and poor prognosis, respectively. […] Compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has considerably improved over time. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved. […] The 5-year-OS of our cohort was 98%, 96%, and 66%, for the good, intermediate and poor prognosis group, respectively. This compares favorably to the 5-year-OS of 91%, 79% and 48% predicted by the original IGCCCG score.

• #6

  https://link.springer.com/article/10.1007/s00432-020-03343-2

  The 66% 5-years OS rate of poor-risk patients remains unsatisfactory although this represents an improvement compared to the original IGCCCG risk classification. However, attempts to improve overall survival by intensification of first line chemotherapy have failed. […] In conclusion, compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has markedly improved. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved.

• #7 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  A female-specific mIGCCCG risk model effectively stratifies patients and should be incorporated into clinical trials. […] Prognosis is excellent, and most GCTs are cured with etoposide and cisplatin-based chemotherapy. […] Accurate risk classification is important to select appropriate therapies to personalize treatment and maximize potential for cure, while minimizing side effects of treatment. […] The IGCCCG model is often extrapolated for female patients with GCT, although data in this setting are limited. […] Our earlier work proposed a modified IGCCCG (mIGCCCG) risk stratification system for female patients undergoing chemotherapy based on the male IGCCCG model but with modification to consider peritoneal spread as a favorable metastatic site given differences in anatomy. […] We found that 3-year PFS and OS were excellent, and histology, age, and stage at diagnosis were significant predictors of survival.

• #8 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  A female-specific mIGCCCG risk model effectively stratifies patients and should be incorporated into clinical trials. […] Prognosis is excellent, and most GCTs are cured with etoposide and cisplatin-based chemotherapy. […] Accurate risk classification is important to select appropriate therapies to personalize treatment and maximize potential for cure, while minimizing side effects of treatment. […] The IGCCCG model is often extrapolated for female patients with GCT, although data in this setting are limited. […] Our earlier work proposed a modified IGCCCG (mIGCCCG) risk stratification system for female patients undergoing chemotherapy based on the male IGCCCG model but with modification to consider peritoneal spread as a favorable metastatic site given differences in anatomy. […] We found that 3-year PFS and OS were excellent, and histology, age, and stage at diagnosis were significant predictors of survival.

• #9 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  We previously developed preoperative and pre-chemotherapy modified versions of the male International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic model and assessed it in female patients with germ cell tumors (GCTs). We sought to validate these modified IGCCCG (mIGCCCG) models in a new cohort. […] In multivariable models, higher stage, older age, and non-dysgerminoma histology predicted worse PFS and OS (p0.05). Among 162 patients who received chemotherapy, preoperative and pre-chemotherapy mIGCCCG models were significantly associated with PFS and OS (p0.001 for all groups). With the preoperative model, 3-year PFS rates were 94%, 76%, and 50% in the good-, intermediate-, and poor-risk patients, respectively; OS rates were 96%, 86%, and 52%, respectively. Even within stage groups, mIGCCCG risk classifications were associated with clinical outcomes.

• #10 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  Our results support the incorporation of the mIGCCCG model into clinical trials, and if successful, potentially into clinical practice. […] OS in the poor-risk group was consistently much worse than in the good- and intermediate-risk groups for all cohorts and risk assessments. This suggests that although both intermediate- and poor-risk patients are more likely to have recurrence or progression compared to good-risk patients, intermediate-risk patients may respond better to salvage therapies, including HDCT/ASCT, leading to better OS than poor-risk patients. […] Although both the pre-chemotherapy and preoperative mIGCCCG risk models were associated with survival, preoperative markers had better discrimination regarding models of PFS and OS.

• #11 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  We previously developed preoperative and pre-chemotherapy modified versions of the male International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic model and assessed it in female patients with germ cell tumors (GCTs). We sought to validate these modified IGCCCG (mIGCCCG) models in a new cohort. […] In multivariable models, higher stage, older age, and non-dysgerminoma histology predicted worse PFS and OS (p0.05). Among 162 patients who received chemotherapy, preoperative and pre-chemotherapy mIGCCCG models were significantly associated with PFS and OS (p0.001 for all groups). With the preoperative model, 3-year PFS rates were 94%, 76%, and 50% in the good-, intermediate-, and poor-risk patients, respectively; OS rates were 96%, 86%, and 52%, respectively. Even within stage groups, mIGCCCG risk classifications were associated with clinical outcomes.

