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1. Fosså SD, Aass N, Harvei S, Tretli S: Increased mortality rates in young and middle-aged patients with malignant germ cell tumours. Br J Cancer; 2004 Feb 9;90(3):607-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Increased mortality rates in young and middle-aged patients with malignant germ cell tumours.
  • Cisplatin-based chemotherapy of malignant germ cell tumours (MGCT) has been reported to increase the risk of cardiovascular morbidity.
  • A high incidence of second nongerm cell malignancies is well documented in MGCT survivors.
  • The death risk due to these conditions is, however, more unknown in MGCT patients.
  • Standard mortality rates (SMRs) were established in 3378 Norwegian MGCT patients treated from 1962 to 1997 aged <or=55 years.
  • The patients represented three principal treatment strategies: 1962/1969 (period 1): radiotherapy only; 1970/1979 (period 2): radiotherapy with or without noncisplatin-containing chemotherapy; 1980/1997 (period 3): surgery only or radiotherapy or cisplatin-based chemotherapy.
  • Patients not dying from MGCT displayed significantly increased SMRs for respectively diseases of the circulatory system (SMR: 1.2, 95% confidence interval (CI): 1.0-1.5), benign gastrointestinal disorders (SMR: 2.1, 95% CI: 1.1-3.5) and nongerm cell malignancies (SMR: 2.0, 95% CI: 1.7-2.4).
  • The risk of dying from a nongerm cell malignancy was increased both in periods 2 and 3.
  • In conclusion, although the overall SMR for diseases of the circulatory system is increased in MCGT survivors, the introduction of cisplatin-based chemotherapy into the treatment of MGCT has so far not resulted in increased death rates due to these conditions.
  • Patients with MGCT have a significantly increased relative death risk due to a second nongerm cell cancer, even after the introduction of modern treatment principles with overall reduction of radiotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cardiovascular Diseases / chemically induced. Cardiovascular Diseases / mortality. Cisplatin / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / mortality. Registries / statistics & numerical data
  • [MeSH-minor] Adolescent. Adult. Age Factors. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Mortality / trends. Neoplasms, Second Primary / etiology. Neoplasms, Second Primary / mortality. Radiation Injuries / mortality. Risk Factors. Survival Analysis

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  • (PMID = 14760372.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2409607
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2. Oldenburg J, Alfsen GC, Waehre H, Fosså SD: Late recurrences of germ cell malignancies: a population-based experience over three decades. Br J Cancer; 2006 Mar 27;94(6):820-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Late recurrences of germ cell malignancies: a population-based experience over three decades.
  • The purpose of this study was to explore the incidence of late relapse in patients with malignant germ cell tumour (MGCT) in a population-based series, with emphasis on the mode of detection, survival, and the relevance of histological findings.
  • Twenty-five patients developed a late relapse.
  • All 10 seminoma patients, but only eight of 15 non-seminoma patients relapsed with vital malignant tumour (P=0.02).
  • Teratoma or necrosis was found in seven of nine primarily chemotherapy-treated non-seminoma patients with normal tumour markers at late relapse.
  • Six of nine patients operated with limited retroperitoneal lymph node dissection as part of the primary treatment had relapsed retroperitoneally outside the original operation field.
  • The 10-year cause-specific survival was 68% in all patients, 50% in patients relapsing with vital malignant tumour and 100% in those with teratoma/ necrosis before or after salvage chemotherapy.
  • The 10-year incidence rate of late relapses of 1.3% might reflect the true incidence rate in a population-based cohort of MGCT patients, with cure in at least half of them.
  • [MeSH-major] Neoplasm Recurrence, Local / epidemiology. Neoplasms, Germ Cell and Embryonal / pathology. Seminoma / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Cohort Studies. Humans. Incidence. Male. Middle Aged. Necrosis. Time Factors

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  • (PMID = 16508636.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3216420
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3. Díaz Muñoz de la Espada VM, Khosravi Shahi P, Hernández Marín B, Encinas García S, Arranz Arija JA, Pérez-Manga G: [Mediastinal germ-cell tumours]. An Med Interna; 2008 May;25(5):241-3

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Mediastinal germ-cell tumours].
  • [Transliterated title] Tumores germinales mediastínicos.
  • Germ-cell tumours of male ussually arise from the testis.
  • However, in 2-5% of the cases, they also occur outside of the testis as a primary site without evidence of testicular primary tumour.
  • Mediastinal germ-cell tumours (MGCT) shall be included in the differential diagnosis of any mediastinic tumour of unknown origin.
  • An accurate diagnosis is essential, due to the fact that these tumours are curable with chemotherapy.
  • The histopathologic and clinical features, and its differences with germ-cell tumours from testicular origin are revised in this article.
  • [MeSH-major] Mediastinal Neoplasms. Neoplasms, Germ Cell and Embryonal
  • [MeSH-minor] Humans. Male

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  • (PMID = 18769749.001).
  • [ISSN] 0212-7199
  • [Journal-full-title] Anales de medicina interna (Madrid, Spain : 1984)
  • [ISO-abbreviation] An Med Interna
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 19
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4. Anthoney DA, McKean MJ, Roberts JT, Hutcheon AW, Graham J, Jones W, Paul J, Kaye SB: Bleomycin, vincristine, cisplatin/bleomycin, etoposide, cisplatin chemotherapy: an alternating, dose intense regimen producing promising results in untreated patients with intermediate or poor prognosis malignant germ-cell tumours. Br J Cancer; 2004 Feb 9;90(3):601-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Bleomycin, vincristine, cisplatin/bleomycin, etoposide, cisplatin chemotherapy: an alternating, dose intense regimen producing promising results in untreated patients with intermediate or poor prognosis malignant germ-cell tumours.
  • Patients with poor and intermediate prognosis metastatic germ-cell tumours (MGCTs) are at a significant risk of relapse after standard platinum-based chemotherapy.
  • Novel treatment regimens are required to improve survival.
  • Dose intense, alternating combinations of drugs with known activity in germ-cell tumours represents one approach.
  • In all, 43 patients with IGCCCG intermediate/poor prognosis MGCT were treated with a dose intense regimen alternating bleomycin, vincristine, cisplatin (BOP) with bleomycin, etoposide, cisplatin (BEP) to a maximum of three cycles.
  • The complete response rate was 58%; a further 7% of patients being rendered disease free by resection of viable residual tumour.
  • With a median follow-up of more than 4 years in surviving patients, 3-year OS and PFS rates of 81% (95% CI: 66-91%) and 72% (95% CI: 56-83%) are seen, respectively.
  • Bleomycin, vincristine, cisplatin (BOP)/bleomycin, etoposide, cisplatin (BEP) represents a practicable, well-tolerated, dose intense chemotherapy regimen with significant activity in intermediate and poor prognosis MGCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Dose-Response Relationship, Drug. Drug Administration Schedule. Etoposide / administration & dosage. Female. Humans. Infusions, Intravenous. Injections, Intramuscular. Middle Aged. Neutropenia / chemically induced. Prognosis. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 14760371.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol; COB protocol
  • [Other-IDs] NLM/ PMC2409589
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5. Fosså SD, Paluchowska B, Horwich A, Kaiser G, de Mulder PH, Koriakine O, van Oosterom AT, de Prijck L, Collette L, de Wit R, EORTC GU Group: Intensive induction chemotherapy with C-BOP/BEP for intermediate- and poor-risk metastatic germ cell tumours (EORTC trial 30948). Br J Cancer; 2005 Nov 28;93(11):1209-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intensive induction chemotherapy with C-BOP/BEP for intermediate- and poor-risk metastatic germ cell tumours (EORTC trial 30948).
  • New chemotherapy regimens are continuously explored in patients with high-risk malignant germ cell tumours (MGCTs).
  • This multicentre phase II trial assessed the efficacy and toxicity of C-BOP/BEP chemotherapy in intermediate and poor prognosis MGCT (IGCCCG criteria).
  • C-BOP/BEP treatment consisted of cycles of cisplatin, vincristine, bleomycin and carboplatin, followed by one cycle of vincristine and bleomycin and three cycles of BEP (bleomycon, etoposide, cisplatin).
  • The trial was designed to demonstrate a 1-year progression-free survival rate of 80%, that is, to exclude a 1-year rate of 70% or less, with a one-sided significance level of 5%.
  • After a median observation time of 40.4 months (range: 13.7-66.3), the 1-year progression-free survival rate was 81.8% 95% CI: 72.5-91.1%).
  • With an 82% 1-year progression-free survival and a lower limit of the 95% CI above 70%, the efficacy of C-BOP/BEP is comparable to that of published alternative chemotherapy schedules in high-risk MGCT patients.
  • The treatment's toxicity is manageable in a multicentre setting.
  • In poor prognosis patients, C-BOP/BEP should be compared to standard chemotherapy of four cycles of BEP.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Disease Progression. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Prognosis. Risk Assessment. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 16251877.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; BEP protocol
  • [Other-IDs] NLM/ PMC2361516
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6. Aoyama A, Bando T, Okubo K, Wada H: [Current strategy for primary mediastinal germ cell tumors]. Nihon Geka Gakkai Zasshi; 2006 Nov;107(6):284-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Current strategy for primary mediastinal germ cell tumors].
  • Mediastinal germ cell tumor (MGCT) is histologically similar to, but is different from that in gonad glands.
  • As to therapy, mature teratoma can be cured by resection alone.
  • But cisplatin-based chemotherapy, often together with resection and radiation, has been playing a primary role in managing malignant MGCT consisting of seminoma and non-seminomatous MGCT.
  • Consequently, comparably high cure rate in MGCT has been achieved.
  • Treatment decisions should be based on the available evidence mainly obtained by retrospective studies because of the rarity of the entity.
  • In this article, we reviewed the current strategy for MGCT, and described the outcome of 30 cases of malignant MGCT in our institution, in addition to presenting a case of nonseminomatous MGCT.
  • Seventeen of 18 patients with malignant MGCT survived after surgery with cisplatin-based chemotherapy, while only 3 of 12 survived before cisplatin was introduced.
  • In non-seminomatous MGCT, we now adopt cisplatin-based chemotherapy followed by surgery, including high-dose chemotherapy with peripheral blood stem cell transplantation to obtain the normalization of tumor markers.
  • Additional chemotherapy is considered, if viable cells are found in resected specimen.
  • [MeSH-major] Mediastinal Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Thoracic Surgical Procedures
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Humans. Male. Peripheral Blood Stem Cell Transplantation. Retrospective Studies

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  • (PMID = 17147288.001).
  • [ISSN] 0301-4894
  • [Journal-full-title] Nihon Geka Gakkai zasshi
  • [ISO-abbreviation] Nihon Geka Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Number-of-references] 17
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7. Oldenburg J, Wahlqvist R, Fosså SD: Late relapse of germ cell tumors. World J Urol; 2009 Aug;27(4):493-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Late relapse of germ cell tumors.
  • OBJECTIVE: To assess the main characteristics of late relapsing malignant germ cell tumors (MGCTs).
  • These tumors are rare and occur by definition 2 years or later after successful treatment.
  • METHODS: We present relevant literature on relapsing MGCT in order to highlight the following issues: incidence, impact of initial treatment on the subsequent risk of late relapse, treatment, and survival.
  • RESULTS: A pooled analysis of 5,880 patients with MGCT revealed late relapses in 119 of 3,704 (3.2%) and in 31 of 2,176 (1.4%) patients with non-seminoma and seminoma, respectively.
  • The retroperitoneal space is the predominant site of relapse in both histological types.
  • The initial treatment is important for the risk and localization of late relapses.
  • Patients with single site teratoma are usually cured by surgery alone, whereas viable MGCT or teratoma with malignant transformation may require multimodal treatment with chemo- and/or radiotherapy as well as surgery.
  • Surgery is the most important part in the treatment of late relapses.
  • Salvage chemotherapy should, if feasible, be based on a representative biopsy.
  • CONCLUSIONS: Treatment of late relapsing MGCT patients is challenging and should be performed in experienced centers only.
  • Referral of late relapsing patients to high-volume institutions ensures the best chances of cure and enables multimodal treatment, and contributes to increased knowledge of tumor biology as well experience with the clinical course of these patients.
  • [MeSH-major] Neoplasm Recurrence, Local / surgery. Neoplasms, Germ Cell and Embryonal / surgery. Retroperitoneal Neoplasms / surgery. Seminoma / surgery
  • [MeSH-minor] Combined Modality Therapy. Humans. Male. Teratoma / drug therapy. Teratoma / secondary. Teratoma / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery

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  • (PMID = 19373473.001).
  • [ISSN] 1433-8726
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Number-of-references] 58
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8. Rogers PC, Olson TA, Cullen JW, Billmire DF, Marina N, Rescorla F, Davis MM, London WB, Lauer SJ, Giller RH, Cushing B, Pediatric Oncology Group 9048, Children's Cancer Group 8891: Treatment of children and adolescents with stage II testicular and stages I and II ovarian malignant germ cell tumors: A Pediatric Intergroup Study--Pediatric Oncology Group 9048 and Children's Cancer Group 8891. J Clin Oncol; 2004 Sep 1;22(17):3563-9
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  • [Title] Treatment of children and adolescents with stage II testicular and stages I and II ovarian malignant germ cell tumors: A Pediatric Intergroup Study--Pediatric Oncology Group 9048 and Children's Cancer Group 8891.
  • PURPOSE: To determine whether children with localized gonadal malignant germ cell tumors (MGCT) stage II testicular and stages I and II ovarian treated with four cycles of standard-dose cisplatin combined with etoposide and low-dose bleomycin (PEB) have an event-free survival (EFS) of at least 85% without significant toxicity.
  • PATIENTS AND METHODS: Between May 1990 and July 1995, eligible pediatric patients with stage II or recurrent from stage I (as a stage II) testicular MGCT and stages I and II ovarian MGCT were enrolled onto this Pediatric Oncology Group and Children's Cancer Group study.
  • PEB chemotherapy consisted of bleomycin 15 U/m2 on day 1, cisplatin 20 mg/m2/d on days 1 to 5, and etoposide 100 mg/m2/d on days 1 to 5.
  • Patients received four cycles of therapy at 21-day intervals.
  • RESULTS: Seventy-four patients with a median age of 10.5 years (range, 8.7 months to 16.7 years) were enrolled.
  • Primary sites included: stage II testicular (n = 17), stage I ovarian (n = 41), and stage II ovarian MGCT (n = 16).
  • Treatment with standard PEB resulted in 6-year EFS of 95% and overall survival (OS) of 95.7%.
  • EFS and OS by primary site were as follows: stage II testicular, 100% and 100%; stage I ovarian, 95.1% and 95.1%; and stage II ovarian, 87.5% and 93.8%, respectively.
  • CONCLUSION: Combination chemotherapy with PEB results in excellent EFS and OS with minimal toxicity in children and adolescents with localized gonadal MGCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Etoposide / therapeutic use. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Child. Combined Modality Therapy. Disease-Free Survival. Female. Germinoma / drug therapy. Germinoma / surgery. Humans. Male. Neutropenia

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  • (PMID = 15337806.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA13539; United States / NCI NIH HHS / CA / U10 CA29139
  • [Publication-type] Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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9. Rescorla F, Billmire D, Vinocur C, Colombani P, London W, Giller R, Cushing B, Lauer S, Cullen J, Davis M, Hawkins E: The effect of neoadjuvant chemotherapy and surgery in children with malignant germ cell tumors of the genital region: a pediatric intergroup trial. J Pediatr Surg; 2003 Jun;38(6):910-2
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  • [Title] The effect of neoadjuvant chemotherapy and surgery in children with malignant germ cell tumors of the genital region: a pediatric intergroup trial.
  • PURPOSE: This study was designed to evaluate (1) the efficacy of standard or high-dose cisplatin with etoposide and bleomycin and (2) the role of surgical resection in infants and children with malignant germ cell tumors (MGCT) of the genital region.
  • METHODS: Fourteen of 317 children enrolled in to the Pediatric Oncology Group/Children's Cancer Group intergroup study of MGCT from 1990 through 1996 had genital tumors.
  • The initial procedure was biopsy in 11 and subtotal resection in 2.
  • Two with relapse were saved with additional therapy, and one with progressive disease died.
  • (1) the current survival rate for genital MGCT is excellent, (2) delayed surgical resection with organ preservation is not associated with an adverse outcome, and (3) the treatment comparison of the effect of cisplatin dose was inconclusive in this small study population.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Germinoma / surgery. Neoadjuvant Therapy / methods. Urogenital Neoplasms / drug therapy. Urogenital Neoplasms / surgery
  • [MeSH-minor] Bleomycin / administration & dosage. Child, Preschool. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant. Male. Neoplasms, Germ Cell and Embryonal. Penile Neoplasms / diagnosis. Penile Neoplasms / drug therapy. Penile Neoplasms / mortality. Penile Neoplasms / surgery. Survival Rate. Treatment Outcome. Uterine Neoplasms / diagnosis. Uterine Neoplasms / drug therapy. Uterine Neoplasms / mortality. Uterine Neoplasms / surgery. Vaginal Neoplasms / diagnosis. Vaginal Neoplasms / drug therapy. Vaginal Neoplasms / mortality. Vaginal Neoplasms / surgery

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  • (PMID = 12778391.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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10. Suita S, Shono K, Tajiri T, Takamatsu T, Mizote H, Nagasaki A, Inomata Y, Hara T, Okamura J, Miyazaki S, Kawakami K, Eguchi H, Tsuneyoshi M, Committee for Pediatric Solid Malignant Tumors in the Kyushu Area: Malignant germ cell tumors: clinical characteristics, treatment, and outcome. A report from the study group for Pediatric Solid Malignant Tumors in the Kyushu Area, Japan. J Pediatr Surg; 2002 Dec;37(12):1703-6
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  • [Title] Malignant germ cell tumors: clinical characteristics, treatment, and outcome. A report from the study group for Pediatric Solid Malignant Tumors in the Kyushu Area, Japan.
  • PURPOSE: This study aims to assess the prognostic factors and optimal treatments for malignant germ cell tumors (MGCT) in childhood.
  • METHODS: Among 117 MGCT, the clinical features were analyzed.
  • The prognostic factors and treatments were assessed based on the 5-year survival rate. RESULTS:.
  • (1) Stage: 100% for stage I (n = 54), 75.0% for stage II (n = 4), 67.3% for stage III (n = 14), and 54.8% for stage IV (n = 33); Unknown: n = 12. (2) Primary site: 93.4% for the testis (n = 52), 86.7% for the ovary (n = 31), 56.9% for the sacrococcygeal (n = 21), and 60.6% for others (n = 12); unknown: n = 1. (3) Surgical intervention for primary tumor: 100% for stage I with a complete resection (n = 53), 78.4% for stage III, IV with a complete resection (n = 26), and 33.3% for stage III, IV with an incomplete resection (n = 21). (4) Type of chemotherapy for the stage III and IV: 83.9% for the PVB (cisplatin, vinblastin, bleomycin; n = 13), 66.7% for the VAC (vincristine, actinomycin D, cyclophosphamide; n = 6), and 47.1% for other regimens (n = 25).
  • Radical complete resection alone is a sufficient treatment for localized MGCT.
  • The PVB regimen is optimal chemotherapy for advanced MGCT; however, high-risk cases still may require more aggressive treatment.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Female. Humans. Incidence. Infant. Infant, Newborn. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Male. Neoplasm Staging. Ovarian Neoplasms / diagnosis. Ovarian Neoplasms / epidemiology. Ovarian Neoplasms / surgery. Prognosis. Retrospective Studies. Survival Rate. Testicular Neoplasms / diagnosis. Testicular Neoplasms / epidemiology. Testicular Neoplasms / surgery. Treatment Outcome

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • [CommentIn] J Urol. 2003 Sep;170(3):1040 [12926414.001]
  • (PMID = 12483635.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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11. Itani Y, Kawa M, Toyoda S, Yamagami K, Hiraoka K: Growing teratoma syndrome after chemotherapy for a mixed germ cell tumor of the ovary. J Obstet Gynaecol Res; 2002 Jun;28(3):166-71
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  • [Title] Growing teratoma syndrome after chemotherapy for a mixed germ cell tumor of the ovary.
  • A retroperitoneal enlarging mass was detected and resected in a 24-year-old nulliparous woman after fertility-preserving surgery and adjuvant chemotherapy for a malignant germ cell tumor (MGCT) of the right ovary.
  • Alpha-fetoprotein, which was elevated to 21236.6 ng/mL before the initial surgery, persisted within normal after the completion of adjuvant platinum-based chemotherapy.
  • Growing teratoma syndrome originating from ovarian germ cell tumor is very rare.
  • Surgical resection and histological confirmation of growing mass after MGCT treatment is essential before conducting salvage chemotherapy.
  • [MeSH-major] Germinoma / surgery. Neoplasms, Second Primary / surgery. Ovarian Neoplasms / surgery. Teratoma / surgery
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Female. Humans. Magnetic Resonance Imaging. Syndrome. alpha-Fetoproteins / analysis

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  • (PMID = 12214834.001).
  • [ISSN] 1341-8076
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / alpha-Fetoproteins
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12. Cushing B, Giller R, Cullen JW, Marina NM, Lauer SJ, Olson TA, Rogers PC, Colombani P, Rescorla F, Billmire DF, Vinocur CD, Hawkins EP, Davis MM, Perlman EJ, London WB, Castleberry RP, Pediatric Oncology Group 9049, Children's Cancer Group 8882: Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study--Pediatric Oncology Group 9049 and Children's Cancer Group 8882. J Clin Oncol; 2004 Jul 1;22(13):2691-700
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  • [Title] Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study--Pediatric Oncology Group 9049 and Children's Cancer Group 8882.
  • PURPOSE: To determine in a randomized comparison whether combination chemotherapy with high-dose cisplatin (HDPEB) improves the event-free (EFS) and overall (OS) survival of children and adolescents with high-risk malignant germ cell tumors (MGCT) as compared with standard-dose cisplatin (PEB) and to compare the regimens' toxicity.
  • PATIENTS AND METHODS: Between March 1990 and February 1996, 299 eligible patients with stage III and IV gonadal and extragonadal (all stages) MGCT were enrolled onto this Pediatric Oncology Group and Children's Cancer Group study.
  • Chemotherapy included bleomycin 15 units/m(2) on day 1, etoposide 100 mg/m(2) on days 1 through 5, and either high-dose cisplatin 40 mg/m(2) on days 1 through 5 (HDPEB; n = 149) or standard-dose cisplatin 20 mg/m(2) on days 1 through 5 (PEB; n = 150).
  • Patients were evaluated after four cycles of therapy, and those with residual disease underwent surgery.
  • RESULTS: One hundred thirty-four eligible patients with advanced testicular (n = 60) or ovarian (n = 74) tumors and 165 with stage I to IV extragonadal tumors were enrolled.
  • HDPEB treatment resulted in significantly improved 6-year EFS rate +/- SE (89.6% +/- 3.6% v 80.5% +/- 4.8% for PEB; P =.0284).
  • Tumor-related deaths were more common after PEB (14 deaths v two deaths).
  • Other treatment-related toxicities were more common with HDPEB.
  • CONCLUSION: Combination chemotherapy with HDPEB significantly improves EFS for children with high-risk MGCT.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Bleomycin. Child. Child, Preschool. Disease-Free Survival. Dose-Response Relationship, Drug. Etoposide. Female. Humans. Male. Prognosis. Risk Factors

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  • (PMID = 15226336.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA13539; United States / NCI NIH HHS / CA / CA30969; United States / NCI NIH HHS / CA / U10CA29139
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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13. Ramani VA, Grey BR, Addla SK, Dunham MP, Sangar VK, Clarke NW: Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis. Clin Oncol (R Coll Radiol); 2008 Apr;20(3):247-52
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  • [Title] Histological outcome of delayed orchidectomy after primary chemotherapy for metastatic germ cell tumour of the testis.
  • AIMS: To identify the incidence of viable local tumour in the testis of patients undergoing delayed orchidectomy after initial presentation with advanced germ cell tumour (GCT) treated by primary chemotherapy.
  • All received chemotherapy without previous orchidectomy.
  • The decision to initiate chemotherapy without orchidectomy was based on a heavy tumour load and the patient's condition at initial presentation.
  • A histological diagnosis was available from a biopsy of metastases in 23 patients; treatment in the remaining 10 patients was initiated after diagnosis based on a combination of elevated serum tumour markers, testicular findings and the presence of a retroperitoneal mass.
  • RESULTS: Seminomatous GCT (SGCT) was diagnosed in 13 patients, non-seminomatous GCT (NSGCT) in 17 patients and mixed GCT (MGCT) in the remaining three patients.
  • Bleomycin/etoposide/cisplatin-based chemotherapy was the principle regimen.
  • After initial chemotherapy, all patients with pure SGCT had only scar tissue in the orchidectomy specimen, with no residual tumour.
  • Nine of 17 patients (52.9%) with NSGCT had viable tumour remaining in the orchidectomy specimen.
  • All three cases of MGCT had persistent viable invasive seminoma.
  • CONCLUSIONS: Thirty-six per cent of patients had residual tumour locally in the testis after primary chemotherapy for metastatic GCT of the testis.
  • However, in the cases with pure seminomatous disease, there was no residual tumour present.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Orchiectomy. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Biomarkers, Tumor / analysis. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Middle Aged. Salvage Therapy. Time Factors. Treatment Outcome

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  • (PMID = 18093814.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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14. Kakimoto K, Ono Y, Meguro N, Takezawa K, Yoshida T, Arai Y, Usami M: Stage I nonseminomatous germ cell tumors of the testis: Clinical outcome of 45 patients on a surveillance protocol after orchiectomy alone at a single institution in Japan. J Clin Oncol; 2009 May 20;27(15_suppl):e16165

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Stage I nonseminomatous germ cell tumors of the testis: Clinical outcome of 45 patients on a surveillance protocol after orchiectomy alone at a single institution in Japan.
  • : e16165 Background: In Japan, risk-adapted treatment for patients with clinical stage I nonseminomatous germ cell tumor of the testis (NSGCTT) has been performed in very few institutions.
  • This retrospective study was performed to evaluate histopathologic prognostic factors with stage I NSGCTT for whom careful follow-up with a surveillance protocol was possible at a single institution.
  • METHODS: We included 45 patients with a median age of 31 years (range 16 - 58) who were managed with a surveillance strategy after orchiectomy in our department between 1972 and 2006.
  • The patients were monitored at follow-up evaluation for tumor marker (AFP, beta-hCG) levels and by abdominal CT scan, chest x-ray, and physical examination.
  • Primary testis tumor samples were assessed for prognostic factors including lymphatic and/or vascular (LV) invasion and pathological components such as the presence of embryonal carcinoma.
  • Of 31 patients with an embryonal carcinoma component, 13 patients (42%) developed metastases, whereas 21% of those without an embryonal carcinoma component developed metastases (p=0.04).
  • After chemotherapy and/or surgical treatment for relapse, the 5-year overall survival rate was 100%.

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  • (PMID = 27963435.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Piulats JM Sr, Nadal M, Martinez-Iniesta M, Puertas S, Gonzalez S, Vidal A, Condom E, Germa-Lluch J, Garcia Del Muro X, Villanueva A: Nude mice model of primary human nonseminoma germ cell tumors to study biology and resistance to cisplatin treatment. J Clin Oncol; 2009 May 20;27(15_suppl):e16143

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nude mice model of primary human nonseminoma germ cell tumors to study biology and resistance to cisplatin treatment.
  • : e16143 Testicular germ cell tumors (TGCTs) are the most common malignancy in young men.
  • Recently, our group has reported the development of a model of human nonseminoma (NSE) after orthotopic nude mice implantation (Piulats et al, Amer Assoc Cancer Res. 2006).
  • Pure and mix NSE anatomies were represented and they reproduce the main histological, genetic and epigenetic characteristics of paired primary tumors.
  • Xenografts mimic distal dissemination patterns and cisplatin (CDDP) tumor behavior responses.
  • This model has been useful for the study of antiangiogenic therapies (Piulats et al, ASCO.
  • We have generated in vivo five tumors showing increased resistance to CDDP by exposition to repetitive cycles and increasing the dose applied through different passages (1 yolk-sac; 1 choriocarcinoma; 2 embrional carcinoma; 1 mix tumor).
  • A shortness time elipse between pasajes was observed for each tumor through CDDP treatments.
  • To confirm increasin resistance, a parallel assay of chemotherapy response was performed between nontreated and CDDP resistant tumors.
  • Whole genome analysis of tour xenografted tumors and their paired CDDP resistant tumor (#3 and #5 passage) were analyzed by CGH NimbeGen arrays using 60 Kb average windows.
  • Few differential genomic changes were identified some of them were consistent across resistant tumors including gain of 9q21.11-9q33.3, 15q23-15q24.1, and 15q26.3 regions and loss of Xp22.33.
  • In one tumour showing strong CDDP resistance compared with its sensitive counterpart it occur in absence of new genomic changes.
  • No changes in the MSI or mutational TP53 status were observed in resisant tumors.
  • Our data suggest that acquisition of tumor resistance to CDDP in TGCTs may proably depend of a combination of different mechanisms, including cromosomal imbalances.

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  • (PMID = 27963427.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Wang J, Zhu XZ, Zhang RY: [Malignant granular cell tumor: a clinicopathologic analysis of 10 cases with review of literature]. Zhonghua Bing Li Xue Za Zhi; 2004 Dec;33(6):497-502
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  • [Title] [Malignant granular cell tumor: a clinicopathologic analysis of 10 cases with review of literature].
  • OBJECTIVE: To investigate the clinicopathologic features of malignant granular cell tumor (MGCT) and evaluate the histologic criteria for diagnosis of malignancy.
  • METHODS: The clinical and pathologic profiles of 10 MGCT cases were evaluated.
  • Electron microscopy was carried out in 3 cases with available fresh or formalin-fixed tissues.
  • The main presenting symptom was a painless nodule or mass located in the subcutis or deep soft tissue.
  • Three of the tumors occurred in the lower extremity, two in the breast, two in the nuchal region, and one each in the chest wall, neck, and peritoneal cavity.
  • The tumor size ranged from 2 to 11 cm (mean size = 4.8 cm).
  • Microscopically, the tumor was composed of nests or sheets of polygonal cells which possessed abundant eosinophilic granular cytoplasm and closely resembled its benign counterpart.
  • After careful assessment, 9 cases exhibited at least 3 of the following suspicious features: enlarged vesicular nuclei with prominent nucleoli, nuclear pleomorphism, high nuclear-to-cytoplasmic ratio, spindling of tumor cells, appreciable mitotic activity, and tumor necrosis.
  • In addition, a hitherto undescribed feature characterized by multinucleated tumor cells was observed in 1 case.
  • Follow-up information available in 7 patients revealed local recurrence in 5, metastasis in 4 and tumor-related deaths in 2 patients.
  • Wide local excision with regional lymph node dissection remains the mainstay of treatment.
  • Chemotherapy and radiotherapy however have not been shown to significantly improve the clinical course of the disease.
  • The morphologic spectrum of MGCT also includes a rare multinucleated variant.
  • [MeSH-major] Breast Neoplasms / pathology. Granular Cell Tumor / pathology. Soft Tissue Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Antigens, CD / metabolism. Antigens, Differentiation, Myelomonocytic / metabolism. Female. Humans. Lower Extremity. Lymph Node Excision. Male. Middle Aged. Phosphopyruvate Hydratase / metabolism. Retrospective Studies. S100 Proteins / metabolism

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  • (PMID = 15634442.001).
  • [ISSN] 0529-5807
  • [Journal-full-title] Zhonghua bing li xue za zhi = Chinese journal of pathology
  • [ISO-abbreviation] Zhonghua Bing Li Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Antigens, Differentiation, Myelomonocytic; 0 / CD68 antigen, human; 0 / S100 Proteins; EC 4.2.1.11 / Phosphopyruvate Hydratase
  • [Number-of-references] 32
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17. Arora M, Shrivastav RK, Jaiprakash MP: A rare germ-cell tumor site: vaginal endodermal sinus tumor. Pediatr Surg Int; 2002 Sep;18(5-6):521-3
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  • [Title] A rare germ-cell tumor site: vaginal endodermal sinus tumor.
  • Malignant germ-cell tumors (MGCT) are rare tumors of childhood accounting for less than 3% of pediatric malignancies.
  • Endodermal sinus tumor (EST) forms the most common histologic subtype of MGCT.
  • A 9-month-old female was admitted with a short history of vaginal bleeding, a mass protruding from the vagina, and difficulty in passing urine.
  • The serum alpha-fetoprotein (AFP) was elevated partial vaginectomy was done and the tumor was excised in toto.
  • Partial vaginectomy with combination chemotherapy is the most recommended line of treatment.
  • The surgery eradicates local tumor cells and makes subsequent chemotherapy more effective.
  • Simple tumor excision is not sufficient, as residual tumor cells induce early recurrence and make chemotherapy ineffective.
  • [MeSH-major] Endodermal Sinus Tumor / surgery. Vaginal Neoplasms / surgery
  • [MeSH-minor] Female. Humans. Infant. Tomography, X-Ray Computed

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  • (PMID = 12415399.001).
  • [ISSN] 0179-0358
  • [Journal-full-title] Pediatric surgery international
  • [ISO-abbreviation] Pediatr. Surg. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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18. Oldenburg J, Martin JM, Fosså SD: Late relapses of germ cell malignancies: incidence, management, and prognosis. J Clin Oncol; 2006 Dec 10;24(35):5503-11

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  • [Title] Late relapses of germ cell malignancies: incidence, management, and prognosis.
  • Late relapses of malignant germ cell tumors (MGCTs) are rare and occur, by definition, 2 years or later after successful treatment.
  • They represent a major challenge of today's treatment of MGCTs.
  • We present relevant literature on relapsing MGCTs to highlight the following issues: incidence, impact of initial treatment on the subsequent risk of late relapse, treatment, and survival.
  • The predominant site of relapse is the retroperitoneal space in both histologic types.
  • The initial treatment appears to be important for the risk and localization of late relapses.
  • The treatment of late relapses should be based on a representative presalvage biopsy and includes radical surgery and salvage chemotherapy in most cases.
  • Diagnosis and treatment of late-relapsing MGCT patients is challenging and should be performed in experienced centers only.
  • Referral of late-relapsing patients to high-volume institutions ensures the best chances of cure and enables increasing understanding of tumor biology and the clinical course of these patients.
  • [MeSH-major] Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / therapy. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Diagnosis, Differential. Humans. Neoplasm Staging. Prognosis

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  • (PMID = 17158535.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 121
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19. Billmire D, Vinocur C, Rescorla F, Colombani P, Cushing B, Hawkins E, London WB, Giller R, Lauer S: Malignant mediastinal germ cell tumors: an intergroup study. J Pediatr Surg; 2001 Jan;36(1):18-24
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  • [Title] Malignant mediastinal germ cell tumors: an intergroup study.
  • PURPOSE: This review was conducted to determine clinical characteristics and response to therapy in this rare pediatric neoplasm.
  • METHODS: An intergroup Pediatric Oncology Group (POG) 9049/Children's Cancer Study Group (CCG) 8882 randomized trial was conducted to evaluate response rate and survival with chemotherapy using etoposide, bleomycin, and high or standard dose cisplatin for high-risk malignant germ cell tumors at extragonadal sites.
  • RESULTS: Of the 38 children with malignant mediastinal germ cell tumors (MGCT), 36 had sufficient data to be included in this review.
  • Thirty-four tumors were anterior mediastinal, 2 were intrapericardial.
  • Yolk sac tumor was the only malignant element in girls.
  • Boys had yolk sac tumor in 7, germinoma in 3, choriocarcinoma in 2, and mixed malignant elements in 15.
  • Four patients had biopsy and chemotherapy without tumor resection, and only 1 survived.
  • Fourteen patients had resection at diagnosis followed by chemotherapy with 12 survivors.
  • Eighteen patients had biopsy followed by chemotherapy and postchemotherapy tumor resection with 13 survivors.
  • Tumor size in response to chemotherapy for these 18 patients was stable or increased in 6, and decreased in 12 (mean decrease of 57% in greatest dimension).
  • Overall, 26 of 36 patients survived, with a 4-year patient survival rate of 71%+/-10%, and a 4-year event-free survival rate of 69%+/-10%.
  • Ten patients died: 5 of tumor (all boys > or =15 yr), 2 of sepsis, and 3 of second malignancy.
  • CONCLUSIONS: Malignant MGCT is a complex tumor of varied histology with frequent coexistence of benign elements.
  • Lesions often have incomplete regression with chemotherapy alone.
  • Tumor resection may be undertaken at diagnosis or after attempted shrinkage with chemotherapy.
  • Aggressive attempt at complete tumor resection should be offered to all patients even if bulky tumor persists after induction chemotherapy with expectation of a significant salvage rate.
  • Boys > or =15 years may be a high-risk subgroup for mortality from tumor progression.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Biopsy. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11150432.001).
  • [ISSN] 0022-3468
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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20. Hara I, Yamada Y, Kumano M, Furukawa J, Yamanaka K, Fujisawa M: High dose chemotherapy including paclitaxel (T-ICE) combined with peripheral blood stem cell transplantation for male germ cell tumor. Preliminary report. Int J Urol; 2005 Dec;12(12):1074-8
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  • [Title] High dose chemotherapy including paclitaxel (T-ICE) combined with peripheral blood stem cell transplantation for male germ cell tumor. Preliminary report.
  • AIM: To evaluate the feasibility and usefulness of high dose chemotherapy including paclitaxel (T-ICE) combined with peripheral blood stem cell transplantation (PBSCT) for male germ cell tumor.
  • METHODS: Five male patients with advanced germ cell tumor underwent 1-6 courses of high dose chemotherapy including paclitaxel (T-ICE; 175 mg/m2 of paclitaxel, 1250 mg/m2 of carboplatin, 1500 mg/m2 of etoposide and 7.5 g/m2 of ifosfamide) with PBSCT after 2-3 courses of induction chemotherapy (PEB or VIP).
  • Two patients underwent resection of residual tumor.
  • In one patient, viable cancer cells were detected in resected lymph node tissue and adjuvant chemotherapy was then performed.
  • CONCLUSIONS: High dose chemotherapy, including T-ICE, combined with PBSCT showed an almost identical degree of side-effects as seen in previous high dose chemotherapy without paclitaxel.
  • Although 80% of the patients showed no evidence of disease so far, the efficacy of T-ICE should be evaluated with more patients and longer follow up.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Neoplasms, Germ Cell and Embryonal / therapy. Paclitaxel / administration & dosage. Peripheral Blood Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Feasibility Studies. Humans. Male. Middle Aged

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  • (PMID = 16409617.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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21. Hara I, Miyake H, Yamada Y, Takenaka A, Fujisawa M: High-dose chemotherapy for male germ cell tumor. Int J Urol; 2006 Aug;13(8):1037-44
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  • [Title] High-dose chemotherapy for male germ cell tumor.
  • Today, 20-30% of male patients with advanced germ cell tumor (GCT) do not have durable, complete remission in spite of cis-platinum (CDDP)-based chemotherapy.
  • High-dose chemotherapy (HDCT) has been tried in CDDP refractory GCT patients.
  • However, the clinical outcome was not good and the treatment-related death rate was not ignorable.
  • Therefore, earlier introduction of HDCT with peripheral blood stem cell transplantation was preferable as it renders HDCT more effective and less toxic, and multicycle HDCT is feasible.
  • HDCT is also performed as first line chemotherapy for poor prognosis GCT patients.
  • Induction chemotherapy followed by multicycles of HDCT was tried.
  • The durable free rate of recent HDCT as first line chemotherapy is 43-73%.
  • Although previous reports suggest the superiority of HDCT, one recent randomized controlled trial (RCT) failed to show an improvement with one cycle of HDCT followed by three cycles of standard-dose chemotherapy (SDCT) compared with four cycles of SDCT.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Bone Marrow Transplantation. Clinical Trials as Topic. Humans. Male. Paclitaxel / therapeutic use. Peripheral Blood Stem Cell Transplantation

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  • (PMID = 16903926.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Antineoplastic Agents; P88XT4IS4D / Paclitaxel
  • [Number-of-references] 76
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22. Hara I, Miyake H, Yamada Y, Yamanaka K, Furukawa J, Kumano M, Takenaka A, Fujisawa M: Feasibility and usefulness of high-dose chemotherapy (high-dose ifosfamide, carboplatin and etoposide) combined with peripheral blood stem cell transplantation for male germ cell tumor: a single-institute experience. Anticancer Drugs; 2006 Oct;17(9):1057-66
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  • [Title] Feasibility and usefulness of high-dose chemotherapy (high-dose ifosfamide, carboplatin and etoposide) combined with peripheral blood stem cell transplantation for male germ cell tumor: a single-institute experience.
  • Although the usefulness of high-dose chemotherapy with peripheral blood stem cell transplantation for advanced germ cell tumor is still under evaluation in phase III randomized controlled studies, this approach is currently used as one treatment option for relapsed or advanced male germ cell tumor.
  • Clinical outcomes of high-dose chemotherapy for a single institute from Japan are presented herein.
  • We administered 63 courses of high-dose ifosfamide, carboplatin and etoposide chemotherapy (1250 mg/m carboplatin; 1500 mg/m etoposide; 7.5 g/m ifosfamide) to 34 men with germ cell tumors.
  • Of these, 27 patients underwent high-dose ifosfamide, carboplatin and etoposide as first-line therapy after 2-3 courses of conventional bleomycin, etoposide and cisplatin chemotherapy, and seven patients underwent high-dose ifosfamide, carboplatin and etoposide for relapsed germ cell tumor.
  • Peripheral blood stem cells were harvested during previous chemotherapy and sufficient CD34 cells were harvested for transplantation.
  • Although all patients experienced grade 4 hemotoxicity, leukocyte counts recovered to above 1000/mul within 8-11 days after peripheral blood stem cell transplantation.
  • No treatment-related deaths occurred.
  • High-dose ifosfamide, carboplatin and etoposide could be performed safely, and could offer an effective means of treating advanced or refractory germ cell tumors in men.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / therapy. Peripheral Blood Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Germinoma / therapy. Humans. Ifosfamide / administration & dosage. Male. Middle Aged

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  • (PMID = 17001179.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; BEP protocol
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23. Feldman DR, Bosl GJ, Sheinfeld J, Motzer RJ: Medical treatment of advanced testicular cancer. JAMA; 2008 Feb 13;299(6):672-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Medical treatment of advanced testicular cancer.
  • CONTEXT: The medical treatment of advanced testicular germ cell tumors has changed over the past 30 years, with long-term survival now achieved in the majority of patients.
  • Clinicians need to be familiar with the available treatment regimens for testicular cancer and their associated toxic effects.
  • OBJECTIVE: To review the treatments used for advanced testicular germ cell tumors and their associated short-term and long-term complications.
  • EVIDENCE ACQUISITION: A search was performed of all English-language literature (1966 to October 2007) within the MEDLINE database using the terms neoplasms, germ cell, or embryonal or testicular neoplasms restricted to humans, drug therapy, complications, and mortality.
  • The Cochrane Register of Controlled Trials Databases (through October 2007) was also searched using the terms testicular cancer or germ cell tumors.
  • One hundred eighty-six articles were selected based on pertinence to advanced testicular cancer treatment, associated complications, and late relapses with an emphasis on randomized controlled trials.
  • DATA SYNTHESIS: The treatment of advanced testicular germ cell tumors with cisplatin combination chemotherapy is based on risk stratification (good, intermediate, or poor prognosis) according to pretreatment clinical features of prognostic value.
  • Complete responses are achieved less frequently for patients with intermediate- and poor-risk germ cell tumors, in whom 4 cycles of bleomycin, etoposide, and cisplatin remains the standard of care.
  • Second- and third-line programs, including high-dose chemotherapy, also have curative potential.
  • Chronic toxicities associated with therapy include cardiovascular disease, infertility, and secondary malignancies.
  • CONCLUSIONS: Clinical trials have led to evidence-based treatment recommendations for advanced testicular cancer based on risk stratification.
  • Clinicians should be familiar with the potential complications of these therapies.