• #12

  http://waocp.com/journal/index.php/apjcc/article/view/1227

  Extragonadal germ cell tumors (EGGCTs) are tumors that arise outside the gonads. Their biological behavior and prognosis differ from their gonadal counterparts. This study aimed to analyze the histological subtypes, outcomes, and prognoses of EGGCTs in patients of various age groups. […] With a median follow-up of 30 months, an overall survival (OS) rate of 93.2% and an event-free survival (EFS) rate of 90.4% were observed across all age groups. OS rates were 100% (neonatal), 96% (prepubertal), and 88.0% (postpubertal), showing a declining trend with increasing age (p=0.324). Significant prognostic factors for OS included histological subtype (mixed germ cell tumors and teratomas with somatic malignancies had reduced OS) and stage (I vs II and III). Stage was the only significant prognostic factor for EFS (P0.0001).

• #13

  http://waocp.com/journal/index.php/apjcc/article/view/1227

  Extragonadal germ cell tumors (EGGCTs) are tumors that arise outside the gonads. Their biological behavior and prognosis differ from their gonadal counterparts. This study aimed to analyze the histological subtypes, outcomes, and prognoses of EGGCTs in patients of various age groups. […] With a median follow-up of 30 months, an overall survival (OS) rate of 93.2% and an event-free survival (EFS) rate of 90.4% were observed across all age groups. OS rates were 100% (neonatal), 96% (prepubertal), and 88.0% (postpubertal), showing a declining trend with increasing age (p=0.324). Significant prognostic factors for OS included histological subtype (mixed germ cell tumors and teratomas with somatic malignancies had reduced OS) and stage (I vs II and III). Stage was the only significant prognostic factor for EFS (P0.0001).

• #14

  http://waocp.com/journal/index.php/apjcc/article/view/1227

  The present study revealed a statistically significant correlation between histological type and stage concerning age. In the neonatal group, all cases were exclusively teratomas. In the prepubertal group, only non-seminomatous tumors were observed, whereas in the post-pubertal group, both seminomatous and non-seminomatous tumors were noted (p=0.002). In the neonatal group, all tumors presented in stage I in contrast to the prepubertal (92.6%) and post-pubertal group (78.5%) (p=0.034). The estimated O.S was 93.4% and EFS was 90.2% across all age groups. Overall survival of 100% was observed in the neonatal, 96.3% in the prepubertal and 88.0% in the post-pubertal group showing a declining trend with increasing age (p=0.324), although not statistically significant. […] An excellent prognosis was noted in the neonatal group regardless of the tumor location. The prepubertal group showed a higher percentage of recurrence with the least EFS (81.8%) among the three subgroups. We observed poorer OS in mediastinal lesions (84.2%) (p=0.239) and the least EFS in retroperitoneal lesions (84.6%) (p=0.446). Kaplan-Meier analysis identified histological subtype as a significant prognostic parameter.

• #15 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8871072/

  Serum tumors markers were elevated in 2875% of the patients at the time of recurrence and were the only indication of recurrence in 439%. […] Serum tumor markers, the onco-fetoproteins (AFP and -hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, -hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs.

• #16 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Serum tumor markers, the “onco”-fetoproteins (AFP and β-hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, β-hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs. The use of these miRNAs could potentially identify patients with a worse prognosis.

• #17 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. […] The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs. […] The usefulness of AFP as a prognostic factor was demonstrated by Frasier et al. […] According to the IGCCC classification, the initial AFP level is one of the factors considered in dividing patients into the following three risk groups, respectively: for the group with good prognosis, <1000 ng/mL; for the group with an intermediate prognosis, ≥1000 and ≤than 10,000 ng/mL; and for group with a poor prognosis, >10,000 ng/mL.