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  • (PMID = 18270356.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 202
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24. Rentinck ME, Nieboer P, Sleijfer DT, Gietema JA, van der Graaf WT: Chemotherapy for metastatic seminoma in elderly patients. Anticancer Res; 2003 May-Jun;23(3C):3093-6
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  • [Title] Chemotherapy for metastatic seminoma in elderly patients.
  • Testicular germ cell tumours are rarely diagnosed in the elderly.
  • In view of the high cure rate of these tumours, even in elderly patients treatment with chemotherapy and/or radiotherapy should be considered.
  • In this report we describe two older patients with metastatic testicular seminoma.
  • Both were treated with chemotherapy with curative intention.
  • Described are the problems related to treatment with chemotherapy in these elderly.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Aged. Humans. Male. Neoplasm Metastasis

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  • (PMID = 12926168.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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25. Pectasides D, Papaxoinis G, Nikolaou M, Valavanis C, Aravantinos G, Fountzilas G, Tamvakis N, Pectasides E, Lekka I, Arapantoni-Dadioti P, Zizi A, Ghiconti I, Economopoulos T: Analysis of 7 immunohistochemical markers in male germ cell tumors demonstrates the prognostic significance of p53 and MIB-1. Anticancer Res; 2009 Feb;29(2):737-44
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  • [Title] Analysis of 7 immunohistochemical markers in male germ cell tumors demonstrates the prognostic significance of p53 and MIB-1.
  • BACKGROUND: Various prognostic factors have been investigated in order to predict the minority of male germ cell tumor (GCT) patients who will develop resistant disease.
  • MATERIALS AND METHODS: Paraffin-embedded tissue specimens, obtained from primary lesions during the initial diagnosis of 83 advanced chemotherapy-treated GCT male patients, were stained for 7 immunohistochemical markers: p53, bax, bcl-2, MIB-1, topoisomerase IIa, c-kit and COX-2.
  • In multivariate analysis, these two markers obtained independent significance only when considered in combination (HR = 6.63, 95% CI = 1.40-31.41, p = 0.017, for patients with one or both markers above their cut-off), while the International Germ Cell Consensus Cancer Group (IGCCCG) risk was the most significant (HR = 7.99, 95% CI = 1.96-32.52, p = 0.004, for the high-risk group).
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / metabolism. Testicular Neoplasms / metabolism. Tumor Suppressor Protein p53 / biosynthesis. Ubiquitin-Protein Ligases / biosynthesis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / biosynthesis. Humans. Immunohistochemistry. Male. Prognosis

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  • (PMID = 19331230.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / TP53 protein, human; 0 / Tumor Suppressor Protein p53; EC 6.3.2.19 / MIB1 ligase, human; EC 6.3.2.19 / Ubiquitin-Protein Ligases
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26. Salazar Soler R, Maroto Rey P, Solà Rocabert C, López López JJ: [Rescue chemotherapy in testicular germ cell tumors]. Arch Esp Urol; 2000 Jul-Aug;53(6):554-64
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  • [Title] [Rescue chemotherapy in testicular germ cell tumors].
  • [Transliterated title] Quimioterapia de rescate en tumores de células germinales testiculares.
  • OBJECTIVE: To review the different salvage chemotherapy regimens according to the prognostic factors based on the response to the different therapeutic alternatives.
  • METHODS: The conventional rescue chemotherapy regimens, as well as the role of surgery, new drugs and therapeutic modalities, particularly high dose second and third line chemotherapy, were reviewed.
  • RESULTS/CONCLUSIONS: Germ cell testicular tumor is the paradigm of curable tumors of the adult.
  • Whereas the cure rate for stage I tumors is higher than 98%, patients with advanced stage tumors have a lower cure rate.
  • Approximately 10% of the patients with good-prognosis factors and 30%-50% of those with poor-prognosis factors show tumor progression or recurrence after first line chemotherapy using cisplatin-based combinations.
  • Patients who have recurrence after first line chemotherapy have a 40% probability of achieving second complete remission with second line chemotherapy, but will be sustained in only 20% of the patients, although rare cases of advanced pure seminoma that recurred have shown a cure rate of 55% with second line chemotherapy.
  • New strategies have been developed using new drugs such as taxanes or high doses of well-known chemotherapeutic agents with autologous hematopoietic rescue that have been utilized with success in patients with refractory germ cell testicular tumors.
  • A global analysis of the patients treated with third line chemotherapy shows a sustained complete remission rate of 22%.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Humans. Male. Neoplasm Recurrence, Local / epidemiology. Prognosis

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  • (PMID = 11002524.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] SPAIN
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 88
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27. Dietrich J, Marienhagen J, Schalke B, Bogdahn U, Schlachetzki F: Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide. Ann Pharmacother; 2004 Feb;38(2):242-6
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  • [Title] Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide.
  • OBJECTIVE: To report a case of acute central nervous system (CNS) toxicity with multiple hemorrhages restricted to the corpus callosum associated with combination therapy of cisplatin, ifosfamide, and etoposide.
  • CASE SUMMARY: A 38-year-old white man with a testicular germ cell tumor received a cisplatin-based chemotherapy consisting of cisplatin 45 mg (20 mg/m2), etoposide 570 mg (250 mg/m2), and ifosfamide 4600 mg (2000 mg/m2) given on 5 consecutive days during each course.
  • After the first course of chemotherapy, the patient appeared to be neuropsychologically impaired with episodes of decreased alertness and features of a depressive syndrome.
  • He became severely diminished in mental function, orientation, and psychomotor activity after a second course of treatment.
  • An objective causality assessment revealed that an adverse drug reaction was probable.
  • To our knowledge, as of December 2, 2003, vascular lesions restricted to the corpus callosum have not been reported as a complication of cisplatin- or ifosfamide-based chemotherapy.
  • Chemotherapy-induced neurotoxicity should be considered in the differential diagnosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Intracranial Hemorrhages / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Cisplatin / adverse effects. Corpus Callosum / radionuclide imaging. Etoposide / administration & dosage. Germinoma / drug therapy. Humans. Ifosfamide / administration & dosage. Magnetic Resonance Imaging. Male

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  • (PMID = 14742759.001).
  • [ISSN] 1060-0280
  • [Journal-full-title] The Annals of pharmacotherapy
  • [ISO-abbreviation] Ann Pharmacother
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 29
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28. Culine S: [Chemotherapy for metastatic germ cell tumours of the testis]. Rev Prat; 2007 Feb 28;57(4):385-8
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  • [Title] [Chemotherapy for metastatic germ cell tumours of the testis].
  • [Transliterated title] Chimiothérapie des tumeurs germinales métastatiques du testicule.
  • The gold standard regimen for metastatic testicular germ cell tumours is a combination of bleomycin, etoposide and cisplatin.
  • The number of cycles is defined by pathology (seminoma or non seminoma) and the prognostic criteria of the international classification (degree of elevation of serum tumour markers and presence or not of non pulmonary visceral metastases).
  • The surgical resection of all residual metastatic masses is mandatory after the normalization of serum tumour markers in non seminoma patients.
  • The cure rates after chemotherapy and surgery are about 90% and 50% in good-risk and poor-risk patients, respectively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Algorithms. Biomarkers, Tumor / blood. Bleomycin / administration & dosage. Bleomycin / adverse effects. Bleomycin / therapeutic use. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cisplatin / therapeutic use. Diagnosis, Differential. Etoposide / administration & dosage. Etoposide / adverse effects. Etoposide / therapeutic use. Humans. Male. Neoplasm Metastasis. Orchiectomy. Prognosis. Risk Factors. Seminoma / blood. Seminoma / diagnosis. Seminoma / drug therapy. Time Factors. Treatment Outcome

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  • (PMID = 17455740.001).
  • [ISSN] 0035-2640
  • [Journal-full-title] La Revue du praticien
  • [ISO-abbreviation] Rev Prat
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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29. Karagoz B, Bilgi O, Akyol I, Ozgun A, Turken O, Kandemir EG: Cerebrovascular accident after chemotherapy for testicular cancer. Mil Med; 2009 Mar;174(3):320-1
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  • [Title] Cerebrovascular accident after chemotherapy for testicular cancer.
  • Arterial thromboembolic events are not common after chemotherapy.
  • We present a case of a cerebrovascular accident, which developed after chemotherapy in a patient with a germ cell tumor.
  • A 34-year-old man with a testicular germ cell tumor who did not have any comorbid disease was admitted to hospital.
  • After a radical inguinal orchiectomy, BEP (bleomycin, etoposide, and cisplatin) chemotherapy regimen was given.
  • On the 10th day of the third cycle, aphasia and hemiplegia developed.
  • This event is a rare complication in a patient receiving BEP chemotherapy who did not have cardiovascular disease or thromboembolic risk factors.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy. Stroke / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Antibiotics, Antineoplastic / adverse effects. Antineoplastic Agents, Phytogenic / adverse effects. Bleomycin / administration & dosage. Bleomycin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Humans. Male

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  • (PMID = 19354100.001).
  • [ISSN] 0026-4075
  • [Journal-full-title] Military medicine
  • [ISO-abbreviation] Mil Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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30. Sakamoto H, Oohta M, Inoue K, Fuji K, Fukagai T, Yoshida H: Testicular sperm extraction in patients with persistent azoospermia after chemotherapy for testicular germ cell tumor. Int J Urol; 2007 Feb;14(2):167-70
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  • [Title] Testicular sperm extraction in patients with persistent azoospermia after chemotherapy for testicular germ cell tumor.
  • Sperm cryopreservation before chemotherapy in young males is recommended because of chemotherapy's gonadotoxic effects.
  • Two azoospermic patients presented to us after chemotherapy, and we obtained sperm from them by testicular sperm extraction (TESE).
  • One patient was 32 years old and had been treated with six cycles of cisplatin, etoposide and bleomycin (BEP) chemotherapy and one cycle of high-dose chemotherapy for stage III non-seminoma.
  • Histopathology of the testicular specimen showed germinal aplasia with focal islands of full spermatogenesis.
  • The other patient was 33 years old who was treated with four cycles of BEP chemotherapy for stage II seminoma.
  • Histopathology of the testicular specimen showed Sertoli-cell-only syndrome.
  • TESE should be considered in patients with persistent azoospermia after chemotherapy if frozen sperm samples are not available.
  • [MeSH-major] Azoospermia / etiology. Neoplasms, Germ Cell and Embryonal / drug therapy. Spermatozoa. Testicular Neoplasms / drug therapy. Tissue and Organ Harvesting
  • [MeSH-minor] Adult. Humans. Male

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  • (PMID = 17302578.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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31. Farmakis D, Pectasides M, Pectasides D: Recent advances in conventional-dose salvage chemotherapy in patients with cisplatin-resistant or refractory testicular germ cell tumors. Eur Urol; 2005 Sep;48(3):400-7
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  • [Title] Recent advances in conventional-dose salvage chemotherapy in patients with cisplatin-resistant or refractory testicular germ cell tumors.
  • Testicular germ cell tumors represent the most frequent malignancy in young males aged 20-35 years.
  • Despite the considerably high cure rates provided by platinum-based chemotherapy, 20-30% of cases with advanced disease do not achieve a long-term disease-free survival with first-line chemotherapy.
  • These patients are candidates for conventional-dose or high-dose salvage chemotherapy.
  • The current conventional-dose salvage regimens of reference are the vinblastine-ifosfamide-cisplatin or etoposide-ifosfamide-cisplatin combinations, which are expected to cure approximately 25% of non-seminomatous germ-cell tumour patients.
  • Paclitaxel has also been proved effective both as monotherapy in heavily-pretreated cases and as part of first-line salvage regimens; the combination of paclitaxel-ifosfamide-cisplatin, followed or not by high-dose chemotherapy, induced a favorable long-term disease-free survival rate, especially in patients with good prognosis.
  • Newer cytotoxic drugs, such as gemcitabine and oxaliplatin have also been proved effective, while other agents, such as temozolamide, or targeted therapies, such as trastuzumab in cases over-expressing HER2/neu (20% of relapsing germ-cell tumors) are currently under evaluation.
  • Seminomas have generally a better prognosis than non-seminomatous tumors and salvage therapy is expected to cure about 50% of all cases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Drug Resistance, Neoplasm. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Male. Organoplatinum Compounds / administration & dosage. Paclitaxel / administration & dosage. Salvage Therapy. Vinblastine / administration & dosage

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  • (PMID = 15964136.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; 0W860991D6 / Deoxycytidine; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; 7673326042 / irinotecan; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; XT3Z54Z28A / Camptothecin
  • [Number-of-references] 47
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32. Boeck S, Metzeler KH, Hausmann A, Baumann A, Gallmeier E, Parhofer KG, Stemmler HJ: Cisplatin-based chemotherapy for pulmonary metastasized germ cell tumors of the testis--be aware of acute respiratory distress syndrome. Onkologie; 2009 Mar;32(3):125-8
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  • [Title] Cisplatin-based chemotherapy for pulmonary metastasized germ cell tumors of the testis--be aware of acute respiratory distress syndrome.
  • BACKGROUND: Cisplatin-based combination chemotherapy is regarded as standard of care for patients with advanced germ cell tumors.
  • In patients with lung metastases and a high tumor load, an association between induction chemotherapy and the development of a 'tumorassociated' acute respiratory distress syndrome (ARDS) has been hypothesized.
  • CASE REPORT: We report the clinical course of a 19-year-old patient who rapidly developed fatal ARDS during the first cycle of chemotherapy using the PEI regimen (cisplatin, etoposide and ifosfamide) for a metastasized (lung, liver, lymph nodes) germ cell tumor of the testis.
  • CONCLUSION: Further clinical research in order to better define risk factors for developing ARDS in this patient population as well as novel strategies for the prevention and treatment of ARDS in those patients are necessary.
  • [MeSH-major] Cisplatin / administration & dosage. Cisplatin / adverse effects. Giant Cell Tumors / drug therapy. Giant Cell Tumors / secondary. Lung Neoplasms / secondary. Respiratory Distress Syndrome, Adult / chemically induced. Testicular Neoplasms / drug therapy. Testicular Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. Humans. Male. Treatment Outcome. Young Adult

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19295253.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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33. Nonomura N, Oka D, Nishimura K, Nakayama M, Inoue H, Mizutani Y, Miki T, Okuyama A: Paclitaxel, ifosfamide, and nedaplatin (TIN) salvage chemotherapy for patients with advanced germ cell tumors. Int J Urol; 2007 Jun;14(6):527-31
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  • [Title] Paclitaxel, ifosfamide, and nedaplatin (TIN) salvage chemotherapy for patients with advanced germ cell tumors.
  • BACKGROUND: The paclitaxel, ifosfamide, and cisplatin regimen has been used to treat metastatic testicular cancer with successful results.
  • We investigated the usefulness of a paclitaxel, ifosfamide, and nedaplatin (TIN) regimen as salvage therapy for patients with advanced testicular germ cell tumors (GCTs).
  • The treatment was performed as salvage therapy for cases refractory to therapies, such as bleomycin, etoposide and cisplatin, and irinotecan with nedaplatin.
  • RESULTS: Seven out of eight patients achieved a disease-free status after chemotherapy, followed by surgical resection of the residual tumor.
  • Six of the seven patients have continued to show no evidence of disease after salvage therapy, with a median follow-up period of 27 months, but one patient developed a 'growing teratoma syndrome' in the mediastinum 31 months after TIN chemotherapy.
  • All patients developed grade 4 leukocytopenia.
  • Only one patient developed grade 2 sensory neuropathy and no patient developed nephrotoxicity.
  • CONCLUSION: The TIN regimen was efficacious and well-tolerated as salvage chemotherapy for Japanese patients with advanced GCTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy. Salvage Therapy / methods. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Acute Kidney Injury / chemically induced. Acute Kidney Injury / prevention & control. Adult. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / adverse effects. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / adverse effects. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Male. Organoplatinum Compounds / administration & dosage. Organoplatinum Compounds / adverse effects. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Treatment Outcome

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  • (PMID = 17593098.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Antineoplastic Agents, Phytogenic; 0 / Organoplatinum Compounds; 8UQ3W6JXAN / nedaplatin; P88XT4IS4D / Paclitaxel; UM20QQM95Y / Ifosfamide
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34. Tsukamoto S, Miyanaga N, Kawai K, Akaza H: [Evidence-based medicine for urological cancer chemotherapy]. Gan To Kagaku Ryoho; 2000 Feb;27(2):183-91

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Evidence-based medicine for urological cancer chemotherapy].
  • We reviewed the treatment results of urological cancer chemotherapy from the standpoint of evidence based medicine.
  • In the treatment of advanced transitional cell carcinoma of the urothelium, M-VAC (MTX + VBL + ADM + CDDP) is regarded as the standard regimen; however, durable event-free survival is rare.
  • Immunotherapy with interferon or interleukin-2 produces a small survival advantage in patients with metastatic renal cell carcinoma.
  • There is no evidence that adjuvant interferon-alpha administration will improve the survival in those with non-metastatic renal cell carcinoma.
  • Systematized cisplatin-based treatment protocols have been established in patients with advanced testicular germ cell tumor by means of many randomized controlled trials.
  • Several clinical trials are under way to prove the efficacy of high dose chemotherapy (with autologous stem-cell support) in patients with poor risk germ cell tumors.
  • We do not yet have sufficient data to conclude whether maximal androgen blockade will prolong the survival in patients with metastatic prostate cancer, nor to conclude whether neoadjuvant androgen depletion treatment improve disease free survival of the patients after radical prostatectomy.
  • [MeSH-major] Carcinoma, Transitional Cell / drug therapy. Evidence-Based Medicine. Urologic Neoplasms / drug therapy

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  • (PMID = 10700888.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] JAPAN
  • [Number-of-references] 47
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35. Fernández-Ortega A, García del Muro X, Navarro M, Germà Lluch JR: [Adjuvant chemotherapy of non-seminoma stage I germ cell tumors of the testis]. Arch Esp Urol; 2000 Jul-Aug;53(6):487-90
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  • [Title] [Adjuvant chemotherapy of non-seminoma stage I germ cell tumors of the testis].
  • [Transliterated title] Tratamiento con quimioterapia adyuvante en los tumores germinales no seminoma de testículo estadio I.
  • OBJECTIVE: To review the treatment of stage I nonseminomatous germ cell testicular tumor with adjuvant chemotherapy.
  • RESULTS/CONCLUSIONS: Overall, 30% of stage I nonseminomatous germ cell testicular tumors that are followed recur within two subsequent years.
  • Several factors associated with a higher risk have been described.
  • The most important are the presence of venous or lymphatic infiltration, the presence of a carcinoembryonic component and the absence of tumor of the endodermal sinus.
  • Over the last few years, some experience using two cycles of BEP adjuvant chemotherapy in patients at a higher risk have shown that this recurrence rate can be reduced to less than 5% with minimal late toxicity.
  • [MeSH-major] Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Follow-Up Studies. Humans. Lymph Node Excision. Male. Neoplasm Staging. Risk Factors

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  • (PMID = 11002516.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] SPAIN
  • [Number-of-references] 14
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36. Meattini I, Scotti V, Pescini F, Livi L, Sulprizio S, Palumbo V, Sarti C, Biti G: Ischemic stroke during cisplatin-based chemotherapy for testicular germ cell tumor: case report and review of the literature. J Chemother; 2010 Apr;22(2):134-6
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  • [Title] Ischemic stroke during cisplatin-based chemotherapy for testicular germ cell tumor: case report and review of the literature.
  • Testicular germ-cell tumors are the most common solid tumor in young men, with an incidence peak between the ages of 20 and 35 years.
  • Even if rare, arterial thromboembolism is a serious and possible complication during cisplatin-based chemotherapy in young patients.
  • The strong association between rapid treatment and favorable outcome is well known.
  • We report the management of a young patient affected by non seminomatous testicular neoplasm without cardiovascular risk factors who developed an ischemic stroke during cisplatin-based treatment.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Brain Ischemia / chemically induced. Cisplatin / adverse effects. Neoplasms, Germ Cell and Embryonal / drug therapy. Stroke / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male

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  • (PMID = 20435575.001).
  • [ISSN] 1973-9478
  • [Journal-full-title] Journal of chemotherapy (Florence, Italy)
  • [ISO-abbreviation] J Chemother
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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37. Assimakopoulos SF, Koutras A, Ravazoula P, Makatsoris T, Petsas T, Iconomou G, Nikolopoulou V, Kalofonos HP: A case of chondrosarcoma developing in a recurrent retroperitoneal mass after chemotherapy for testicular germ cell tumor. Urol Int; 2006;77(1):86-8
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  • [Title] A case of chondrosarcoma developing in a recurrent retroperitoneal mass after chemotherapy for testicular germ cell tumor.
  • Teratomas with malignant transformation occur in a small proportion of patients with metastatic germ cell tumors treated with platinum-based chemotherapy.
  • Chondrosarcoma has rarely been reported as a component of the second non-germ cell malignancy.
  • We report the case of a 37-year-old man who developed a chondrosarcoma in a recurrent retroperitoneal mass after chemotherapy for testicular germ cell tumor.
  • Malignant transformation of the retroperitoneal teratomatous mass occurred in the absence of any symptoms or clinical signs, elevation in serum tumor markers, or the presence of atypical elements in previously resected specimens, suggesting the need for close radiographic follow-up of these patients.
  • [MeSH-major] Chondrosarcoma / diagnosis. Neoplasm Recurrence, Local / diagnosis. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Second Primary / diagnosis. Retroperitoneal Neoplasms / diagnosis. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Humans. Male