• #18 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  In the final results, AFP > 10,000 ng/mL was defined as predictive of a poor outcome of event-free survival (EFS) and overall survival (OS). […] The most valuable analysis that negates the prognostic value of AFP at the time of diagnosis seems to be performed by Frazier et al. […] In multivariable analysis, AFP ≥ 10,000 ng/mL, which was found in 49% of the tested patients, was connected with a worse outcome, but this result was not statistically significant. […] AFP decline during anti-neoplasm treatment has a proven prognostic value in adults. […] A study that confirmed the prognostic value of AFP decline in pediatric patients was performed by O’Neill et al. […] The 3-year cumulative incidence of relapse in this group was 11% (38% for the group with unsatisfactory marker decline).

• #19 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  In the final results, AFP > 10,000 ng/mL was defined as predictive of a poor outcome of event-free survival (EFS) and overall survival (OS). […] The most valuable analysis that negates the prognostic value of AFP at the time of diagnosis seems to be performed by Frazier et al. […] In multivariable analysis, AFP ≥ 10,000 ng/mL, which was found in 49% of the tested patients, was connected with a worse outcome, but this result was not statistically significant. […] AFP decline during anti-neoplasm treatment has a proven prognostic value in adults. […] A study that confirmed the prognostic value of AFP decline in pediatric patients was performed by O’Neill et al. […] The 3-year cumulative incidence of relapse in this group was 11% (38% for the group with unsatisfactory marker decline).

• #20 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  In the final results, AFP > 10,000 ng/mL was defined as predictive of a poor outcome of event-free survival (EFS) and overall survival (OS). […] The most valuable analysis that negates the prognostic value of AFP at the time of diagnosis seems to be performed by Frazier et al. […] In multivariable analysis, AFP ≥ 10,000 ng/mL, which was found in 49% of the tested patients, was connected with a worse outcome, but this result was not statistically significant. […] AFP decline during anti-neoplasm treatment has a proven prognostic value in adults. […] A study that confirmed the prognostic value of AFP decline in pediatric patients was performed by O’Neill et al. […] The 3-year cumulative incidence of relapse in this group was 11% (38% for the group with unsatisfactory marker decline).

• #21 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8871072/

  Serum tumors markers were elevated in 2875% of the patients at the time of recurrence and were the only indication of recurrence in 439%. […] Serum tumor markers, the onco-fetoproteins (AFP and -hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, -hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs.

• #22 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8871072/

  Serum tumors markers were elevated in 2875% of the patients at the time of recurrence and were the only indication of recurrence in 439%. […] Serum tumor markers, the onco-fetoproteins (AFP and -hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, -hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs.

• #23 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Serum tumor markers, the “onco”-fetoproteins (AFP and β-hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, β-hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs. The use of these miRNAs could potentially identify patients with a worse prognosis.

• #24 Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy | British Journal of Cancer

  https://www.nature.com/articles/bjc2017467

  The prognostic utility of systemic inflammatory markers has so far not been investigated in patients with metastatic testicular germ cell tumours (GCTs). […] In univariate Cox regression, low haemoglobin and albumin as well as high leukocytes, N, NLR, SII and CRP were associated with a shorter OS. […] In multivariable Cox regression analyses, high leukocyte (hazard ratio (HR) 1.274 (95% confidence interval (CI) 1.0571.535); P=0.011) and N count (1.470 (1.0921.980); P=0.011), higher NLR (84.5 (2.23193.4); P=0.017) and SII (12.15 (1.17126.26); P=0.037) remained independent prognostic predictors for OS besides the IGCCCG risk groups. […] Systemic inflammatory markers might have prognostic utility for patients with metastatic GCT. […] In the present investigation, we were able to show, to the best of our knowledge for the first time, that different markers of systemic inflammation (namely leukocytes, neutrophils, NLR and SII) have the potential to improve prediction of oncologic outcome in patients with metastatic GCT in addition to the well-established IGCCCG classification system. […] Several systemic inflammatory markers, which are available from routinely performed inexpensive blood tests, demonstrated incremental prognostic information in addition to the IGCCCG risk groups for patients with metastatic GCT undergoing first-line chemotherapy.