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  • (PMID = 16825823.001).
  • [ISSN] 0042-1138
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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38. Baltaci S, Orhan D, Türkölmez K, Yesilli C, Bedük Y, Tulunay O: P53, bcl-2 and bax immunoreactivity as predictors of response and outcome after chemotherapy for metastatic germ cell testicular tumours. BJU Int; 2001 May;87(7):661-6
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  • [Title] P53, bcl-2 and bax immunoreactivity as predictors of response and outcome after chemotherapy for metastatic germ cell testicular tumours.
  • OBJECTIVE: To evaluate the roles of p53, bcl-2 and bax as determinants of chemosensitivity in testicular cancers and to assess whether immunohistochemical expression of these proteins in testicular germ cell tumours (GCTs) could be used to predict the outcome in patients with metastatic testicular GCTs.
  • PATIENTS AND METHODS: Immunoreactivity for p53, bcl-2 and bax were examined in primary testicular tumours from 24 patients with metastatic GCTs who were treated with bleomycin, etoposide and cisplatin chemotherapy.
  • All immunostaining results were scored for the appropriate percentage of positive tumour cells and relative immunostaining intensity (score range 0-15) and compared with the response of the patients to chemotherapy.
  • The median survival after chemotherapy was 30.5 months; however, taking the median values of the immunostaining scores as threshold values for the survival analysis, none of the three proteins were associated with significant differences in survival.
  • CONCLUSIONS: The incidence of p53 and bax immuno-reactivity in testicular GCTs is higher than that of bcl-2 immunoreactivity.
  • However, only p53 immuno-reactivity could be used to predict the response to chemotherapy.
  • P53, bcl-2 and bax scores were not significant prognostic factors for survival after chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Proto-Oncogene Proteins / metabolism. Proto-Oncogene Proteins c-bcl-2 / metabolism. Testicular Neoplasms / drug therapy. Tumor Suppressor Protein p53 / metabolism
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Metastasis. Orchiectomy / methods. Survival Analysis. Treatment Outcome. bcl-2-Associated X Protein

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  • (PMID = 11350408.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / BAX protein, human; 0 / Proto-Oncogene Proteins; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53; 0 / bcl-2-Associated X Protein; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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39. Kollmannsberger C, Mayer F, Kuczyk M, Kanz L, Bokemeyer C: Treatment of patients with metastatic germ cell tumors relapsing after high-dose chemotherapy. World J Urol; 2001 Apr;19(2):120-5
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  • [Title] Treatment of patients with metastatic germ cell tumors relapsing after high-dose chemotherapy.
  • With the use of cisplatin-based combination chemotherapy, metastatic testicular germ cell tumors can be cured in 70-80% of patients.
  • Patients refractory to cisplatin-based chemotherapy have a very poor prognosis.
  • Several mechanisms have been discussed for the development of platinum resistance such as a decreased intracellular concentration of the drug, increased repair of the drug induced damage, or an altered apoptotic response to this damage.
  • Two recent studies have evaluated gemcitabine in refractory germ cell tumors, demonstrating a response rate of 17% (95% CI: 7-28%) in 52 intensively pretreated patients, two-thirds of whom had relapsed after previous high-dose chemotherapy plus autologous stem cell transplantation.
  • Ongoing studies in refractory germ cell tumors performed by the German Testicular Cancer Study Group (GTCSG) are evaluating oxaliplatin, a platinum derivative with incomplete cross-resistance to cisplatin.
  • Future trials combining new active agents may make it possible to test the use of alternating treatment strategies in patients with "poor prognostic" disease or as salvage treatment.
  • It is hoped that the increase in knowledge of the molecular mechanism of testicular cancer may lead to the development of new therapeutic options.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Humans. Male. Neoplasm Recurrence, Local

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  • (PMID = 11374314.001).
  • [ISSN] 0724-4983
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 44
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40. Escalera Almendros C, Chiva Robles V, Pascual Mateo C, Rodríguez García N, García Tello A, Berenguer Sánchez A: [Post chemotherapy laparoscopic retroperitoneal lymph node dissection]. Arch Esp Urol; 2006 Jun;59(5):517-23
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  • [Title] [Post chemotherapy laparoscopic retroperitoneal lymph node dissection].
  • OBJECTIVES: To describe the laparoscopic excision of a postchemotherapy retroperitoneal residual mass in a patient with mixed germ cell testicular tumor.
  • METHODS/RESULTS: We report the operative technique of laparoscopic excision of a retroperitoneal mass in a 33 year old patient with mixed germ cell testicular tumor.
  • CONCLUSION: The laparoscopic approach is another option for the surgical treatment of residual masses after chemotherapy in testicular tumors.
  • [MeSH-major] Laparoscopy. Lymph Node Excision / methods. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Male. Neoplasm, Residual. Retroperitoneal Space

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  • (PMID = 16903554.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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41. Schenk PW, Stoop H, Bokemeyer C, Mayer F, Stoter G, Oosterhuis JW, Wiemer E, Looijenga LH, Nooter K: Resistance to platinum-containing chemotherapy in testicular germ cell tumors is associated with downregulation of the protein kinase SRPK1. Neoplasia; 2004 Jul-Aug;6(4):297-301
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  • [Title] Resistance to platinum-containing chemotherapy in testicular germ cell tumors is associated with downregulation of the protein kinase SRPK1.
  • Male germ cell tumors (GCTs) are extremely sensitive to platinum-containing chemotherapy, with only 10% of patients showing therapy resistance.
  • However, the biological basis of the high curability of disseminated GCTs by chemotherapy is still unknown.
  • Because, in mammalians, the expression of SRPK1 is preferentially high in testicular tissues, cisplatin responsiveness of male GCTs might be associated with SRPK1 levels.
  • Randomly selected GCTs (n = 70) and tumors from patients responding to standard chemotherapy (n = 20) generally showed strong SRPK1 staining.
  • In contrast, expression in refractory GCTs (n = 20) as well as in GCTs from poor-prognosis patients responding to high-dose chemotherapy only (n = 11) was significantly lower (two-sided Wilcoxon rank sum test: P < .001).
  • [MeSH-major] Germinoma / enzymology. Platinum Compounds / therapeutic use. Protein-Serine-Threonine Kinases / genetics. Testicular Neoplasms / enzymology
  • [MeSH-minor] Adolescent. Adult. Drug Resistance, Neoplasm. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Male. Middle Aged. RNA Splicing. Survival Analysis

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  • [Copyright] Copyright 2004 Neoplasia Press, Inc.
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  • (PMID = 15256051.001).
  • [ISSN] 1522-8002
  • [Journal-full-title] Neoplasia (New York, N.Y.)
  • [ISO-abbreviation] Neoplasia
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Platinum Compounds; EC 2.7.1.- / SRPK1 protein, human; EC 2.7.11.1 / Protein-Serine-Threonine Kinases
  • [Other-IDs] NLM/ PMC1502111
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42. Giménez Bachs JM, Salinas Sánchez AS, Ruíz Mondéjar R, Lorenzo Romero JG, Donate Moreno MJ, Segura Martín M, Hernández Millán IR, Cañamares Pabolaza L, Virseda Rodríguez JA: [Surgery of large residual mass after chemotherapy in advanced testicular germ cell tumor]. Actas Urol Esp; 2004 Mar;28(3):230-3
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  • [Title] [Surgery of large residual mass after chemotherapy in advanced testicular germ cell tumor].
  • [Transliterated title] Cirugía de gran masa residual tras quimioterapia en tumor germinal testicular avanzado.
  • Treatment for testicular tumours has progress in such a manner in the last years that high cure percentages can at present be achieved.
  • After chemotherapy, in most cases, residual mass can appear.
  • In this cases surgery is considered a viable therapeutic option although it implies an advanced surgical training since it is a complex technique and implies serious implications.
  • We submit the case of a patient who presented a large residual mass from a testicular germ cell tumour after being treated with orquiectomía and chemotherapy.
  • [MeSH-major] Germinoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Disease Progression. Humans. Male. Neoplasm, Residual

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  • (PMID = 15141420.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas espanolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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43. Krainer M, Wolf HM, Wiltschke C, Wilfing A, Kaider A, Kratzik C, Eibl MM, Zielinski CC: Transient increase in mitogen-induced lymphoproliferative responses in patients with testicular cancer after BEP chemotherapy. Urology; 2000 Jun;55(6):934-8
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  • [Title] Transient increase in mitogen-induced lymphoproliferative responses in patients with testicular cancer after BEP chemotherapy.
  • OBJECTIVES: To investigate the impact of polychemotherapy on cellular immunity in patients with testicular cancer.
  • METHODS: Lymphocyte subpopulations, lymphoproliferative responses to mitogenic stimulation, and mitogen-induced release of soluble interleukin-2 receptor from peripheral blood mononuclear cells were investigated in 15 patients with testicular germ cell tumors a median of 61 months (range 7 to 73) after polychemotherapy with bleomycin, etoposide, and cisplatin (BEP).
  • When two groups of patients were formed according to elapsed time from BEP polychemotherapy and study onset (group A, 12 months and group B, 69 months after termination of BEP), a significant increase in lymphoproliferative response to concanavalin A (P <0.05) was found in group A 1 year after chemotherapy.
  • CONCLUSIONS: BEP chemotherapy administered to patients with testicular cancer does not result in impairment of cellular immunity but rather leads to a significant increase in the capacity of patients' lymphocytes to respond to mitogenic stimulation up to 1 year after polychemotherapy.
  • Moreover, the increased T-cell activity found after BEP therapy may contribute to the high rate of long-term complete remission.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Germinoma / immunology. Leukocytes, Mononuclear. Lymphocyte Activation. Testicular Neoplasms / drug therapy. Testicular Neoplasms / immunology
  • [MeSH-minor] Bleomycin / administration & dosage. Cisplatin / administration & dosage. Concanavalin A. Etoposide / administration & dosage. Humans. Immunity, Cellular. Lectins. Male. Receptors, Interleukin-2

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  • (PMID = 10840113.001).
  • [ISSN] 0090-4295
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Lectins; 0 / Receptors, Interleukin-2; 11028-71-0 / Concanavalin A; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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44. Weissbach L, Bussar-Maatz R, Flechtner H, Pichlmeier U, Hartmann M, Keller L: RPLND or primary chemotherapy in clinical stage IIA/B nonseminomatous germ cell tumors? Results of a prospective multicenter trial including quality of life assessment. Eur Urol; 2000 May;37(5):582-94
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  • [Title] RPLND or primary chemotherapy in clinical stage IIA/B nonseminomatous germ cell tumors? Results of a prospective multicenter trial including quality of life assessment.
  • BACKGROUND: In order to reduce therapy-related morbidity in patients with nonseminomatous testicular germ cell tumors in clinical stage IIA/B, we performed a prospective multicenter trial comparing the standard retroperitoneal lymph node dissection (RPLND) +2 cycles of chemotherapy (arm A) with 3-4 cycles of primary chemotherapy (arm B).
  • 109 received primary RPLND and 78 primary chemotherapy.
  • Two different chemotherapies were applied (PEB and CEB as adjuvant or inductive treatment).
  • The quality of life (QoL), therapy-related morbidity, suspected predictive factors (histology and size of metastases), and outcome were assessed.
  • In arm B, 67% achieved complete remission with chemotherapy alone, 33% required a secondary RPLND.
  • Two patients died due to complications of chemotherapy.
  • Acute toxicity of chemotherapy was higher in the group receiving primary chemotherapy.
  • CONCLUSION: We recommend primary RPLND because adjuvant chemotherapy can be spared in PS I, two cycles of chemotherapy are less toxic than 3 or 4 cycles, the primary operation is associated with less complications than that following chemotherapy and, with modern surgical procedures, ejaculation can be preserved in most of the patients, provided that the operation is carried out by an experienced surgeon.
  • No statistically significant differences in the QoL outcome occurred between the treatment groups, suggesting that chemotherapy alone is not superior to primary or secondary RPLND in this respect.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Germinoma / surgery. Lymph Node Excision. Quality of Life. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Bleomycin / administration & dosage. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Neoplasm Staging. Retroperitoneal Space

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  • (PMID = 10765098.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] SWITZERLAND
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; BEP protocol; JEB protocol
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45. Kleinschmidt K, Dieckmann KP, Georgiew A, Loy V, Weissbach L: Chemotherapy is of limited efficacy in the control of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell cancer. Oncology; 2009;77(1):33-9
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  • [Title] Chemotherapy is of limited efficacy in the control of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell cancer.
  • INTRODUCTION: Testicular intraepithelial neoplasia (TIN, also called carcinoma in situ of the testis), the precursor of testicular germ cell tumors, will progress to invasive cancer unless appropriate treatment is instituted.
  • The efficacy of chemotherapy is equivocal to date.
  • PATIENTS AND METHODS: Eleven patients with unilateral testicular cancer (5 pure seminoma, 6 nonseminoma) and biopsy-proven contralateral TIN underwent chemotherapy.
  • Four patients received 2 courses of carboplatin single agent, 4 had 2 courses of platin, etoposide, bleomycin (PEB) treatment and 3 had a full 3-cycle treatment with PEB.
  • Each of the patients failing to chemotherapy had undergone 2 or 3 cycles of the PEB regimen, while 3 had received carboplatin treatment.
  • Two of the patients with no TIN upon rebiopsy developed invasive testis cancer subsequently.
  • In summary, 7 of 11 patients thus failed to chemotherapy (64%; exact 95% confidence interval 30.8-89.1%).
  • CONCLUSIONS: Chemotherapy was shown to be of only littleeffect in eradicating TIN.
  • As the majority of failing cases had received carboplatin single-agent therapy or adjuvant PEB therapy with 2 cycles, it may be speculated that the efficacy of chemotherapy regarding TIN clearance is dose dependent.
  • Multidrug regimens appear to be more efficacious than single-agent therapy.
  • As spermatogenesis is only incompletely eliminated by chemotherapy, it is postulated that chemotherapy does no more than temporarily suppress TIN, while only selected cases are cleared of the lesion.
  • Practically, rebiopsy to look for retained TIN about 2 years after completion of chemotherapy is valuable.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma in Situ / drug therapy. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Male. Neoplasm Staging. Orchiectomy. Prognosis. Radiotherapy Dosage. Treatment Outcome. Young Adult

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19440001.001).
  • [ISSN] 1423-0232
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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46. Pectasides D, Pectasides M, Farmakis D, Nikolaou M, Koumpou M, Kostopoulou V, Mylonakis N: Testicular function in patients with testicular cancer treated with bleomycin-etoposide-carboplatin (BEC(90)) combination chemotherapy. Eur Urol; 2004 Feb;45(2):187-93
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  • [Title] Testicular function in patients with testicular cancer treated with bleomycin-etoposide-carboplatin (BEC(90)) combination chemotherapy.
  • OBJECTIVE: To investigate the impact of bleomycin-etoposide-carboplatin combination chemotherapy on long-term fertility in patients with testicular germ cell tumors.
  • METHODS: Twenty-five patients with high risk stage I and IM non-seminomatous germ cell tumors (NSGCT, Group A) and 44 with advanced seminoma or NSGCT (Group B) were treated with bleomycin 30 mg (days 2, 9, 16), etoposide 165 mg/m(2) (days 1-3) and carboplatin 400mg/m(2) or AUC 5 (day 1) (BEC(90)).
  • Treatment was repeated every 3 weeks.
  • Sperm count and hormonal analyses were examined pre- and post-chemotherapy.
  • RESULTS: Patients were followed for a median of 2.9 years post-chemotherapy.
  • Thirty-eight (55%) patients had NS pre-chemotherapy.
  • None of the 14 NS patients who received 2 cycles of BEC(90) had AS post-chemotherapy, while only 1 of the 24 NS patients who were treated with > or =4 cycles of BEC(90) had AS post-treatment.
  • Among the NS patients, 93% and 83%, respectively, remained NS following chemotherapy.
  • Overall, 90% of patients had recovery (61% NS, 29% OS) of spermatogenesis after treatment.
  • The median FSH serum values were significantly elevated at least 1-year post-chemotherapy when compared with the pre-treatment levels.
  • Eighteen months post-chemotherapy the median FSH values had returned to the reference limits.
  • Serum LH and T levels were unaffected by treatment.
  • The pre-treatment sperm count and the bulk of disease were significantly associated with recovery of spermatogenesis.
  • No association was found between recovery of spermatogenesis and 2 or > or =4 cycles of chemotherapy, age > or =30 years and post-chemotherapy lymph node dissection.
  • CONCLUSION: The BEC(90) regimen has no major effect on fertility and Leydig cell function.
  • However, carboplatin-based chemotherapy has been proved less effective than cisplatin-based chemotherapy and is not currently used in the treatment of testicular cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / administration & dosage. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Etoposide / administration & dosage. Hormones / blood. Humans. Male. Neoplasm Staging. Sperm Count. Time Factors

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  • (PMID = 14734005.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Hormones; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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47. Inoue T, Habuchi T, Shimoda N, Satoh S, Sato K, Kato T, Minamiya Y, Ogawa J, Matuo S, Sasaki S: [A case of long-term remission with salvage surgeries for chemotherapy-resistant germ cell tumor of testis]. Nihon Hinyokika Gakkai Zasshi; 2002 Sep;93(6):715-8
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  • [Title] [A case of long-term remission with salvage surgeries for chemotherapy-resistant germ cell tumor of testis].
  • A patient with non-seminomatous germ cell tumor of testis underwent operations for metastases in the lung and mediastinum three times, when the serum AFP level remained remarkably high despite of intensive chemotherapy, and has been disease-free for three years after the last treatment.
  • Our experience illustrates that the salvage surgery even under high serum marker levels may provide a beneficial outcome for selected cases of chemotherapy-resistant germ cell tumors.
  • [MeSH-major] Germinoma / secondary. Germinoma / surgery. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Mediastinal Neoplasms / secondary. Mediastinal Neoplasms / surgery. Salvage Therapy / methods. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Biomarkers, Tumor / blood. Drug Resistance, Neoplasm. Humans. Male. Remission Induction. Time Factors. alpha-Fetoproteins / analysis

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  • (PMID = 12385098.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins
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48. Matsumoto S, Matsuda H, Uejima S, Kurita T: [Secondary leukemia following ultra high-dose chemotherapy with peripheral blood stem cell autotransplantation for refractory testicular cancer]. Nihon Hinyokika Gakkai Zasshi; 2000 Oct-Nov;91(10-11):687-91
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  • [Title] [Secondary leukemia following ultra high-dose chemotherapy with peripheral blood stem cell autotransplantation for refractory testicular cancer].
  • Secondary leukemia following chemotherapy or radiotherapy for mediastinal germ cell tumors in a well-described entity.
  • It also may occur in patients with testicular germ cell tumors.
  • We report a case of secondary leukemia occurring in a 31-year-old man who received ultra high-dose chemotherapy with peripheral blood stem cell autotransplantation (PBSCT) for a refractory testicular cancer (pathology; Seminoma, Embryonal carcinoma, Yolk sac tumor, Choriocarcinoma) with IIIB2 under Japanese classification, poor-risk group under Indiana classification.
  • He received total 11 cycles of systemic chemotherapy (2 cycles of PVB regimen, 4 cycles of PEB regimen, 3 cycles of VIP regimen and 2 cycles of ultra high-dose chemotherapy with PBSCT for pulmonary and para-aortic lymph node metastasis following his initial orchiectomy.
  • Severe and persistent pancytopenia developed 25 months after his initial orchiectomy.
  • Therefore, he was diagnosed as secondary leukemia following high-dose chemotherapy.
  • He received total 6 cycles of systematic chemotherapy for the secondary leukemia in the internal department.
  • To our knowledge, this is the first reported case in the literature relevant to secondary leukemia following ultra high-dose chemotherapy with PBSCT in testicular tumor in Japan.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Embryonal / drug therapy. Choriocarcinoma / drug therapy. Hematopoietic Stem Cell Transplantation. Leukemia / etiology. Neoplasms, Second Primary / etiology. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Bleomycin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / adverse effects. Humans. Male. Transplantation, Autologous

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  • (PMID = 11109821.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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49. Westermann DH, Schefer H, Thalmann GN, Karamitopoulou-Diamantis E, Fey MF, Studer UE: Long-term followup results of 1 cycle of adjuvant bleomycin, etoposide and cisplatin chemotherapy for high risk clinical stage I nonseminomatous germ cell tumors of the testis. J Urol; 2008 Jan;179(1):163-6
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  • [Title] Long-term followup results of 1 cycle of adjuvant bleomycin, etoposide and cisplatin chemotherapy for high risk clinical stage I nonseminomatous germ cell tumors of the testis.
  • PURPOSE: We evaluated the long-term outcome after 1 cycle of adjuvant modified bleomycin, etoposide and cisplatin chemotherapy in patients who underwent orchiectomy for high risk clinical stage I nonseminomatous germ cell tumor of the testis.
  • MATERIALS AND METHODS: Between 1995 and 1999 a consecutive series of 44 patients underwent orchiectomy for clinical stage I nonseminomatous germ cell tumor of the testis, followed by a single postoperative cycle of adjuvant modified bleomycin, etoposide and cisplatin for vascular or lymphatic tumor invasion, and/or a predominance (50% or greater) of embryonal carcinoma.
  • One patient with progression after 13 months showed complete remission after 3 cycles of salvage bleomycin, etoposide and cisplatin chemotherapy but he died of pneumonia 4 weeks after the third course.
  • Two patients underwent orchiectomy for contralateral testis cancer at 18 and 42 months, respectively, followed by an additional 3 cycles of adjuvant chemotherapy.
  • Late side effects were tinnitus in 3 patients and involuntary childlessness in 3, of whom 2 had cryptorchidism of the contralateral testis.
  • CONCLUSIONS: One cycle of bleomycin, etoposide and cisplatin effectively decreases the risk of relapse in patients with high risk stage I nonseminomatous germ cell tumor of the testis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Follow-Up Studies. Humans. Male. Neoplasm Staging. Orchiectomy. Prospective Studies. Risk Factors. Time Factors

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  • (PMID = 18001800.001).
  • [ISSN] 1527-3792
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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50. Luz MA, Kotb AF, Aldousari S, Brimo F, Tanguay S, Kassouf W, Aprikian AG: Retroperitoneal lymph node dissection for residual masses after chemotherapy in nonseminomatous germ cell testicular tumor. World J Surg Oncol; 2010;8:97
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  • [Title] Retroperitoneal lymph node dissection for residual masses after chemotherapy in nonseminomatous germ cell testicular tumor.
  • BACKGROUND: Retroperitoneal lymph node dissection has been advocated for the management of post-chemotherapy (PC-RPLND) residual masses of non-seminomatous germ cell tumors of the testis (NSGCT).
  • Between 1994 and 2008, three surgeons operated 73 patients with residual masses after cisplatin-based chemotherapy for a metastatic testicular cancer.
  • Patients needed to have normal postchemotherapy serum tumor markers, no prior surgical attempts to resect retroperitoneal masses and resectable retroperitoneal tumor mass at surgery to be included in this analysis RESULTS: Mean age was 30.4 years old.
  • Fifty-three percent had mixed germ cell tumors.
  • The mean size of retroperitoneal metastasis was 6.3 and 4.0 cm, before and post-chemotherapy, respectively.
  • In 56% of patients, the surgeon was able to perform a nerve sparing procedure.
  • The pathologic review showed presence of fibrosis/necrosis, teratoma and viable tumor (non-teratoma) in 27 (37.0%), 30 (41.1%) and 16 (21.9%) patients, respectively.
  • The subgroups presenting fibrosis and large tumors were more likely to have a surgical complication and had less nerve sparing procedures.
  • CONCLUSION: PC-RPLND is a relatively safe procedure.
  • The presence of fibrosis and large residual masses are associated with surgical complications and non-nerve-sparing procedure.
  • [MeSH-major] Lymph Node Excision / methods. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Diagnosis, Differential. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / secondary. Neoplasms, Germ Cell and Embryonal / surgery. Retroperitoneal Space. Retrospective Studies. Tomography, X-Ray Computed. Treatment Outcome. Young Adult

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  • (PMID = 21062470.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Nonseminomatous germ cell tumor
  • [Other-IDs] NLM/ PMC2991320
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51. Ozen H, Ekici S, Sozen S, Ergen A, Tekgül S, Kendi S: Resection of residual masses alone: an alternative in surgical therapy of metastatic testicular germ cell tumors after chemotherapy. Urology; 2001 Feb;57(2):323-7
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  • [Title] Resection of residual masses alone: an alternative in surgical therapy of metastatic testicular germ cell tumors after chemotherapy.
  • OBJECTIVES: The standard approach in postchemotherapy surgery of testicular cancer is retroperitoneal lymph node dissection.
  • METHODS: Seventy-five patients underwent resection of residual masses after chemotherapy.
  • After tumor marker levels returned to normal, patients with residual lymph nodes greater than 2 cm in nonseminomatous germ cell tumors and greater than 4 cm in seminomas and any resectable parenchymal lesions were candidates for the limited surgery.
  • [MeSH-major] Germinoma / drug therapy. Germinoma / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Ejaculation. Fibrosis. Humans. Liver Neoplasms / secondary. Lymphatic Metastasis. Male. Middle Aged. Necrosis. Postoperative Complications. Retroperitoneal Neoplasms / secondary. Retrospective Studies. Survival Rate. Thoracic Neoplasms / secondary

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  • (PMID = 11182346.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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52. Mezvrishvili Z, Managadze L: One cycle of bleomycin, etoposide and cisplatin plus two cycles of etopeside and cisplatin chemotherapy in selected patients with low-volume stage II nonseminomatous germ cell tumor of the testis. Urol Int; 2005;75(4):304-8
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  • [Title] One cycle of bleomycin, etoposide and cisplatin plus two cycles of etopeside and cisplatin chemotherapy in selected patients with low-volume stage II nonseminomatous germ cell tumor of the testis.
  • OBJECTIVE: To assess the feasibility of bleomycin omission from second and third cycles of bleomycin, etoposide and cisplatin (BEP) chemotherapy in low-volume stage II nonseminomatous germ cell tumor patients who achieve a normal tumor marker level after the first cycle of treatment.
  • MATERIALS AND METHODS: Out of 59 nonseminomatous testicular cancer patients with low-volume retroperitoneal disease, serum markers normalized after the first cycle of treatment in 30 cases.
  • 12 patients completed 3BEP (group 1; years 1994-1998) and other 18 patients received etoposide and cisplatin (EP) as second and third cycles of chemotherapy (group 2; years 1998-2004).
  • RESULTS: All patients from each group achieved complete response with chemotherapy alone or by subsequent resection of teratoma or necrosis.
  • There was no relapse with active cancer after the treatment.
  • CONCLUSIONS: One cycle of BEP plus two cycles of EP chemotherapy was as effective as three standard cycles of BEP.
  • The regimen can be suggested as a less toxic therapeutic alternative in these selected patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Diagnosis, Differential. Disease Progression. Etoposide / administration & dosage. Follow-Up Studies. Humans. Male. Neoplasm Staging. Retrospective Studies. Seminoma / diagnosis. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 16327295.001).
  • [ISSN] 0042-1138
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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53. Korfel A, Fischer L, Foss HD, Koch HC, Thiel E: Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature. Bone Marrow Transplant; 2001 Oct;28(8):787-9
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  • [Title] Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature.
  • Treatment and prognosis have not been well characterized in germ cell tumors (GCT) with a malignant nongerm cell component.
  • Patients with a mediastinal tumor, neural or rhabdomyosarcomatous differentiation and distant metastases have the poorest prognosis.
  • The patient was treated with differentiation-tailored chemotherapy (CHT) including a disease-adapted high-dose (HD) CHT regimen with purified autologous PBSCT (APBSCT) and pamidronate.
  • Tumor-adapted CHT including HD-CHT with APBSCT can induce long term remissions in high-risk patients with transformed GCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Neoplasms, Multiple Primary / drug therapy. Rhabdomyosarcoma / drug therapy. Seminoma / drug therapy. Teratoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Bone Marrow / pathology. Carboplatin / administration & dosage. Cell Differentiation. Cisplatin / administration & dosage. Combined Modality Therapy. Diphosphonates / therapeutic use. Epirubicin / administration & dosage. Etoposide / administration & dosage. Humans. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Lumbar Vertebrae. Male. Middle Aged. Neoplasm Metastasis. Orchiectomy. Remission Induction. Seizures / etiology. Spinal Neoplasms / drug therapy. Spinal Neoplasms / secondary. Spinal Neoplasms / therapy. Transplantation, Autologous

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  • (PMID = 11781632.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Diphosphonates; 3Z8479ZZ5X / Epirubicin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; OYY3447OMC / pamidronate; Q20Q21Q62J / Cisplatin
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54. Fernández Aparicio T, Miñana López B, Chaves A, Guzmán Martínez-Valls P, Hita Villaplana G, Cuesta Climent FJ, Lorca García J: [Conservative treatment of germ cell tumor of the testis]. Actas Urol Esp; 2000 Nov-Dec;24(10):810-5; discussion 816
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  • [Title] [Conservative treatment of germ cell tumor of the testis].
  • [Transliterated title] Tratamiento conservador del tumor testicular de células germinales.
  • Testis germ cell tumor is the most frequent cancer in men between 15 and 35 years old.
  • The therapeutic results of radical orchiectomy and chemotherapy reaches 90% free disease survival al the present time.
  • This great chemosensibility is opening new doors to alternative therapeutic options, directed to preserve the sufficient amount of tissue to avoid the problems derived from testicular insufficiency.
  • Such alternatives are clearly beneficial in bilateral germinal tumors or in solitary testis.
  • In this article we describe a case of seminoma developed in a solitary functional testis managed in a conservative approach: organ preserving surgery and surveillance.
  • [MeSH-major] Germinoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Humans. Male

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  • (PMID = 11199298.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas espanolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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55. Hermans BP, Sweeney CJ, Foster RS, Einhorn LE, Donohue JP: Risk of systemic metastases in clinical stage I nonseminoma germ cell testis tumor managed by retroperitoneal lymph node dissection. J Urol; 2000 Jun;163(6):1721-4
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  • [Title] Risk of systemic metastases in clinical stage I nonseminoma germ cell testis tumor managed by retroperitoneal lymph node dissection.
  • PURPOSE: We assess the risk of systemic recurrence after retroperitoneal lymph node dissection for clinical stage I nonseminoma germ cell testis tumor based on predominance of embryonal carcinoma and/or vascular invasion in the orchiectomy specimen.
  • MATERIALS AND METHODS: A total of 292 cases of clinical stage I nonseminoma germ cell testis tumor treated with retroperitoneal lymph node dissection from 1990 to 1995 were identified from the Indiana University database.
  • Review of the written pathological reports classified tumors as embryonal carcinoma predominant, when it was present at a level greater than any other histology, nonpredominant, when it was present but not as the main histological subtype, and absent.
  • None of the 35 pathological stage II cases treated with adjuvant chemotherapy had relapse, whereas relapse occurred in 7 of 31 pathological stage II cases (22.6%) not treated with adjuvant chemotherapy.
  • Dissection alone still has a major therapeutic impact (77%) in patients with clinical stage I, pathological stage II nonseminoma germ cell testis tumor.
  • [MeSH-major] Germinoma / pathology. Germinoma / surgery. Lymph Node Excision. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Risk Assessment

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  • (PMID = 10799168.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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56. Cheng L, Zhang S, Wang M, Davidson DD, Morton MJ, Huang J, Zheng S, Jones TD, Beck SD, Foster RS: Molecular genetic evidence supporting the neoplastic nature of stromal cells in 'fibrosis' after chemotherapy for testicular germ cell tumours. J Pathol; 2007 Sep;213(1):65-71
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  • [Title] Molecular genetic evidence supporting the neoplastic nature of stromal cells in 'fibrosis' after chemotherapy for testicular germ cell tumours.
  • A residual retroperitoneal mass containing only fibrosis and necrosis is present in 40-52% of patients with advanced testicular germ cell tumours after chemotherapy.
  • Laser-microdissected stromal cells from 27 patients who underwent retroperitoneal lymph node dissection after chemotherapy for metastatic testicular germ cell tumour were analysed.
  • Chromosome arm 12p anomalies, the hallmark of germ cell neoplasia, were present in nine (33%) cases.
  • The high frequency of allelic losses and chromosome arm 12p anomalies in the stromal cells from residual retroperitoneal fibrous masses after chemotherapy for testicular germ cell tumours suggests that the stromal cells are derived from the same tumour progenitor cells as the pre-existing metastatic germ cell tumour.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / genetics. Stromal Cells / pathology. Testicular Neoplasms / genetics
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chromosome Aberrations. Combined Modality Therapy. Fibrosis. Humans. In Situ Hybridization, Fluorescence. Loss of Heterozygosity. Lymph Node Excision. Lymphatic Metastasis. Male. Microdissection. Microsatellite Repeats / genetics. Microscopy, Confocal. Necrosis. Orchiectomy

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  • (PMID = 17634958.001).
  • [ISSN] 0022-3417
  • [Journal-full-title] The Journal of pathology
  • [ISO-abbreviation] J. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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57. Albers P, Siener R, Krege S, Schmelz HU, Dieckmann KP, Heidenreich A, Kwasny P, Pechoel M, Lehmann J, Kliesch S, Köhrmann KU, Fimmers R, Weissbach L, Loy V, Wittekind C, Hartmann M, German Testicular Cancer Study Group: Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I Nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group. J Clin Oncol; 2008 Jun 20;26(18):2966-72
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  • [Title] Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I Nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group.
  • PURPOSE: Retroperitoneal lymph node dissection (RPLND) and adjuvant chemotherapy are two adjuvant treatment options for patients with clinical stage I nonseminomatous germ cell tumors of the testis (NSGCT).
  • Aim of this trial was to prove the advantage of one cycle of bleomycin, etoposide, and cisplatin (BEP) chemotherapy compared with RPLND in terms of recurrence.
  • The trial was powered to detect a 7% reduction (from 10% to 3%) of recurrence with chemotherapy compared with surgery.
  • RESULTS: After a median follow-up of 4.7 years, two and 15 recurrences were observed in the intention-to-treat population with chemotherapy and surgery, respectively (P = .0011).
  • The difference in the 2-year recurrence-free survival rate between chemotherapy (99.46%; 95% CI, 96.20% to 99.92%) and surgery (91.87%; 95% CI, 86.87% to 95.02%) was 7.59% (95% CI, 3.13% to 12.05%).
  • The hazard ratio to experience a tumor recurrence with surgery as opposed to chemotherapy was 7.937 (95% CI, 1.808 to 34.48).
  • CONCLUSION: To our knowledge, this is the largest randomized trial investigating adjuvant treatment strategies in clinical stage I NSGCT, which showed the superiority of one course BEP over RPLND performed according to community standards to prevent recurrence.
  • Although not standard treatment, one course of BEP is active in an unselected group of patients with clinical stage I disease and merits further investigation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Aged. Bleomycin / administration & dosage. Bleomycin / adverse effects. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / adverse effects. Disease-Free Survival. Etoposide / administration & dosage. Etoposide / adverse effects. Humans. Lymph Node Excision / adverse effects. Lymph Node Excision / methods. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Orchiectomy

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  • [CommentIn] J Clin Oncol. 2008 Jun 20;26(18):2934-6 [18458042.001]
  • [CommentIn] J Clin Oncol. 2009 May 1;27(13):2114-6 [19307494.001]
  • [ErratumIn] J Clin Oncol. 2010 Mar 10;28(8):1439. Dosage error in article text
  • (PMID = 18458040.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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58. Clevenger JA, Foster RS, Ulbright TM: Differentiated rhabdomyomatous tumors after chemotherapy for metastatic testicular germ-cell tumors: a clinicopathological study of seven cases mandating separation from rhabdomyosarcoma. Mod Pathol; 2009 Oct;22(10):1361-6
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  • [Title] Differentiated rhabdomyomatous tumors after chemotherapy for metastatic testicular germ-cell tumors: a clinicopathological study of seven cases mandating separation from rhabdomyosarcoma.
  • To gain insight concerning prognosis, we investigated seven cases of post-chemotherapy retroperitoneal lymph-node dissections from patients with testicular germ-cell tumors that contained sizable nodules of differentiated skeletal muscle, but that lacked both a primitive cellular component and mitotic activity.
  • The patients were 18-28 years old at the time of retroperitoneal lymph-node dissection.
  • All had a previous non-seminomatous germ-cell tumor of the testis, five of which had a teratoma component.
  • In one the testicular tumor had foci of embryonal rhabdomyosarcoma.
  • The retroperitoneal lymph-node dissections were performed 0.2-4.7 years after orchiectomy, all following cisplatin-based chemotherapy, and contained rhabdomyomatous tumors that ranged from 0.8-5 cm.
  • These consisted of nodular to diffuse aggregates of fetal-type rhabdomyocytes with central to peripheral nuclei and abundant, eosinophilic, fibrillary cytoplasm with occasional cross striations.
  • Follow-up in six patients showed three were disease free at 2.2-3.4 years; two developed recurrent teratoma at 1.3-3.7 years; and a sixth developed recurrent teratoma at 0.5 and 2 years, followed at 17 years by progressive tumor with elevated alpha-fetoprotein.
  • No patient with available follow-up developed progressive sarcoma.
  • We conclude that rhabdomyomatous tumors in retroperitoneal lymph-node dissection specimens after chemotherapy for metastatic testicular germ-cell tumors show clinical behavior similar to teratoma rather than rhabdomyosarcoma.
  • We believe the most likely explanation for the finding of pure rhabdomyomatous tumors in this setting, a phenomenon sometimes termed 'cytodifferentiation,' is selective persistence of differentiated tumor cells because of chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cell Differentiation / drug effects. Lymph Nodes / pathology. Neoplasms, Germ Cell and Embryonal / secondary. Rhabdomyosarcoma, Embryonal / secondary. Teratoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Disease-Free Survival. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Orchiectomy. Retrospective Studies. Time Factors. Treatment Outcome. Young Adult

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  • (PMID = 19633644.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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59. Böhlen D, Burkhard FC, Mills R, Sonntag RW, Studer UE: Fertility and sexual function following orchiectomy and 2 cycles of chemotherapy for stage I high risk nonseminomatous germ cell cancer. J Urol; 2001 Feb;165(2):441-4
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  • [Title] Fertility and sexual function following orchiectomy and 2 cycles of chemotherapy for stage I high risk nonseminomatous germ cell cancer.
  • PURPOSE: We investigate fertility and sexual function in patients following orchiectomy and adjuvant cisplatin based chemotherapy for high risk, stage I nonseminomatous germ cell tumor of the testis.
  • MATERIALS AND METHODS: Between 1985 and 1994, 59 patients with stage I nonseminomatous germ cell tumor and poor prognostic factors were treated with 2 cycles of cisplatin, vinblastine and bleomycin, or bleomycin, etoposide and cisplatin after orchiectomy.
  • At least 32 months following treatment all patients were contacted and asked to complete a questionnaire regarding fertility and sexual activity, and to volunteer for a semen and hormonal analysis.
  • Before chemotherapy 18 (37%) patients had fathered children, 6 (12%) were involuntarily childless and none had a major sexual dysfunction.
  • After treatment 11 (22%) patients fathered children, and 5 (10%) were involuntarily childless, with 4 involuntarily childless before chemotherapy.
  • CONCLUSIONS: Two cycles of cisplatin based adjuvant chemotherapy do not seem to affect adversely fertility or sexual activity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Germinoma / therapy. Infertility, Male / etiology. Orchiectomy / adverse effects. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Humans. Male. Middle Aged. Neoplasm Staging. Risk Factors. Surveys and Questionnaires

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  • (PMID = 11176393.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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60. Hioki T, Ogawa K, Yamada Y, Fumino M, Sugimura Y: [Kinetics of peripheral blood CD34-positive cells and the optimum timing for harvesting peripheral blood stem cells during BEP chemotherapy in patients with testicular germ cell tumor]. Nihon Hinyokika Gakkai Zasshi; 2000 Jan;91(1):14-20
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  • [Title] [Kinetics of peripheral blood CD34-positive cells and the optimum timing for harvesting peripheral blood stem cells during BEP chemotherapy in patients with testicular germ cell tumor].
  • PURPOSE: Recently, high-dose chemotherapy with peripheral blood stem cell (PBSC) rescue has been developed for poor risk testicular germ cell cancer.
  • In this study, we investigated the optimum timing for harvesting PBSCs with the use of bleomycin + etoposide + cisplatin (BEP) chemotherapy, which is a well known first-line regimen for the testicular cancer.
  • MATERIAL AND METHOD: Peripheral blood CD34-positive cell ratios were measured during a total of 10 courses of BEP chemotherapy in 6 patients with metastatic germ cell cancer between 1996 and 1998.
  • RESULTS: The peripheral blood CD34-positive cell ratios became maximum (3.0-24.6%; average 10.0%) on the day 18 to 21 (median day 19) of BEP chemotherapy with rhG-CSF administration.
  • The maximum ratios of peripheral blood CD34 positive cells were achieved when the number of leukocyte were 6,880-23,600/microliter and exceeded 6,000/microliter after the 18th day of BEP chemotherapy.
  • CONCLUSION: Efficient hematopoietic progenitor cells were mobilized by BEP chemotherapy with rhG-CSF administration of first-line setting.
  • Our results suggest that the optimum timing of PBSCs harvest is the day when the numbers of leukocyte exceed 6,000/microliter after the 18th day of BEP chemotherapy and the following day.
  • [MeSH-major] Antigens, CD34 / blood. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / therapy. Hematopoietic Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Blood Component Removal. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Granulocyte Colony-Stimulating Factor / therapeutic use. Humans. Leukocyte Count. Male. Recombinant Proteins / therapeutic use. Time Factors. Tissue and Organ Harvesting

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  • (PMID = 10689878.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Antigens, CD34; 0 / Recombinant Proteins; 11056-06-7 / Bleomycin; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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61. Eskicorapci SY, Ekici S, Atsu MN, Dogan R, Ozen H: Resection of pulmonary metastases following chemotherapy for high stage testicular tumors. Int J Urol; 2004 Aug;11(8):634-9
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  • [Title] Resection of pulmonary metastases following chemotherapy for high stage testicular tumors.
  • BACKGROUND: Our objective was to analyze retrospectively our experience with 19 patients who had metastatic germ cell testicular tumor and had undergone resection of pulmonary metastases following chemotherapy.
  • METHODS: Of 103 patients in need of postchemotherapeutic surgery for metastatic germ cell testicular tumors, 19 patients (mean age 31) underwent surgery for thoracic masses following cis-platin based chemotherapy.
  • Resection of pulmonary metastases was performed on patients with normal tumor markers after chemotherapy, who did not achieve complete radiological remission.
  • RESULTS: Disease-free and overall survival rates were 14/19 (73%) and 16/19 (84%), respectively, within a median follow-up time of 30 months (15-212 months).
  • Patients with and without viable tumor cells in their thoracic histopathological specimen had 40% and 85% disease-free survival rates, respectively (P < 0.05).
  • With the resection of the pulmonary metastases only, surgery can be performed without significant morbidity and is essential to select patients for further chemotherapy, to remove all visible masses and to provide histopathological confirmation.
  • Patients with viable tumor cells in the thoracic surgical specimen have a poor prognosis.
  • [MeSH-major] Germinoma / secondary. Germinoma / surgery. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Disease-Free Survival. Etoposide / therapeutic use. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Orchiectomy. Retrospective Studies. Treatment Outcome