• #25 Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy | British Journal of Cancer

  https://www.nature.com/articles/bjc2017467

  The prognostic utility of systemic inflammatory markers has so far not been investigated in patients with metastatic testicular germ cell tumours (GCTs). […] In univariate Cox regression, low haemoglobin and albumin as well as high leukocytes, N, NLR, SII and CRP were associated with a shorter OS. […] In multivariable Cox regression analyses, high leukocyte (hazard ratio (HR) 1.274 (95% confidence interval (CI) 1.0571.535); P=0.011) and N count (1.470 (1.0921.980); P=0.011), higher NLR (84.5 (2.23193.4); P=0.017) and SII (12.15 (1.17126.26); P=0.037) remained independent prognostic predictors for OS besides the IGCCCG risk groups. […] Systemic inflammatory markers might have prognostic utility for patients with metastatic GCT. […] In the present investigation, we were able to show, to the best of our knowledge for the first time, that different markers of systemic inflammation (namely leukocytes, neutrophils, NLR and SII) have the potential to improve prediction of oncologic outcome in patients with metastatic GCT in addition to the well-established IGCCCG classification system. […] Several systemic inflammatory markers, which are available from routinely performed inexpensive blood tests, demonstrated incremental prognostic information in addition to the IGCCCG risk groups for patients with metastatic GCT undergoing first-line chemotherapy.

• #26 Systemic inflammatory markers have independent prognostic value in patients with metastatic testicular germ cell tumours undergoing first-line chemotherapy | British Journal of Cancer

  https://www.nature.com/articles/bjc2017467

  The prognostic utility of systemic inflammatory markers has so far not been investigated in patients with metastatic testicular germ cell tumours (GCTs). […] In univariate Cox regression, low haemoglobin and albumin as well as high leukocytes, N, NLR, SII and CRP were associated with a shorter OS. […] In multivariable Cox regression analyses, high leukocyte (hazard ratio (HR) 1.274 (95% confidence interval (CI) 1.0571.535); P=0.011) and N count (1.470 (1.0921.980); P=0.011), higher NLR (84.5 (2.23193.4); P=0.017) and SII (12.15 (1.17126.26); P=0.037) remained independent prognostic predictors for OS besides the IGCCCG risk groups. […] Systemic inflammatory markers might have prognostic utility for patients with metastatic GCT. […] In the present investigation, we were able to show, to the best of our knowledge for the first time, that different markers of systemic inflammation (namely leukocytes, neutrophils, NLR and SII) have the potential to improve prediction of oncologic outcome in patients with metastatic GCT in addition to the well-established IGCCCG classification system. […] Several systemic inflammatory markers, which are available from routinely performed inexpensive blood tests, demonstrated incremental prognostic information in addition to the IGCCCG risk groups for patients with metastatic GCT undergoing first-line chemotherapy.

• #27 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  Germ Cell Tumors (GCT) have a high cure rate, but we currently lack the ability to accurately identify the small subset of patients who will die from their disease. […] We built several models based on these differentially expressed genes, then tested them in an independent validation set of 54 NSGCTs. These predictive models correctly classified outcome in 6479.6% of patients in the validation set, depending on the endpoint utilized. […] This novel set of predictive genes from altered genomic regions is almost entirely independent of our previously identified set of predictive genes for patients with NSGCTs. These genes may aid in the identification of the small subset of patients who are at high risk of poor outcome. […] While the IGCCCG classification is useful for making treatment decisions, it does not perform as well in predicting patient outcome.

• #28 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  The addition of prognostic molecular markers could improve patient outcome prediction, as well as identify patients who might benefit from more aggressive or alternative treatments that are traditionally reserved for second line or salvage therapies, such as high dose chemotherapy with stem cell rescue or ifosfamide based therapies. […] For 5yDSS, the full set of 75 probe sets was optimal, giving a prediction rate of 75.6% in the independent data set. […] Based on the predicted outcome using only the 5yDSS associated probe sets or the combined set of probe sets in the independent tumor set, we performed survival analysis by the Kaplan-Meier method. […] The gene set appears to be effective in further stratifying patients who are at higher risk, which could be beneficial in identifying patients who would benefit from more stringent monitoring and/or aggressive chemotherapy.

• #29 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  The addition of prognostic molecular markers could improve patient outcome prediction, as well as identify patients who might benefit from more aggressive or alternative treatments that are traditionally reserved for second line or salvage therapies, such as high dose chemotherapy with stem cell rescue or ifosfamide based therapies. […] For 5yDSS, the full set of 75 probe sets was optimal, giving a prediction rate of 75.6% in the independent data set. […] Based on the predicted outcome using only the 5yDSS associated probe sets or the combined set of probe sets in the independent tumor set, we performed survival analysis by the Kaplan-Meier method. […] The gene set appears to be effective in further stratifying patients who are at higher risk, which could be beneficial in identifying patients who would benefit from more stringent monitoring and/or aggressive chemotherapy.

• #30 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  Germ Cell Tumors (GCT) have a high cure rate, but we currently lack the ability to accurately identify the small subset of patients who will die from their disease. […] We built several models based on these differentially expressed genes, then tested them in an independent validation set of 54 NSGCTs. These predictive models correctly classified outcome in 6479.6% of patients in the validation set, depending on the endpoint utilized. […] This novel set of predictive genes from altered genomic regions is almost entirely independent of our previously identified set of predictive genes for patients with NSGCTs. These genes may aid in the identification of the small subset of patients who are at high risk of poor outcome. […] While the IGCCCG classification is useful for making treatment decisions, it does not perform as well in predicting patient outcome.

• #31 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8871072/

  Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. […] The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs. […] The usefulness of AFP as a prognostic factor was demonstrated by Frasier et al., who checked how using the IGCCC classification in pediatric malignant NSGCTs has an influence on prognostic factors. […] In the final results, AFP 10,000 ng/mL was defined as predictive of a poor outcome of event-free survival (EFS) and overall survival (OS).

• #32 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. […] The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs. […] The usefulness of AFP as a prognostic factor was demonstrated by Frasier et al. […] According to the IGCCC classification, the initial AFP level is one of the factors considered in dividing patients into the following three risk groups, respectively: for the group with good prognosis, <1000 ng/mL; for the group with an intermediate prognosis, ≥1000 and ≤than 10,000 ng/mL; and for group with a poor prognosis, >10,000 ng/mL.

• #33 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8871072/

  Serum tumors markers were elevated in 2875% of the patients at the time of recurrence and were the only indication of recurrence in 439%. […] Serum tumor markers, the onco-fetoproteins (AFP and -hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, -hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs.

• #34 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Serum tumor markers, the “onco”-fetoproteins (AFP and β-hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, β-hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs. The use of these miRNAs could potentially identify patients with a worse prognosis.

• #35 Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

  https://www.mdpi.com/2075-4418/12/2/278

  Serum tumor markers, the “onco”-fetoproteins (AFP and β-hCG), are helpful in the diagnosis and monitoring of GCTs, as well as in the detection of residual or progressive disease. […] However, the following conventional biomarkers, AFP, β-hCG and LDH, have limited utility for the diagnosis and follow-up of malignant GCTs. […] Embryonic miRNAs show great potential for the clinical management of testicular GCTs. The use of these miRNAs could potentially identify patients with a worse prognosis.

• #36 Nomograms to predict the prognosis in malignant ovarian germ cell tumors: a large cohort study | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09324-7

  Malignant ovarian germ cell tumors (MOGCTs) are rare gynecologic neoplasms. The prognosis is usually good, with a 5-year overall survival (OS) of 95% for stage I tumors and 73% for advanced stage IIIV tumors. Mangili et al. showed that the OS of patients with MOGCTs is correlated to tumor stage and histological classification, but not surgical type, tumor size, or tumor marker elevation. A nomogram constructed using multiple clinical indicators provided a more accurate prognosis than FIGO staging alone. This nomogram may assist clinicians in identifying patients who are at increased risk, thus implementing individualized treatment regimens. […] The nomogram can better predict OS of MOGCTs, and has better clinical benefits. […] The nomogram has a better predictive power and clinical utility than the simple FIGO staging system using ROC and DCA analyses. Excellent consistency between the predicted and observed OS was observed through internal validation. Based on our findings, nomograms can be used to effectively assess prognoses of MOGCTs and provide individual references for the follow-up treatment of patients.