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  • (PMID = 15285754.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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62. Azak A, Oksüzoğlu B, Deren T, Oneç BM, Zengin N: Cerebrovascular accident during cisplatin-based combination chemotherapy of testicular germ cell tumor: an unusual case report. Anticancer Drugs; 2008 Jan;19(1):97-8
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  • [Title] Cerebrovascular accident during cisplatin-based combination chemotherapy of testicular germ cell tumor: an unusual case report.
  • Even though testicular nonseminomatous germ cell tumors (NSGCTs) usually have a good prognosis and high curability rates, unpredicted complications owing to chemotherapy regimens might complicate the course.
  • Thromboembolism, which is infrequently associated with germ cell tumors and the vascular toxicity of chemotherapeutics, causes morbidity and mortality.
  • We report a young testicular NSGCT patient, without any known underlying risk factor, who experienced an unpredicted cerebrovascular accident after he received cisplatin-based combination chemotherapy.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Cisplatin / adverse effects. Neoplasms, Germ Cell and Embryonal / complications. Stroke / etiology. Testicular Neoplasms / complications
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blood Coagulation Tests. Cerebral Infarction / chemically induced. Cerebral Infarction / etiology. Fatal Outcome. Humans. Male. Thromboembolism / chemically induced. Thromboembolism / etiology. Tomography, X-Ray Computed

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  • (PMID = 18043135.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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63. Dinis da Gama A, Vilhena-Ayres J, Silva E, Passos Coelho P, Oliveira PS: [Germ cell tumor of the testis with invasion of inferior vena cava. Multidisciplinary surgical management]. Rev Port Cir Cardiotorac Vasc; 2008 Jul-Sep;15(3):163-6
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  • [Title] [Germ cell tumor of the testis with invasion of inferior vena cava. Multidisciplinary surgical management].
  • [Transliterated title] Tumor germinativo testicular com invasão da veia cava inferior. Tratamento cirúrgico multidisciplinar.
  • The authors report the clinical case of a 34 years old male, with a germ cell tumor of the testis, who developed large retroperitoneal metastasis, with compression and later on invasion of the inferior vena cava.
  • The patient underwent chemotherapy followed by resection of the original tumor and of the retroperitoneal metastasis and the vena cava was replaced by a vascular prosthesis.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery. Vascular Neoplasms / pathology. Vascular Neoplasms / surgery. Vena Cava, Inferior
  • [MeSH-minor] Adult. Humans. Male. Neoplasm Invasiveness

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  • (PMID = 19116682.001).
  • [ISSN] 0873-7215
  • [Journal-full-title] Revista portuguesa de cirurgia cardio-torácica e vascular : órgão oficial da Sociedade Portuguesa de Cirurgia Cardio-Torácica e Vascular
  • [ISO-abbreviation] Rev Port Cir Cardiotorac Vasc
  • [Language] por
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Portugal
  • [Number-of-references] 8
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64. Nonomura N, Nishimura K, Takaha N, Inoue H, Nomoto T, Mizutani Y, Nakao M, Okuyama A, Miki T: Nerve-sparing retroperitoneal lymph node dissection for advanced testicular cancer after chemotherapy. Int J Urol; 2002 Oct;9(10):539-44
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  • [Title] Nerve-sparing retroperitoneal lymph node dissection for advanced testicular cancer after chemotherapy.
  • BACKGROUND: Nerve-sparing techniques are commonly used in retroperitoneal lymph node dissection (RPLND) in patients with early stage testicular germ cell tumors to preserve postoperative ejaculation.
  • The indications for nerve-sparing procedures have been extended to patients who have residual retroperitoneal tumor postchemotherapy with an increase in the incidence of local recurrence.
  • Here, we report on 26 Japanese men with advanced testicular cancer who underwent nerve-sparing RPLND after partially successful chemotherapy.
  • METHODS: Between January 1995 and December 2000, 26 patients with metastatic or recurrent testicular cancer underwent nerve-sparing RPLND after chemotherapy.
  • Three patients received high-dose chemotherapy with carboplatin (250 mg/m2 per day x 5 days), etoposide (300 mg/m2 per day x 5 days) and ifosfamide (1.5 g/m2 per day x 5 days) in combination with peripheral blood stem cell transplantation.
  • CONCLUSION: Nerve-sparing procedures for RPLND are appropriate for patients with metastatic testicular cancer, even after chemotherapy.
  • The procedure preserves ejaculatory function in the majority of the patients without increasing the risk of local recurrence.
  • Nerve-sparing RPLND improves the quality of life in patients who require postchemotherapy RPLND to treat residual tumor.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasm Recurrence, Local / prevention & control. Neoplasms, Germ Cell and Embryonal / surgery. Sexual Dysfunction, Physiological / prevention & control. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Male. Middle Aged. Neoplasm, Residual. Retroperitoneal Space. Treatment Outcome

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  • (PMID = 12445231.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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65. Ondrus D, Hornák M, Schnorrer M, Mat'oska J: [Delayed orchiectomy and surgery of metastases after primary chemotherapy in the treatment of advanced testicular tumors]. Rozhl Chir; 2001 Nov;80(11):612-4
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  • [Title] [Delayed orchiectomy and surgery of metastases after primary chemotherapy in the treatment of advanced testicular tumors].
  • [Transliterated title] Odlozená orchiektómia a metastazektómia po primárnej chemoterapii v liecbe nádoru testis v pokrocilom stádiu.
  • OBJECTIVE: The therapeutic procedures in the management of testicular germ cell tumors (TGCT) are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis.
  • However, all advanced TGCT could be treated by primary chemotherapy (CHT) regardless of histological findings.
  • The current imaging techniques (ultrasonography of the testis, abdominal and thoracic CT examination) and laboratory tests (determination of serum tumor markers AFP and hCG) provide sufficient evidence for the presence of TGCT.
  • In cases of acute abdominal and/or pulmonary symptoms because of life-threatening distant metastases, when the diagnosis of advanced TGCT is evident, it is possible to start the treatment without primary orchiectomy (OE).
  • The aim of this study was to evaluate the advantages of neo-adjuvant CHT with delayed OE in the management of advanced TGCT.
  • MATERIAL AND METHODS: During last 12 years a total of 40 patients with advanced TGCT were treated by neo-adjuvant cisplatin-based combination CHT without previous OE.
  • In three of them residual tumorous mass was removed also from the lungs without finding of viable tumor.
  • Viable malignant tumor in the removed retroperitoneal tissue was identified in two patients (7.4%).
  • Residual viable malignant tumor in the testis was found in 5 patients (12.5%).
  • Overall survival was 29/40 patients--72.5% (by mean of 55.2 months since the start of the therapy).
  • CONCLUSIONS: The benefit of this therapeutic approach in the immediate management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases.
  • Another advantage is the like hood of surgical treatment of residual metastatic masses simultaneously with delayed OE on the same day, under one anaesthesia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / therapy. Orchiectomy. Testicular Neoplasms / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Humans. Male. Middle Aged. Neoadjuvant Therapy

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  • (PMID = 11794064.001).
  • [ISSN] 0035-9351
  • [Journal-full-title] Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
  • [ISO-abbreviation] Rozhl Chir
  • [Language] slo
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Czech Republic
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66. Miki T, Mizutani Y, Akaza H, Ozono S, Tsukamoto T, Terachi T, Naito K, Nonomura N, Hara I, Yoshida O, Japan Blood Cell Transplantation Study Group for Testicular Germ Cell Tumor: Long-term results of first-line sequential high-dose carboplatin, etoposide and ifosfamide chemotherapy with peripheral blood stem cell support for patients with advanced testicular germ cell tumor. Int J Urol; 2007 Jan;14(1):54-9
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  • [Title] Long-term results of first-line sequential high-dose carboplatin, etoposide and ifosfamide chemotherapy with peripheral blood stem cell support for patients with advanced testicular germ cell tumor.
  • OBJECTIVE: Standard chemotherapy shows relatively low long-term survival in patients with poor-risk testicular germ cell tumor (GCT).
  • First-line high-dose chemotherapy (HD-CT) may improve the result.
  • High-dose carboplatin, etoposide, ifosfamide chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) was investigated as first-line chemotherapy in patients with advanced testicular GCT.
  • METHODS: Fifty-five previously untreated testicular GCT patients with Indiana 'advanced disease' criteria received three cycles of bleomycin, etoposide and cisplatin (BEP) followed by one cycle of HD-CT plus PBSCT, if elevated serum tumor markers were observed after three cycles of the BEP regimen.
  • RESULTS: Thirty patients were treated with BEP alone, because the tumor marker(s) declined to normal range.
  • Fifteen (63%) are alive and 14 (58%) are free of disease at a median follow-up time of 54 months.
  • Severe toxicity included treatment-related death (4%).
  • CONCLUSIONS: HD-CT with peripheral stem cell support can be successfully applied in a multicenter setting.
  • HD-CT demonstrated modest anticancer activity for Japanese patients with advanced testicular GCT and was well tolerated.
  • This regimen might be examined for further investigation in randomized trials in first-line chemotherapy for patients with poor-risk testicular GCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / therapy. Peripheral Blood Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Male. Middle Aged. Time Factors

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  • (PMID = 17199861.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; UM20QQM95Y / Ifosfamide
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67. Spermon JR, De Geus-Oei LF, Kiemeney LA, Witjes JA, Oyen WJ: The role of (18)fluoro-2-deoxyglucose positron emission tomography in initial staging and re-staging after chemotherapy for testicular germ cell tumours. BJU Int; 2002 Apr;89(6):549-56
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  • [Title] The role of (18)fluoro-2-deoxyglucose positron emission tomography in initial staging and re-staging after chemotherapy for testicular germ cell tumours.
  • OBJECTIVE: To investigate the role of 18fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in the initial staging of clinical stage I and II nonseminomatous germ cell tumours (NSGCTs) and in re-staging (non)seminomatous GCTs after chemotherapy.
  • Stage I patients underwent a retroperitoneal lymph node dissection because of vascular invasion in the primary tumour.
  • Thirty-eight scans were taken after completing chemotherapy (28 NSGCTs and 10 seminomatous GCTs), and validated by histology or clinical follow-up.
  • RESULTS: In stage I NSGCT, FDG-PET staging was equivalent to computed tomography (CT) staging.
  • In stage II NSGCT, FDG-PET missed two lesions (mature teratoma and retroperitoneal mass with a small component of embryonal cell carcinoma) whereas CT correctly classified all.
  • In 20 of 28 patients with NSGCT, histology was obtained after chemotherapy.
  • In four of five patients with necrosis after chemotherapy the PET result was correctly negative.
  • Interestingly, of the 12 patients with a correct negative PET result, 11 had no mature teratoma in their primary tumour.
  • Moreover, it could be useful to predict fibrotic residual mass in NSGCT in those patients with no teratoma component in their primary tumour.
  • [MeSH-major] Fluorodeoxyglucose F18. Germinoma / radionuclide imaging. Neoplasm Staging / methods. Radiopharmaceuticals. Testicular Neoplasms / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Tomography, Emission-Computed / methods

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  • (PMID = 11942962.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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68. Schrader M, Muller M, Straub B, Miller K: Testicular sperm extraction in azoospermic patients with gonadal germ cell tumors prior to chemotherapy--a new therapy option. Asian J Androl; 2002 Mar;4(1):9-15
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  • [Title] Testicular sperm extraction in azoospermic patients with gonadal germ cell tumors prior to chemotherapy--a new therapy option.
  • BACKGROUND: In view of the high cure rates in patients with testicular germ cell tumors (TGCT), increasing clinical importance is attached to protection of fertility.
  • Long-term infertility due to cytostatic therapy may be expected in more than 50% of the patients at a cumulative dose of cisplatin > 0.6 g/m2.
  • The standard procedure for fertility protection in cancer patients includes cryopreservation of ejaculated spermatozoa.
  • Considering that some patients have tumor-induced azoospermia, we examined the usefulness of testicular sperm extraction before therapy.
  • METHOD: A survey of the literature served as a basis for investigating biological and clinical aspects of the impact of chemotherapy on male fertility.
  • A study of our patient population also enabled us to explore the option of extracting sperm from the contralateral healthy testis prior to treatment in 14 azoospermic patients with testicular germ cell tumors.
  • RESULTS: We were able to successfully recover haploid germ cells in 6/14 testicular biopsies from azoospermic patients with testicular germ cell cancer prior to treatment.
  • Maturation arrest was found in 3/14 cases and Sertoli-cell-only syndrome in the rest.
  • None of the patients had secondary healing or a treatment delay because of the testicular biopsy.
  • CONCLUSION: Since the post-therapeutic fertility status is difficult to predict in cancer patients, we think that TESE should be regarded as a general option prior to cancer treatment and offered to azoospermic cancer patients.
  • [MeSH-major] Germinoma / pathology. Infertility, Male / therapy. Oligospermia / pathology. Spermatozoa / cytology. Testicular Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Agents / adverse effects. Humans. Male

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  • (PMID = 11907623.001).
  • [ISSN] 1008-682X
  • [Journal-full-title] Asian journal of andrology
  • [ISO-abbreviation] Asian J. Androl.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 54
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69. Baretti R, Schaumann B, Meyer R, Alfaouri D, Hetzer R: [Metastasizing malignant germ cell tumor of the testis with infiltration of the thoracic aorta--a case for metastasis surgery]. Dtsch Med Wochenschr; 2000 Sep 29;125(39):1164-6
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  • [Title] [Metastasizing malignant germ cell tumor of the testis with infiltration of the thoracic aorta--a case for metastasis surgery].
  • [Transliterated title] Metastasierender maligner Keimzelltumor des Hodens mit Infiltration der Aorta thoracica--Kasuistik zur Metastasenchirurgie.
  • HISTORY AND FINDINGS: A 33-year-old man was admitted 7 years after a testicular teratomatous carcinoma had first been diagnosed, treated by a right orchiectomy and two-stage radical retroperitoneal lymphadenectomy.
  • Five years later the first mediastinal metastases were treated with high-dosage chemotherapy and autologous germ-cell transplantation, and remaining paraaortic--mediastinal tumour tissue was resected.
  • Two years later another tumour at that site was only partially resected.
  • A curing treatment seemed impossible, because the aortic wall had been invaded.
  • TREATMENT AND COURSE: Five months after re-thoracotomy the metastasis and the invaded aortic segment were resected, the latter replaced by a vascular prosthesis.
  • Histology indicated metastasis of a malignant teratoma of intermediate type.
  • CONCLUSION: Combined orchidectomy, lymphadenectomy, high-dosage chemotherapy with cisplatin and autologous germ-cell transplantation at present constitute the standard treatment of malignant testicular germ-cell tumour.
  • In case of metastatic infiltration of vital structures, such as the aortic wall, special operative procedures can prolong the period of remission when the success of a standard treatment seems limited.
  • [MeSH-major] Aorta, Thoracic / surgery. Teratocarcinoma / secondary. Teratocarcinoma / surgery. Testicular Neoplasms / pathology. Vascular Neoplasms / secondary. Vascular Neoplasms / surgery
  • [MeSH-minor] Adult. Aortic Diseases / radiography. Aortic Diseases / surgery. Blood Vessel Prosthesis. Chemotherapy, Adjuvant. Humans. Lymph Node Excision. Male. Mediastinal Neoplasms / secondary. Mediastinal Neoplasms / surgery. Orchiectomy. Retroperitoneal Space. Tomography, X-Ray Computed

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  • (PMID = 11075244.001).
  • [ISSN] 0012-0472
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] GERMANY
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70. Lin CK, Liu HT: Evidence-based treatment for advanced germ cell tumor of the testis with a case illustration. J Chin Med Assoc; 2010 Jul;73(7):343-52
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  • [Title] Evidence-based treatment for advanced germ cell tumor of the testis with a case illustration.
  • Testicular germ cell tumor is rare in the Asian population.
  • This case has shown very good results from the treatment.
  • This is the standard therapy for poor- and intermediate-risk patients with germ cell tumors in the advanced stage, supported by current evidence-based literature.
  • BEP x 3 cycles or EP x 4 cycles is the standard therapy for good-risk patients with advanced germ cell tumors.
  • Using these treatments, we can achieve durable remissions of approximately 90%, 75%, and 45% in good-, intermediate-, and poor-risk patients, respectively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Evidence-Based Practice. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Follow-Up Studies. Humans. Male. Neoplasm Staging. Tomography, X-Ray Computed

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  • [Copyright] 2010 Elsevier. Published by Elsevier B.V. All rights reserved.
  • (PMID = 20688298.001).
  • [ISSN] 1728-7731
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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71. Lee SC, Kim KH, Kim SH, Lee NS, Park HS, Won JH: Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy. Cancer Res Treat; 2009 Dec;41(4):229-32

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  • [Title] Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving multiple lung metastases that was effectively treated with high-dose chemotherapy.
  • Choriocarcinoma in the testis is very rare, and it represents less than 1% (0.3%) of all the testicular germ cell tumors.
  • It is a particularly aggressive variant of non-seminoma tumor, which is characterized by a high serum beta-HCG level and multiple lung metastases.
  • We report here on a case of choriocarcinoma with multiple lung metastases, and the patient has achieved continuous remission for 2 years after combination chemotherapy of BEP (bleomycin, etoposide and cisplatin) and sequential high-dose chemotherapy with autologous peripheral stem cell rescue.

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  • (PMID = 20057969.001).
  • [ISSN] 2005-9256
  • [Journal-full-title] Cancer research and treatment : official journal of Korean Cancer Association
  • [ISO-abbreviation] Cancer Res Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2802842
  • [Keywords] NOTNLM ; Germ cell and embryonal / High-dose chemotherapy / Neoplasms / Testicular choriocarcinoma
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72. Willis SF, Winkler M, Savage P, Seckl MJ, Christmas TJ: Repeat retroperitoneal lymph-node dissection after chemotherapy for metastatic testicular germ cell tumour. BJU Int; 2007 Oct;100(4):809-12
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  • [Title] Repeat retroperitoneal lymph-node dissection after chemotherapy for metastatic testicular germ cell tumour.
  • OBJECTIVES: To examine the operative findings, histopathology and clinical outcome of patients undergoing repeat retroperitoneal lymph node dissection (RPLND) after initial chemotherapy and RPLND (PC-RPLND) for metastatic testicular germ cell tumour (GCT), as a small proportion relapse or have residual disease after incomplete resection in the lung, retrocrural or pelvic nodes, and retroperitoneum.
  • RESULTS: The median (range) time from original to repeat surgery was 2.4 (0.25-26.5) years, and the median follow-up after the repeat procedure was 5.8 (0.08-12.9) years.
  • There was no difference in survival between patients requiring only one PC-RPLND and those having a repeat procedure (P = 0.592).
  • The most common pathological findings in the repeat PC-RPLNDs were differentiated teratoma (19, 35%), malignant teratoma undifferentiated (nine, 17%), adenocarcinoma (eight, 15%) and necrotic tissue (five, 9.2%).
  • However, to avoid cancer recurrence and reoperation, it is crucial that the first PC-RPLND is careful and complete, preferably done in a centre with expertise in this procedure.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Lymph Node Excision. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Combined Modality Therapy. Disease-Free Survival. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Neoplasm, Residual. Prognosis. Reoperation. Retroperitoneal Space. Risk Factors. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 17711512.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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73. Koul S, McKiernan JM, Narayan G, Houldsworth J, Bacik J, Dobrzynski DL, Assaad AM, Mansukhani M, Reuter VE, Bosl GJ, Chaganti RS, Murty VV: Role of promoter hypermethylation in Cisplatin treatment response of male germ cell tumors. Mol Cancer; 2004 May 18;3:16
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  • [Title] Role of promoter hypermethylation in Cisplatin treatment response of male germ cell tumors.
  • BACKGROUND: Male germ cell tumor (GCT) is a highly curable malignancy, which exhibits exquisite sensitivity to cisplatin treatment.
  • The genetic pathway(s) that determine the chemotherapy sensitivity in GCT remain largely unknown.
  • The promoter hypermethylation and/or the down-regulated expression of MGMT is seen in the majority of tumors.
  • We also demonstrate that cisplatin treatment induce de novo promoter hypermethylation in vivo.
  • In addition, we show that the acquired cisplatin resistance in vitro alters the expression of specific genes and the highly resistant cells fail to reactivate gene expression after treatment to demethylating and histone deacetylase inhibiting agents.