• #37 Nomograms to predict the prognosis in malignant ovarian germ cell tumors: a large cohort study | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09324-7

  Malignant ovarian germ cell tumors (MOGCTs) are rare gynecologic neoplasms. The prognosis is usually good, with a 5-year overall survival (OS) of 95% for stage I tumors and 73% for advanced stage IIIV tumors. Mangili et al. showed that the OS of patients with MOGCTs is correlated to tumor stage and histological classification, but not surgical type, tumor size, or tumor marker elevation. A nomogram constructed using multiple clinical indicators provided a more accurate prognosis than FIGO staging alone. This nomogram may assist clinicians in identifying patients who are at increased risk, thus implementing individualized treatment regimens. […] The nomogram can better predict OS of MOGCTs, and has better clinical benefits. […] The nomogram has a better predictive power and clinical utility than the simple FIGO staging system using ROC and DCA analyses. Excellent consistency between the predicted and observed OS was observed through internal validation. Based on our findings, nomograms can be used to effectively assess prognoses of MOGCTs and provide individual references for the follow-up treatment of patients.

• #38 Nomograms to predict the prognosis in malignant ovarian germ cell tumors: a large cohort study | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09324-7

  Malignant ovarian germ cell tumors (MOGCTs) are rare gynecologic neoplasms. The prognosis is usually good, with a 5-year overall survival (OS) of 95% for stage I tumors and 73% for advanced stage IIIV tumors. Mangili et al. showed that the OS of patients with MOGCTs is correlated to tumor stage and histological classification, but not surgical type, tumor size, or tumor marker elevation. A nomogram constructed using multiple clinical indicators provided a more accurate prognosis than FIGO staging alone. This nomogram may assist clinicians in identifying patients who are at increased risk, thus implementing individualized treatment regimens. […] The nomogram can better predict OS of MOGCTs, and has better clinical benefits. […] The nomogram has a better predictive power and clinical utility than the simple FIGO staging system using ROC and DCA analyses. Excellent consistency between the predicted and observed OS was observed through internal validation. Based on our findings, nomograms can be used to effectively assess prognoses of MOGCTs and provide individual references for the follow-up treatment of patients.

• #39 Nomograms to predict the prognosis in malignant ovarian germ cell tumors: a large cohort study | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09324-7

  In summary, the nomogram of this study demonstrated better prognostic accuracy than that of the FIGO staging system and reliably predicted 1-year, 3-year, and 5-year OS in patients with MOGCTs. This nomogram may prove to be a good predictive tool for gynecological clinical practice and help in the management of patients with MOGCTs.

• #40

  https://journals.lww.com/indianjcancer/fulltext/2007/44010/outcome_of_patients_with_stage_ii_and_iii.2.aspx

  The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. […] The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. […] Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% (P 0.001) and disease-free survival rates were 83%, 34% and 7% (P 0.001) in good, intermediate and poor risk groups, respectively. […] This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site.

• #41

  https://journals.lww.com/indianjcancer/fulltext/2007/44010/outcome_of_patients_with_stage_ii_and_iii.2.aspx

  In our study, we found that, five-year overall survival rates were 85% and 44% and five-year disease-free survival rates were 75% and 29% in patients with stage II and III disease, respectively. However, according to risk groups, five-year overall survival rates were 97%, 75% and 7%; and five-year disease-free survival rates were 83%, 34% and 7% in good risk, intermediate risk and poor risk groups, respectively. This data shows that the outcome of patients was closely related with risk groups. […] Our study showed that persistent elevation of serum tumor markers was a significant prognostic factor in univariate analysis (P 0.001) but not in multivariate analysis (p: 0.59). […] In summary, although our study retrospectively examined the patients most of whom underwent their surgery at different centers, their survival rates according to risk groups are similar to the current literature data and the outcome of patients with advanced stage nonseminomatous germ cell tumors is closely related with the localization site and the relapse site of the tumor.

• #42

  http://waocp.com/journal/index.php/apjcc/article/view/1227

  The present study revealed a statistically significant correlation between histological type and stage concerning age. In the neonatal group, all cases were exclusively teratomas. In the prepubertal group, only non-seminomatous tumors were observed, whereas in the post-pubertal group, both seminomatous and non-seminomatous tumors were noted (p=0.002). In the neonatal group, all tumors presented in stage I in contrast to the prepubertal (92.6%) and post-pubertal group (78.5%) (p=0.034). The estimated O.S was 93.4% and EFS was 90.2% across all age groups. Overall survival of 100% was observed in the neonatal, 96.3% in the prepubertal and 88.0% in the post-pubertal group showing a declining trend with increasing age (p=0.324), although not statistically significant. […] An excellent prognosis was noted in the neonatal group regardless of the tumor location. The prepubertal group showed a higher percentage of recurrence with the least EFS (81.8%) among the three subgroups. We observed poorer OS in mediastinal lesions (84.2%) (p=0.239) and the least EFS in retroperitoneal lesions (84.6%) (p=0.446). Kaplan-Meier analysis identified histological subtype as a significant prognostic parameter.

• #43

  https://journals.lww.com/indianjcancer/fulltext/2007/44010/outcome_of_patients_with_stage_ii_and_iii.2.aspx

  The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. […] The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. […] Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% (P 0.001) and disease-free survival rates were 83%, 34% and 7% (P 0.001) in good, intermediate and poor risk groups, respectively. […] This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site.

• #44

  https://journals.lww.com/indianjcancer/fulltext/2007/44010/outcome_of_patients_with_stage_ii_and_iii.2.aspx

  In our study, we found that, five-year overall survival rates were 85% and 44% and five-year disease-free survival rates were 75% and 29% in patients with stage II and III disease, respectively. However, according to risk groups, five-year overall survival rates were 97%, 75% and 7%; and five-year disease-free survival rates were 83%, 34% and 7% in good risk, intermediate risk and poor risk groups, respectively. This data shows that the outcome of patients was closely related with risk groups. […] Our study showed that persistent elevation of serum tumor markers was a significant prognostic factor in univariate analysis (P 0.001) but not in multivariate analysis (p: 0.59). […] In summary, although our study retrospectively examined the patients most of whom underwent their surgery at different centers, their survival rates according to risk groups are similar to the current literature data and the outcome of patients with advanced stage nonseminomatous germ cell tumors is closely related with the localization site and the relapse site of the tumor.

• #45

  https://journals.lww.com/indianjcancer/fulltext/2007/44010/outcome_of_patients_with_stage_ii_and_iii.2.aspx

  In our study, we found that, five-year overall survival rates were 85% and 44% and five-year disease-free survival rates were 75% and 29% in patients with stage II and III disease, respectively. However, according to risk groups, five-year overall survival rates were 97%, 75% and 7%; and five-year disease-free survival rates were 83%, 34% and 7% in good risk, intermediate risk and poor risk groups, respectively. This data shows that the outcome of patients was closely related with risk groups. […] Our study showed that persistent elevation of serum tumor markers was a significant prognostic factor in univariate analysis (P 0.001) but not in multivariate analysis (p: 0.59). […] In summary, although our study retrospectively examined the patients most of whom underwent their surgery at different centers, their survival rates according to risk groups are similar to the current literature data and the outcome of patients with advanced stage nonseminomatous germ cell tumors is closely related with the localization site and the relapse site of the tumor.

• #46 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  A female-specific mIGCCCG risk model effectively stratifies patients and should be incorporated into clinical trials. […] Prognosis is excellent, and most GCTs are cured with etoposide and cisplatin-based chemotherapy. […] Accurate risk classification is important to select appropriate therapies to personalize treatment and maximize potential for cure, while minimizing side effects of treatment. […] The IGCCCG model is often extrapolated for female patients with GCT, although data in this setting are limited. […] Our earlier work proposed a modified IGCCCG (mIGCCCG) risk stratification system for female patients undergoing chemotherapy based on the male IGCCCG model but with modification to consider peritoneal spread as a favorable metastatic site given differences in anatomy. […] We found that 3-year PFS and OS were excellent, and histology, age, and stage at diagnosis were significant predictors of survival.

• #47 GAMEC – a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours | British Journal of Cancer

  https://www.nature.com/articles/6603865

  There is no consensus as to the management of untreated poor prognosis or relapsed/refractory germ cell tumours. […] Twenty of the untreated patients were progression free following GAMEC and appropriate surgery, as were 18 individuals in the pretreated group. […] None of the established prognostic factors for therapy for pretreated patients could identify a poor-prognosis group. […] GAMEC is a novel intensive regimen for this group of patients producing encouraging responses, although with significant toxicity. […] The majority of patients had non-seminomatous GCT and the median age measured was 33 years. At a median follow-up of 2.5 years, 20 (74%) untreated patients were PF following GAMEC and appropriate surgery. […] Eighteen (51%) of the pretreated group were similarly PF and a further four were salvaged by additional therapy. […] We could only identify two prognostic factors that correlated with poor outcome, namely age and raised LDH before GAMEC. […] Overall, these results show that GAMEC is an effective therapy both for untreated patients and those who relapse.