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  • (PMID = 15149548.001).
  • [ISSN] 1476-4598
  • [Journal-full-title] Molecular cancer
  • [ISO-abbreviation] Mol. Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA75925
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / FANCF protein, human; 0 / Fanconi Anemia Complementation Group F Protein; 0 / Hic1 protein, mouse; 0 / Histones; 0 / Kruppel-Like Transcription Factors; 0 / RASSF1 protein, human; 0 / RNA-Binding Proteins; 0 / Transcription Factors; 0 / Tumor Suppressor Proteins; EC 2.1.1.- / Methyltransferases; EC 2.1.1.63 / O(6)-Methylguanine-DNA Methyltransferase; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC420487
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74. Souchon R, Gertenbach U, Dieckmann KP, Hahn E, Ruwe M, Stambolis C, Loy V, Classen J: Contralateral testicular cancer in spite of TIN-negative double biopsies and interval cisplatin chemotherapy. Strahlenther Onkol; 2006 May;182(5):289-92
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  • [Title] Contralateral testicular cancer in spite of TIN-negative double biopsies and interval cisplatin chemotherapy.
  • BACKGROUND: Current models of tumorigenesis postulate that testicular germ cell cancer uniformly develops through a preinvasive lesion termed testicular intraepithelial neoplasia (TIN).
  • An open testicular biopsy is a simple and highly sensitive method to diagnose TIN, and this procedure constitutes the basis for curative treatment of TIN.
  • Patients with testis cancer carry a significantly increased risk of developing contralateral testicular tumors.
  • A negative biopsy was assumed to exclude the risk of a subsequent germ cell cancer in the testis due to the high sensitivity of the method.
  • Reports on false-negative biopsies gave rise to the idea that TIN is not uniformly distributed throughout the testis.
  • CASE REPORT: A 24-year-old patient with nonseminomatous testis cancer is reported.
  • The patient had TIN-negative double biopsies in the contralateral testis.
  • He received three cycles of standard PEB (cisplatin, etoposide, bleomycin) chemotherapy for visceral metastasis.
  • 1 year after treatment the patient developed a nonseminomatous contralateral testis cancer which was treated by partial orchiectomy and subsequent local radiotherapy with 20 Gy.
  • CONCLUSION: The case presented here highlights some clinically important aspects: a) even double biopsies of the testis may fail to detect TIN.
  • b) Systemic cisplatin-based chemotherapy may fail to prevent contralateral testicular germ cell cancer.
  • c) A metachronous contralateral testis cancer may-in contrast to common clinical perception-develop even soon after the diagnosis of the first testis tumor.
  • Furthermore, the case could foster the hypothesis that testicular germ cell tumors may in some cases develop without a preceding stage of TIN.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Biopsy. Cisplatin / therapeutic use. Neoplasms, Germ Cell and Embryonal. Neoplasms, Second Primary. Testicular Neoplasms
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Bleomycin / therapeutic use. Etoposide / administration & dosage. Etoposide / therapeutic use. False Negative Reactions. Humans. Magnetic Resonance Imaging. Male. Predictive Value of Tests. Sensitivity and Specificity. Testis / pathology. Time Factors

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  • (PMID = 16673063.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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75. Lutke Holzik MF, Hoekstra HJ, Mulder NH, Suurmeijer AJ, Sleijfer DT, Gietema JA: Non-germ cell malignancy in residual or recurrent mass after chemotherapy for nonseminomatous testicular germ cell tumor. Ann Surg Oncol; 2003 Mar;10(2):131-5
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  • [Title] Non-germ cell malignancy in residual or recurrent mass after chemotherapy for nonseminomatous testicular germ cell tumor.
  • BACKGROUND: After chemotherapy for nonseminomatous testicular germ cell tumor (NSTGCT), residual masses or recurrent disease may contain a non-germ cell malignancy (NGCM).
  • Residual tumor masses were resected in 244 patients and recurrent tumor masses in 37 patients.
  • RESULTS: Nine patients developed an NGCM.
  • Four patients had an NGCM in the resected residual tumor mass after chemotherapy: three patients had a sarcoma, and one patient had both a sarcoma and an adenocarcinoma.
  • Five patients developed a late recurrence with an NGCM after 39, 40, 72, 72, and 84 months.
  • One patient had a primitive neuroectodermal tumor, one had a sarcoma, and three had an adenocarcinoma in the resected recurrent tumor mass.
  • CONCLUSIONS: Sarcoma, adenocarcinoma, or both in residual or recurrent tumor masses after combined-modality NSTGCT treatment are rare.
  • Complete surgical resection of the tumor mass is the only curative treatment option.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / radiography. Adult. Cisplatin / administration & dosage. Humans. Male. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiography. Neoplasm, Residual / pathology. Neoplasm, Residual / radiography. Sarcoma / pathology. Sarcoma / radiography. Survival Rate. Teratoma / pathology. Teratoma / radiography. Tomography, X-Ray Computed. Treatment Outcome

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  • [CommentOn] Ann Surg Oncol. 2003 Mar;10(2):100-1 [12620901.001]
  • (PMID = 12620907.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comment; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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76. Eggener SE, Carver BS, Loeb S, Kondagunta GV, Bosl GJ, Sheinfeld J: Pathologic findings and clinical outcome of patients undergoing retroperitoneal lymph node dissection after multiple chemotherapy regimens for metastatic testicular germ cell tumors. Cancer; 2007 Feb 1;109(3):528-35
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  • [Title] Pathologic findings and clinical outcome of patients undergoing retroperitoneal lymph node dissection after multiple chemotherapy regimens for metastatic testicular germ cell tumors.
  • BACKGROUND: Postchemotherapy surgery is an essential component in the management of patients with metastatic germ cell tumors (GCT).
  • The authors assessed their institutional experience of retroperitoneal lymph node dissection (RPLND) after multiple chemotherapy regimens for advanced GCT.
  • METHODS: By analyzing the institutional prospective surgical database from 1989 to 2004, 71 patients were identified who underwent RPLND after multiple chemotherapy regimens.
  • Clinicopathologic and treatment trends were characterized, and predictors of disease-specific survival (DSS) were evaluated.
  • Patients who received taxane-containing chemotherapy regimens as salvage therapy had lower rates of GCT at RPLND (14% vs 42%; P = .01), higher rates of fibrosis (63% vs 39%; P = .04), and similar rates of teratoma (31% vs 33%; P = .9).
  • The current data support RPLND in select patients after salvage chemotherapy, because a considerable proportion has teratoma or GCT, and the 10-year DSS rate after resection is 70%.
  • [MeSH-major] Lymph Node Excision. Retroperitoneal Neoplasms / surgery. Teratoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Lymphatic Metastasis / pathology. Male. Middle Aged. Prognosis. Prospective Studies. Salvage Therapy. Survival Rate

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  • [Copyright] (c) 2007 American Cancer Society.
  • (PMID = 17177200.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / T32-CA82088-06
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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77. McNeish IA, Kanfer EJ, Haynes R, Giles C, Harland SJ, Driver D, Rustin GJ, Newlands ES, Seckl MJ: Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours. Br J Cancer; 2004 Mar 22;90(6):1169-75
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  • [Title] Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours.
  • High-dose regimes containing etoposide, carboplatin and an oxazaphospharine can salvage 30-40% of patients with relapsed or refractory male germ cell tumours (GCTs).
  • The additional benefit of paclitaxel in such high-dose therapy has not been tested.
  • Between March 1995 and November 2002, 36 male GCT patients were treated with Carbop-EC-T (paclitaxel 75 mg x m(-2), etoposide 450 mg x m(-2), carboplatin AUC 10 on days -7, -5 and -3 and cyclophosphamide 60 mg x kg(-1) on days -5 and -3) followed by peripheral blood stem cell infusion (day 0).
  • There were also six treatment-related deaths, five associated with pneumonitis.
  • Since altering our protocol so that paclitaxel is infused over 24 h with steroid prophylaxis, only one of 18 patients (13 testicular GCTs and five other tumour types) has had a treatment-related death.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Cyclophosphamide / administration & dosage. Drug Resistance, Neoplasm. Etoposide / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Paclitaxel / administration & dosage. Peripheral Blood Stem Cell Transplantation. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 15026797.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2410221
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78. Schrader M, Müller M, Sofikitis N, Straub B, Krause H, Miller K: "Onco-tese": testicular sperm extraction in azoospermic cancer patients before chemotherapy-new guidelines? Urology; 2003 Feb;61(2):421-5
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  • [Title] "Onco-tese": testicular sperm extraction in azoospermic cancer patients before chemotherapy-new guidelines?
  • OBJECTIVES: To examine the usefulness of pretreatment testicular sperm extraction because some patients have tumor-induced azoospermia.
  • In view of the high cure rates for testicular germ cell tumors and malignant lymphomas, increasing clinical importance is attached to protecting fertility.
  • High-dose cytostatic therapy may be expected to cause long-term infertility.
  • Thus, the standard procedure for fertility protection is cryopreservation of ejaculated spermatozoa before therapy.
  • METHODS: Contralateral testicular biopsies were taken from 14 azoospermic patients with malignant testicular germ cell tumors.
  • In addition, 17 patients with malignant lymphomas underwent unilateral (n = 6) or bilateral (n = 11) testicular biopsy.
  • The tissue specimens were cryopreserved, and the histologic workup was performed at the same time.
  • RESULTS: Of the 14 patients with malignant testicular germ cell tumors, 6 had spermatozoa in their testicular biopsies.
  • Sertoli cell-only syndrome was found in 5 patients, and 3 had maturation arrest without detection of spermatozoa.
  • Successful sperm recovery was possible in 8 of the 17 patients with malignant lymphoma, 4 had Sertoli cell-only syndrome, and 5 had maturation arrest.
  • None of the patients had evidence of secondary wound healing or treatment delay because of the testicular biopsy.
  • CONCLUSIONS: Our results show that testicular sperm extraction is a useful technique for obtaining spermatozoa before cytotoxic therapy in azoospermic cancer patients.
  • This procedure should be considered as an option for fertility preservation in azoospermic cancer patients, because high cumulative cytostatic doses can cause irreversible fertility alterations.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Germinoma / drug therapy. Oligospermia / chemically induced. Spermatozoa / physiology. Testicular Neoplasms / drug therapy. Testis / surgery. Tissue and Organ Harvesting / methods
  • [MeSH-minor] Biopsy, Needle. Cryopreservation / methods. Humans. Lymphoma / pathology. Male. Sertoli Cell Tumor / drug therapy. Sertoli Cell Tumor / pathology. Sperm Count

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  • (PMID = 12597960.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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79. Inci K, Dogan HS, Akdogan B, Ergen A, Tasar C, Ozen H: Does age affect the prognosis of patients with testicular germ cell tumor? Urol Int; 2007;79(2):117-23
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  • [Title] Does age affect the prognosis of patients with testicular germ cell tumor?
  • INTRODUCTION: In this study, the effect of age on the prognosis of testicular germ cell tumors in patients over 40 was investigated.
  • MATERIALS AND METHODS: Ninety-three patients with testicular germ cell tumor who were 40 years old and over were identified in our germ cell tumor database.
  • Group III patients had a significantly lower response rate to initial chemotherapy and a higher disease progression rate during therapy (complete response rate: 33.3%, progression rate: 44.4%, p = 0.035).
  • CONCLUSION: Testicular germ cell tumor patients over 50 years old presented with a more advanced stage and had higher disease progression and disease mortality rates.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / mortality. Testicular Neoplasms / mortality
  • [MeSH-minor] Adult. Age Factors. Aged. Antineoplastic Agents / therapeutic use. Databases as Topic. Disease Progression. Humans. Male. Middle Aged. Prognosis. Survival Analysis

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  • [Copyright] 2007 S. Karger AG, Basel
  • (PMID = 17851279.001).
  • [ISSN] 1423-0399
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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80. Hayashi T, Yamada T, Kageyama Y, Kihara K: Expression failure of the notch signaling system is associated with the pathogenesis of testicular germ cell tumor. Tumour Biol; 2004 May-Jun;25(3):99-105
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  • [Title] Expression failure of the notch signaling system is associated with the pathogenesis of testicular germ cell tumor.
  • OBJECTIVES: The expression of Notch 1 and its ligand Jagged 2, critical factors in cell type specification, in testicular germ cell tumors was examined in order to evaluate its possible relationship with their pathogenesis.
  • METHODS: Northern blot analysis and immunohistochemical staining for Notch 1 and Jagged 2 were done in 139 samples of testicular germ cell tumors.
  • RESULTS: Notch 1 and Jagged 2 transcripts were expressed in noncancerous testicular tissues and Notch 1 and Jagged 2 proteins were positive in the spermatids.
  • CONCLUSIONS: Our results offer, for the first time, the possibility that the activity of the Notch signaling system, one of the cell proliferation and differentiation pathways, correlates with the different histological subtypes of germ cell tumor, which may be responsible for characteristics of cancer cells such as responses to chemotherapy and/or irradiation.
  • [MeSH-major] Cell Transformation, Neoplastic. Gene Expression Regulation, Neoplastic. Germinoma / genetics. Germinoma / physiopathology. Membrane Proteins / biosynthesis. Receptors, Cell Surface / biosynthesis. Seminoma / genetics. Seminoma / physiopathology. Testicular Neoplasms / genetics. Testicular Neoplasms / physiopathology. Transcription Factors
  • [MeSH-minor] Blotting, Northern. Calcium-Binding Proteins. Cell Differentiation. Humans. Immunohistochemistry. Intercellular Signaling Peptides and Proteins. Jagged-1 Protein. Male. Morphogenesis. Nuclear Proteins. Receptor, Notch1. Serrate-Jagged Proteins. Signal Transduction. Trans-Activators

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  • (PMID = 15361705.001).
  • [ISSN] 1010-4283
  • [Journal-full-title] Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine
  • [ISO-abbreviation] Tumour Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Calcium-Binding Proteins; 0 / Intercellular Signaling Peptides and Proteins; 0 / JAG1 protein, human; 0 / Jagged-1 Protein; 0 / Membrane Proteins; 0 / NOTCH1 protein, human; 0 / Nuclear Proteins; 0 / Receptor, Notch1; 0 / Receptors, Cell Surface; 0 / Serrate-Jagged Proteins; 0 / Trans-Activators; 0 / Transcription Factors
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81. Benedetti G, Rastelli F, Fedele M, Castellucci P, Damiani S, Crinò L: Presentation of nonseminomatous germ cell tumor of the testis with symptomatic solitary bone metastasis. A case report with review of the literature. Tumori; 2006 Sep-Oct;92(5):433-6
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  • [Title] Presentation of nonseminomatous germ cell tumor of the testis with symptomatic solitary bone metastasis. A case report with review of the literature.
  • Metastatic bone lesions are exceptional at diagnosis in germ cell tumors (GCTs).
  • Bone examination is not considered a standard procedure in the staging of GCTs, and this may contribute to underestimation of the real proportion of bone metastases.
  • Here we report a case of nonseminomatous GCT of the testis with a synchronous, symptomatic, solitary pubic bone metastasis that was completely controlled by systemic chemotherapy and locoregional radiation therapy.
  • We propose individualized management for symptomatic GCT patients including bone scintigraphy and/or PET examination at diagnosis and a combined cytotoxic approach with chemotherapy and radiation therapy.
  • [MeSH-major] Bone Neoplasms / secondary. Neoplasms, Germ Cell and Embryonal / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Biopsy, Fine-Needle. Chemotherapy, Adjuvant. Humans. Male. Middle Aged. Positron-Emission Tomography. Radiotherapy, Adjuvant. Tomography, X-Ray Computed


82. Wang JW, Yang L, Wang JY, Qu T, Cai RG, Huang J, Sun Y: [Long-term results of multimodality therapy of testicular germ cell tumor]. Zhonghua Zhong Liu Za Zhi; 2003 Jul;25(4):382-5
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  • [Title] [Long-term results of multimodality therapy of testicular germ cell tumor].
  • OBJECTIVE: To study the clinical characteristics, outcome, prognostic factors and survival of patients with testicular germ cell tumors (TGCTs).
  • METHODS: 107 TGCT patients received chemotherapy after orchiectomy.
  • Seventy-four patients had non-seminomatous germ cell tumors (NSGCTT) with 21 (28.4%) stage I lesions.
  • Therapy including chemotherapy, radiation and necessary salvage operation were performed after orchiectomy.
  • RESULTS: Clinical stage and pathological type were the main prognostic factors.
  • Seventeen (26.6%) patients achieved CR by chemotherapy alone and an additional 8 patients (12.5%) achieved CR by chemotherapy plus salvage operation or radiation.
  • CONCLUSION: The long-term outcome for stage I germ cell tumors is excellent.
  • The treatment outcome and survival in patients with metastatic TGCTs can be greatly improved by adopting multi-modality therapy with combined chemotherapy as the chief means.
  • [MeSH-major] Germinoma / surgery. Orchiectomy. Seminoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Child. Child, Preschool. Cisplatin / therapeutic use. Combined Modality Therapy. Etoposide / therapeutic use. Follow-Up Studies. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Male. Middle Aged. Neoplasm Staging. Survival Rate. Treatment Outcome

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  • (PMID = 12921572.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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83. Brandli DW, Ulbright TM, Foster RS, Cummings OW, Zhang S, Sweeney CJ, Eble JN, Cheng L: Stroma adjacent to metastatic mature teratoma after chemotherapy for testicular germ cell tumors is derived from the same progenitor cells as the teratoma. Cancer Res; 2003 Sep 15;63(18):6063-8
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  • [Title] Stroma adjacent to metastatic mature teratoma after chemotherapy for testicular germ cell tumors is derived from the same progenitor cells as the teratoma.
  • Metastatic mature teratoma is often present in postchemotherapy surgical specimens of lymph nodes from patients with pathological stage II or III testicular germ cell tumors.
  • The stromal cells in these lesions have generally been considered "fibrosis" secondary to the chemotherapy and the necrosis it causes, although the frequent cytological atypia of the stromal cells suggests that they may be neoplastic.
  • We studied 25 patients with pathological stage II or III testicular cancer who were treated with platinum-based chemotherapy followed by surgical resection of retroperitoneal lymph nodes that contained metastatic mature teratoma with "fibrosis" to determine the reactive or neoplastic nature of the stromal cells.
  • A laser capture microdissection technique facilitated preparation of genomic DNA from the epithelial components of teratoma, adjacent stromal cells, and normal lymph node tissue from each patient.
  • Concordant genetic alterations observed in teratoma and stroma suggest that both are derived from the same element of the original germ cell tumor or the same progenitor cell.
  • [MeSH-major] Neoplastic Stem Cells / pathology. Teratoma / genetics. Teratoma / pathology. Testicular Neoplasms / genetics. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Embryonal Carcinoma Stem Cells. Humans. Loss of Heterozygosity. Male. Neoplasm Metastasis. Stromal Cells / pathology

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  • (PMID = 14522936.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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84. Nishida T, Nishiyama N, Inoue K, Kawata Y, Ichikawa T, Tsukioka T, Wakasa T, Wakasa K, Suehiro S: Successful resection of massively enlarged residual pulmonary metastases from a nonseminomatous germ cell testicular tumor. Osaka City Med J; 2006 Dec;52(2):87-92
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  • [Title] Successful resection of massively enlarged residual pulmonary metastases from a nonseminomatous germ cell testicular tumor.
  • A 25-year-old man was referred to our hospital in June 2000 for treatment of massive enlargement of residual pulmonary metastases from a nonseminomatous germ cell testicular tumor.
  • He had undergone right orchiectomy followed by cisplatin-based combination chemotherapy 7 years ago.
  • Chest radiography and computed tomography showed complete opacification of the left hemithorax with mediastinal shift to the right, and two smaller nodules in the right lung.
  • After salvage chemotherapy, elevated serum alpha-fetoprotein concentrations decreased to the normal range.
  • Postoperative pathologic examination disclosed metastatic germ cell tumors composed of mature teratoma.
  • When technically possible, resection of even massive pulmonary metastases after a favorable response to chemotherapy for a nonseminomatous germ cell tumor, can provide pathologic assessment of the response and offer patients a chance of long-term survival.
  • [MeSH-major] Lung Neoplasms / secondary. Lung Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Humans. Male. Neoplasm, Residual

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  • (PMID = 17330397.001).
  • [ISSN] 0030-6096
  • [Journal-full-title] Osaka city medical journal
  • [ISO-abbreviation] Osaka City Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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85. Parkinson MC, Harland SJ, Harnden P, Sandison A: The role of the histopathologist in the management of testicular germ cell tumour in adults. Histopathology; 2001 Mar;38(3):183-94
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  • [Title] The role of the histopathologist in the management of testicular germ cell tumour in adults.
  • In the last 20--30 years the availability of effective chemotherapy and more accurate clinical staging has greatly improved the prognosis for patients with testicular germ cell tumours.
  • Initially, such treatment appeared to diminish the role of histopathology to the distinction between seminoma and nonseminomatous germ cell tumour (NSGCT) in the primary specimen.
  • However, histopathology has evolved as a prognostic tool indicating the risk of relapse in various defined clinical contexts thereby facilitating therapeutic decisions.
  • The clinical emphasis has been on quality of life and reduction of therapy both in terms of the number of patients treated and the number of chemotherapy courses given to each patient.
  • The treatment of adult testicular germ cell tumours may differ between countries but protocols are established.
  • Therefore it is appropriate to discuss the role of histopathology during this era of relative therapeutic stability.
  • [MeSH-major] Germinoma / pathology. Pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Biopsy. Humans. Lymph Node Excision. Male. Neoplasm Metastasis. Orchiectomy. Physician's Role. Prognosis

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  • (PMID = 11260297.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 113
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86. Dieckmann KP, Albers P, Classen J, De Wit M, Pichlmeier U, Rick O, Müllerleile U, Kuczyk M: Late relapse of testicular germ cell neoplasms: a descriptive analysis of 122 cases. J Urol; 2005 Mar;173(3):824-9
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  • [Title] Late relapse of testicular germ cell neoplasms: a descriptive analysis of 122 cases.
  • PURPOSE: The problem of late relapse of testicular germ cell tumor (GCT) is poorly understood.
  • In the present study we increased the understanding of L/R by analyzing these events in a large patient sample.
  • MATERIALS AND METHODS: Late relapse was defined as recurrence of disease more than 2 years after completion of primary treatment.
  • Several parameters were analyzed including age, clinical stage, treatment at primary presentation, occurrence of prior early relapse, interval to L/R, tumor markers, site of relapse, and mode and outcome of L/R treatment.
  • Possible effects of various clinical parameters on treatment results were studied by multivariate statistical analysis.
  • A total of 75% of nonseminomas but only 20% of seminomas had disseminated disease at first presentation, while 51 patients with nonseminoma had initially received chemotherapy. alpha-Fetoprotein was increased in 45 patients (of 59 eligible) with nonseminoma at L/R, human chorionic gonadotropin in 12 cases. alpha-Fetoprotein levels greater than 100 U/l indicated poor prognosis.
  • Treatment should include surgery in nonseminoma.
  • Seminomas and otherwise chemotherapy naive cases might respond to chemotherapy only.
  • Particular risk groups for late relapse are nonseminoma with prior early relapse, patients receiving chemotherapy for disseminated disease at first presentation and those with pure teratoma.
  • [MeSH-major] Germinoma / epidemiology. Neoplasm Recurrence, Local / epidemiology. Testicular Neoplasms / epidemiology
  • [MeSH-minor] Adolescent. Adult. Humans. Male. Middle Aged. Retrospective Studies. Time Factors