• #48 GAMEC – a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours | British Journal of Cancer

  https://www.nature.com/articles/6603865

  There is no consensus as to the management of untreated poor prognosis or relapsed/refractory germ cell tumours. […] Twenty of the untreated patients were progression free following GAMEC and appropriate surgery, as were 18 individuals in the pretreated group. […] None of the established prognostic factors for therapy for pretreated patients could identify a poor-prognosis group. […] GAMEC is a novel intensive regimen for this group of patients producing encouraging responses, although with significant toxicity. […] The majority of patients had non-seminomatous GCT and the median age measured was 33 years. At a median follow-up of 2.5 years, 20 (74%) untreated patients were PF following GAMEC and appropriate surgery. […] Eighteen (51%) of the pretreated group were similarly PF and a further four were salvaged by additional therapy. […] We could only identify two prognostic factors that correlated with poor outcome, namely age and raised LDH before GAMEC. […] Overall, these results show that GAMEC is an effective therapy both for untreated patients and those who relapse.

• #49

  https://link.springer.com/article/10.1007/s00432-020-03343-2

  The 66% 5-years OS rate of poor-risk patients remains unsatisfactory although this represents an improvement compared to the original IGCCCG risk classification. However, attempts to improve overall survival by intensification of first line chemotherapy have failed. […] In conclusion, compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has markedly improved. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved.

• #50 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  The addition of prognostic molecular markers could improve patient outcome prediction, as well as identify patients who might benefit from more aggressive or alternative treatments that are traditionally reserved for second line or salvage therapies, such as high dose chemotherapy with stem cell rescue or ifosfamide based therapies. […] For 5yDSS, the full set of 75 probe sets was optimal, giving a prediction rate of 75.6% in the independent data set. […] Based on the predicted outcome using only the 5yDSS associated probe sets or the combined set of probe sets in the independent tumor set, we performed survival analysis by the Kaplan-Meier method. […] The gene set appears to be effective in further stratifying patients who are at higher risk, which could be beneficial in identifying patients who would benefit from more stringent monitoring and/or aggressive chemotherapy.

• #51 Predicting outcomes in female germ cell tumors using a modified International Germ Cell Cancer Collaborative Group classification system to guide management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10023473/

  A female-specific mIGCCCG risk model effectively stratifies patients and should be incorporated into clinical trials. […] Prognosis is excellent, and most GCTs are cured with etoposide and cisplatin-based chemotherapy. […] Accurate risk classification is important to select appropriate therapies to personalize treatment and maximize potential for cure, while minimizing side effects of treatment. […] The IGCCCG model is often extrapolated for female patients with GCT, although data in this setting are limited. […] Our earlier work proposed a modified IGCCCG (mIGCCCG) risk stratification system for female patients undergoing chemotherapy based on the male IGCCCG model but with modification to consider peritoneal spread as a favorable metastatic site given differences in anatomy. […] We found that 3-year PFS and OS were excellent, and histology, age, and stage at diagnosis were significant predictors of survival.

• #52 Development and Validation of a Gene-Based Model for Outcome Prediction in Germ Cell Tumors Using a Combined Genomic and Expression Profiling Approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0142846

  Germ Cell Tumors (GCT) have a high cure rate, but we currently lack the ability to accurately identify the small subset of patients who will die from their disease. […] We built several models based on these differentially expressed genes, then tested them in an independent validation set of 54 NSGCTs. These predictive models correctly classified outcome in 6479.6% of patients in the validation set, depending on the endpoint utilized. […] This novel set of predictive genes from altered genomic regions is almost entirely independent of our previously identified set of predictive genes for patients with NSGCTs. These genes may aid in the identification of the small subset of patients who are at high risk of poor outcome. […] While the IGCCCG classification is useful for making treatment decisions, it does not perform as well in predicting patient outcome.

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