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  • (PMID = 15711278.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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87. Idrees MT, Kuhar M, Ulbright TM, Zhang S, Agaram N, Wang M, Grignon DJ, Eble JN, Cheng L: Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma. Hum Pathol; 2010 Jan;41(1):139-44
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  • [Title] Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma.
  • Testicular germ cell tumors may have multiple histologic subtypes.
  • An alternative hypothesis for the development of angiosarcoma in a patient with germ cell tumors is secondary to radiation or chemotherapy.
  • We report a patient with a mixed testicular germ cell tumor who presented with retroperitoneal, mediastinal, and pulmonary metastases after chemotherapy.
  • Using tissue microdissection-loss of heterozygosity analysis and fluorescence in situ hybridization, we analyzed the clonality of the primary germ cell tumor, angiosarcoma, and metastatic teratoma.
  • Loss of heterozygosity was demonstrated for microsatellite loci of all 3 chromosomes, and completely concordant loss of heterozygosity patterns were observed among primary germ cell tumor components, metastatic teratoma, and angiosarcoma.
  • Isochromosome 12p and 12p overrepresentations were consistently found in the primary germ cell tumor components, metastatic teratoma, and angiosarcoma.
  • The results indicated a clonal origin of the tumors, which supports that angiosarcoma, as well as the teratomas, arose from the testicular germ cell tumors.
  • [MeSH-major] Hemangiosarcoma / pathology. Mediastinal Neoplasms / pathology. Neoplasms, Second Primary / pathology. Teratoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Clone Cells. DNA, Neoplasm / analysis. Disease Progression. Disease-Free Survival. Humans. In Situ Hybridization, Fluorescence. Loss of Heterozygosity. Male. Microdissection. Microsatellite Repeats / genetics

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  • (PMID = 19836053.001).
  • [ISSN] 1532-8392
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Neoplasm
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88. Kwan AS, Sahu A, Palexes G: Retinal ischemia with neovascularization in cisplatin related retinal toxicity. Am J Ophthalmol; 2006 Jan;141(1):196-7
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  • PURPOSE: To report a case of macular ischemia and retinal neovascularization in a patient who received cisplatin related chemotherapy.
  • METHODS: A patient with germ cell testicular tumor received polychemotherapy (bleomycin, etoposide, and cisplatin or BEP) for a recurrence of his tumor.
  • Ten weeks after completion of treatment, he presented with loss of vision in his left eye.
  • CONCLUSIONS: Like interferon, cisplatin related chemotherapy could cause considerable ocular morbidity.
  • It can cause marked irreversible visual loss at therapeutic dose, and it is not well recognized.
  • Retinal neovascularization related to cisplatin therapy has not been previously reported.
  • Physicians should be aware and warn patients of the potential ophthalmic side effects of cisplatin related chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Ischemia / chemically induced. Retinal Neovascularization / chemically induced. Retinal Vessels / drug effects
  • [MeSH-minor] Adult. Bleomycin / adverse effects. Bleomycin / therapeutic use. Cisplatin / adverse effects. Cisplatin / therapeutic use. Etoposide / adverse effects. Etoposide / therapeutic use. Fluorescein Angiography. Germinoma / drug therapy. Humans. Laser Coagulation. Male. Testicular Neoplasms / drug therapy. Visual Acuity

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  • (PMID = 16387001.001).
  • [ISSN] 0002-9394
  • [Journal-full-title] American journal of ophthalmology
  • [ISO-abbreviation] Am. J. Ophthalmol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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89. Khurana K, Gilligan TD, Stephenson AJ: Management of poor-prognosis testicular germ cell tumors. Indian J Urol; 2010 Jan-Mar;26(1):108-14

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  • [Title] Management of poor-prognosis testicular germ cell tumors.
  • Currently, the outcome of patients with intermediate-and poor-risk germ cell tumors at diagnosis is optimized by the use of risk-appropriate chemotherapy and post-chemotherapy surgical resection of residual masses.
  • Currently, there is no role for high-dose chemotherapy in the first-line setting.
  • Patients who progress on first-line chemotherapy or who relapse after an initial complete response also have a poor prognosis.
  • In the setting of early relapse, the standard approach at most centers is conventional-dose, ifosfamide-based regimens and post-chemotherapy resection of residual masses.
  • The treatment of patients with late relapse is complete surgical resection whenever feasible.
  • Salvage chemotherapy for late relapse may be used prior to surgery in patients where a complete resection is not feasible.
  • A complete surgical resection of all residual sites of disease after chemotherapy is critical for the prevention of relapse and the long-term survival of patients with advanced germ cell tumors.

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  • (PMID = 20535296.001).
  • [ISSN] 1998-3824
  • [Journal-full-title] Indian journal of urology : IJU : journal of the Urological Society of India
  • [ISO-abbreviation] Indian J Urol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC2878420
  • [Keywords] NOTNLM ; Testicular neoplasms / antineoplastic combined chemotherapy protocols / germ cell and embryonal / lymph node excision / neoplasms / prognosis / retroperitoneum / risk factors / salvage therapy
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90. Beyrouthy MJ, Garner KM, Hever MP, Freemantle SJ, Eastman A, Dmitrovsky E, Spinella MJ: High DNA methyltransferase 3B expression mediates 5-aza-deoxycytidine hypersensitivity in testicular germ cell tumors. Cancer Res; 2009 Dec 15;69(24):9360-6
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  • [Title] High DNA methyltransferase 3B expression mediates 5-aza-deoxycytidine hypersensitivity in testicular germ cell tumors.
  • Testicular germ cell tumors (TGCT) are the most common solid tumors of 15- to 35-year-old men.
  • TGCT patients are frequently cured with cytotoxic cisplatin-based therapy.
  • However, TGCT patients refractory to cisplatin-based chemotherapy have a poor prognosis, as do those having a late relapse.
  • Pluripotent embryonal carcinomas (EC) are the malignant counterparts to embryonic stem cells and are considered the stem cells of TGCTs.
  • Here, we show that human EC cells are highly sensitive to 5-aza-deoxycytidine (5-aza-CdR) compared with somatic solid tumor cells.
  • Decreased proliferation and survival with low nanomolar concentrations of 5-aza-CdR is associated with ATM activation, H2AX phosphorylation, increased expression of p21, and the induction of genes known to be methylated in TGCTs (MGMT, RASSF1A, and HOXA9).
  • Notably, 5-aza-CdR hypersensitivity is associated with markedly abundant expression of the pluripotency-associated DNA methyltransferase 3B (DNMT3B) compared with somatic tumor cells.
  • Intriguingly, cisplatin-resistant EC cells retain an exquisite sensitivity to low-dose 5-aza-CdR treatment, and pretreatment of 5-aza-CdR resensitizes these cells to cisplatin-mediated toxicity.
  • These novel findings indicate that high expression of DNMT3B, a likely byproduct of their pluripotency and germ cell origin, sensitizes TGCT-derived EC cells to low-dose 5-aza-CdR treatment.

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  • (PMID = 19951990.001).
  • [ISSN] 1538-7445
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R21 CA124817; United States / NCI NIH HHS / CA / R01-CA087546; United States / NCI NIH HHS / CA / R21 CA124817-02; United States / NCI NIH HHS / CA / CA104312-05; United States / NCI NIH HHS / CA / R01 CA111422; United States / NCI NIH HHS / CA / CA124817-02; United States / NCI NIH HHS / CA / R01-CA111422; United States / NCI NIH HHS / CA / P30 CA023108; United States / NCI NIH HHS / CA / R01-CA104312; United States / NCI NIH HHS / CA / CA087546-09; United States / NCI NIH HHS / CA / R01 CA087546; United States / NCI NIH HHS / CA / CA111422-04; United States / NCI NIH HHS / CA / R01 CA087546-09; United States / NCI NIH HHS / CA / R01 CA104312-05; United States / NCI NIH HHS / CA / R01 CA111422-04; United States / NCI NIH HHS / CA / R21 R21CA124817; United States / NCI NIH HHS / CA / R01 CA104312
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cell Cycle Proteins; 0 / DNA-Binding Proteins; 0 / H2AFX protein, human; 0 / Histones; 0 / RNA, Small Interfering; 0 / Tumor Suppressor Proteins; 776B62CQ27 / decitabine; EC 2.1.1.37 / DNA (Cytosine-5-)-Methyltransferase; EC 2.1.1.37 / DNA methyltransferase 3B; EC 2.7.11.1 / ATM protein, human; EC 2.7.11.1 / Ataxia Telangiectasia Mutated Proteins; EC 2.7.11.1 / Protein-Serine-Threonine Kinases; M801H13NRU / Azacitidine; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS152147; NLM/ PMC2795063
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91. Ishibashi M, Nakayama K, Oride A, Yeasmin S, Katagiri A, Iida K, Nakayama N, Miyazaki K: [A case of PEP(BEP)-resistant ovarian dysgerminoma successfully treated by VeIP therapy]. Gan To Kagaku Ryoho; 2009 Mar;36(3):513-7
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  • [Title] [A case of PEP(BEP)-resistant ovarian dysgerminoma successfully treated by VeIP therapy].
  • Ovarian germ cell tumors are malignant tumors which commonly develop during childhood, and which are sensitive to chemotherapy.
  • We have had a case of germ cell tumors which showed resistance to first-line PEP(BEP)chemotherapy.
  • As second-line chemotherapy, VeIP therapy was used, because it is possible that this therapy is effective against recurrent testicular germ cell tumors.
  • She experienced acute abdominal pain and visited the hospital, where she was diagnosed with torsion of an ovarian tumor.
  • Then she received chemotherapy PEP(BEP), but after eight months of PEP (BEP), her serum hCG-CTP was again elevated to 14.5 mIU/mL.
  • After the operation, the patient again underwent chemotherapy.
  • After 6 courses of this therapy, she had a follow-up operation.
  • She remains without recurrence of this disease 24 months after VeIP therapy.
  • This case suggests that VeIP therapy might be an effective second-line therapy for patients with PEP(BEP)-resistant ovarian dysgerminoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm / drug effects. Dysgerminoma / drug therapy. Dysgerminoma / pathology. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adolescent. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Positron-Emission Tomography. Remission Induction. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19295284.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; Q20Q21Q62J / Cisplatin
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92. Mottet N, Rousmans S, Culine S: [Systematic review 2007: Primary treatments of testicular germ cell tumors after radical orchydectomy]. Bull Cancer; 2008 Feb;95(2):205-34
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  • [Title] [Systematic review 2007: Primary treatments of testicular germ cell tumors after radical orchydectomy].
  • [Transliterated title] Synthèse méthodique des données scientifiques 2007: Traitements de première intention des tumeurs germinales du testicule après orchidectomie totale.
  • In this context, the SOR, in collaboration with the French Association of Urology (AFU), has developed a systematic review on the management of nonseminomatous (NSTGC) or seminomatous(STGC) testicular germ cell cancer treated with primary radiotherapy (RT), chemotherapy (CT) or surveillance (SV) after radical orchidectomy.
  • Today, 80 % of patients with testicular germ cell cancer, including metastatic stage, can be cured.
  • Actual challenges are to limit morbidity and late sequels of treatments while maintaining their therapeutic efficacy.
  • Following this goal, surveillance, considered as a therapeutic option, is being broadly developed particularly for localised tumours.
  • CONCLUSIONS: The choice of risk-adapted treatment for patients with locally NSTGC of the testis seems to be appropriate: SV for low risk patients and CT for others.
  • For local STGC, the choice of SV or CT versus RT needs to be confirmed by RCT with prolonged follow-up according to promising results in term of toxicity obtained with carboplatine or lower irradiation dose (20 Gy instead of 30 Gy).
  • Finally, for advanced STGC, the utility of carboplatine single agent treatment versus cisplatin-based combination chemotherapy has not been proved.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal. Testicular Neoplasms
  • [MeSH-minor] Humans. Lymph Node Excision. Male. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Neoplasm, Residual. Orchiectomy. Practice Guidelines as Topic. Randomized Controlled Trials as Topic. Risk Assessment. Seminoma / drug therapy. Seminoma / pathology. Seminoma / radiotherapy. Seminoma / therapy. Treatment Outcome

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  • (PMID = 18330045.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Meta-Analysis; Review
  • [Publication-country] France
  • [Number-of-references] 126
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93. Dimov ND, Zynger DL, Luan C, Kozlowski JM, Yang XJ: Topoisomerase II alpha expression in testicular germ cell tumors. Urology; 2007 May;69(5):955-61
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  • [Title] Topoisomerase II alpha expression in testicular germ cell tumors.
  • OBJECTIVES: Inhibitors of topoisomerase II alpha (TopoIIalpha), an enzyme with a crucial role in DNA maintenance, are included in the chemotherapy protocols for testicular germ cell tumors (GCTs).
  • Despite the success of current chemotherapy regimens, a significant number of patients experience relapse.
  • We analyzed TopoIIalpha expression in primary and metastatic testicular GCTs because this enzyme is a target for some antineoplastic agents.
  • METHODS: Primary GCT specimens from 109 patients, including 57 seminomas and 52 mixed GCTs (41 embryonal carcinomas, 23 yolk sac tumors, 19 seminomas, 8 choriocarcinomas, 17 teratomas with immature elements, and 16 teratomas with mature elements), were obtained from our archives.
  • The metastatic lesions from 11 of the patients with mixed GCTs included seven teratomas with mature components, five embryonal carcinomas, one yolk sac tumor, one choriocarcinoma, and one teratoma with immature components.
  • RESULTS: Most embryonal carcinoma (100%), yolk sac tumor (95%), seminoma (88%), and choriocarcinoma (62%) components of the GCTs were TopoIIalpha immunoreactive.
  • CONCLUSIONS: The results of our study have shown that TopoIIalpha is expressed in most seminomas, embryonal carcinomas, yolk sac tumors, and choriocarcinomas, suggesting a possible mechanism of sensitivity of these components to TopoIIalpha inhibitors.
  • These findings imply that the variable chemoresponsiveness of testicular GCTs could have an underlying molecular basis.
  • [MeSH-major] Antigens, Neoplasm / metabolism. Biomarkers, Tumor / analysis. DNA Topoisomerases, Type II / metabolism. DNA-Binding Proteins / antagonists & inhibitors. DNA-Binding Proteins / metabolism. Neoplasms, Germ Cell and Embryonal / enzymology. Testicular Neoplasms / enzymology. Topoisomerase II Inhibitors
  • [MeSH-minor] Adolescent. Adult. Biopsy, Needle. Carcinoma, Embryonal / drug therapy. Carcinoma, Embryonal / enzymology. Carcinoma, Embryonal / pathology. Choriocarcinoma / drug therapy. Choriocarcinoma / enzymology. Choriocarcinoma / pathology. Endodermal Sinus Tumor / drug therapy. Endodermal Sinus Tumor / enzymology. Endodermal Sinus Tumor / pathology. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Male. Middle Aged. Prognosis. Sampling Studies. Seminoma / drug therapy. Seminoma / enzymology. Seminoma / pathology. Sensitivity and Specificity. Teratoma / drug therapy. Teratoma / enzymology. Teratoma / pathology. Treatment Outcome

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  • (PMID = 17482942.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Topoisomerase II Inhibitors; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
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94. Kondagunta GV, Bacik J, Donadio A, Bajorin D, Marion S, Sheinfeld J, Bosl GJ, Motzer RJ: Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol; 2005 Sep 20;23(27):6549-55
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  • [Title] Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors.
  • PURPOSE: The efficacy of paclitaxel was evaluated in combination with ifosfamide and cisplatin as second-line chemotherapy for patients with relapsed testicular germ cell tumors (GCTs).
  • PATIENTS AND METHODS: Forty-six patients with progressive metastatic GCTs were treated with paclitaxel and ifosfamide plus cisplatin (TIP) as second-line therapy.
  • Eligibility required that patients have both a testis primary tumor site and a prior complete response (CR) to a first-line chemotherapy program, which had been identified previously as favorable prognostic factors to conventional-dose salvage chemotherapy.
  • RESULTS: Thirty-two (70%) of 46 patients achieved a CR to treatment.
  • Three patients (7%) who achieved a CR relapsed after TIP chemotherapy.
  • Twenty-nine patients are continuously disease free at a median follow-up time of 69 months, resulting in a 63% durable CR rate and a 2-year progression-free survival rate of 65% (95% CI, 51% to 79%).
  • CONCLUSION: Four cycles of TIP as second-line therapy achieved a durable CR rate in a high proportion of patients with relapsed testicular GCT.
  • The high CR rate emphasizes the importance of patient selection according to prognostic factors to achieve a favorable outcome to conventional-dose salvage therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / mortality. Salvage Therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Cisplatin / therapeutic use. Confidence Intervals. Dose-Response Relationship, Drug. Drug Administration Schedule. Humans. Ifosfamide / therapeutic use. Male. Maximum Tolerated Dose. Middle Aged. Paclitaxel / therapeutic use. Patient Selection. Probability. Prognosis. Prospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 16170162.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 5T32-CA-09207-26; United States / NCI NIH HHS / CA / K24 CA-82431
  • [Publication-type] Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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95. Heidenreich A, Krege S, Flasshove M: [Interdisciplinary cooperation in the treatment of complex patients with advanced testicular germ cell tumor]. Urologe A; 2004 Dec;43(12):1521-30
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  • [Title] [Interdisciplinary cooperation in the treatment of complex patients with advanced testicular germ cell tumor].
  • [Transliterated title] Interdisziplinäre Kooperation in der Therapie von komplexen Patienten mit fortgeschrittenem testikulärem Keimzelltumor.
  • Testicular germ cell tumors represent the classic example of a curable solid cancer even in the metastatic stage.
  • Cure rates are as high as 95% and 80-85% in patients with good and intermediate prognosis; even in patients with poor prognosis cure rates of 50% have been achieved by interdisciplinary collaboration of all specialties involved in the management of testis cancer.
  • Standardization of diagnosis and therapy should be further optimized due to the recently published interdisciplinary national and European guidelines.
  • Besides realization of standardized guidelines, treatment of patients with extensive primary disease or recurrent germ cell tumors following standard therapy requires comprehensive knowledge in conservative and surgical management, which is basically only available at specialized cancer centers.
  • Patients with complex findings, especially if associated with a poor prognosis according to IGCCCG, should be referred to specialized tertiary referral centers at a very early stage, since the cure rates depend not only on the consideration of guidelines but also on the expertise of the attending oncologist and surgeon.
  • When treating these patients, one has to consider that inadequately administered chemotherapy (dosage, length of cycles, number of cycles) cannot be compensated for by surgery and that inadequately performed retroperitoneal lymphadenectomy or residual tumor resection cannot be compensated for by chemotherapy.
  • In any case, suboptimal primary therapy will result in inferior cure rates and an unnecessarily increased mortality rate.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasms, Germ Cell and Embryonal / secondary. Neoplasms, Germ Cell and Embryonal / therapy. Patient Care Team / organization & administration. Practice Patterns, Physicians' / organization & administration. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Combined Modality Therapy / methods. Cooperative Behavior. European Union. Germany. Humans. Lymphatic Metastasis. Male. Middle Aged. Peritoneal Neoplasms / drug therapy. Peritoneal Neoplasms / secondary. Peritoneal Neoplasms / surgery. Peritoneum / surgery. Practice Guidelines as Topic. Severity of Illness Index. Treatment Outcome

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  • (PMID = 15592709.001).
  • [ISSN] 0340-2592
  • [Journal-full-title] Der Urologe. Ausg. A
  • [ISO-abbreviation] Urologe A
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 35
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96. Noel EE, Yeste-Velasco M, Mao X, Perry J, Kudahetti SC, Li NF, Sharp S, Chaplin T, Xue L, McIntyre A, Shan L, Powles T, Oliver RT, Young BD, Shipley J, Berney DM, Joel SP, Lu YJ: The association of CCND1 overexpression and cisplatin resistance in testicular germ cell tumors and other cancers. Am J Pathol; 2010 Jun;176(6):2607-15
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  • [Title] The association of CCND1 overexpression and cisplatin resistance in testicular germ cell tumors and other cancers.
  • Development of chemoresistance limits the clinical efficiency of platinum-based therapy.
  • Although many resistance mechanisms have been demonstrated, genetic/molecular alterations responsible for drug resistance in the majority of clinical cases have not been identified.
  • We analyzed three pairs of testicular germ cell tumor cell lines using Affymetrix expression microarrays and revealed a limited number of differentially expressed genes across the cell lines when comparing the parental and resistant cells.
  • Analysis of testicular germ cell tumor clinical samples by quantitative reverse transcription PCR analysis revealed that overall expression of CCND1 was significantly higher in resistant cases compared with sensitive samples (P < 0.0001).
  • Finally combined CCND1 knockdown using small-interfering RNA and cisplatin treatment inhibited cell growth in vitro significantly more effectively than any of these single treatments.
  • Therefore, deregulation of CCND1 may be a major cause of cisplatin resistance in testicular germ cell tumors and may also be implicated in ovarian and prostate cancers.
  • CCND1 could be potentially used as a marker for treatment stratification and as a molecular target to improve the treatment of platinum-resistant tumors.

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  • (PMID = 20395447.001).
  • [ISSN] 1525-2191
  • [Journal-full-title] The American journal of pathology
  • [ISO-abbreviation] Am. J. Pathol.
  • [Language] ENG
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / RNA, Small Interfering; 136601-57-5 / Cyclin D1; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2877824
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97. Murphy AM, McKiernan JM: Reoperative retroperitoneal lymph-node dissection for testicular germ cell tumor. World J Urol; 2009 Aug;27(4):501-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Reoperative retroperitoneal lymph-node dissection for testicular germ cell tumor.
  • METHODS: A PubMED and Medline search was performed to identify reoperative retroperitoneal surgery series for patients with nonseminomatous germ cell tumor.
  • RESULTS: A reliance on cisplatin-based chemotherapy to treat residual disease after RPLND is inadequate for most patients.
  • Clinical outcomes after reoperative RPLND are influenced by serum tumor markers, histologic findings and completeness of surgical resection.
  • [MeSH-major] Lymph Node Excision / methods. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Humans. Male. Neoplasm Metastasis / prevention & control. Reoperation / methods. Retroperitoneal Neoplasms / secondary. Retroperitoneal Neoplasms / surgery

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  • (PMID = 19636565.001).
  • [ISSN] 1433-8726
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 30
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98. Mannuel HD, Hussain A: Update on testicular germ cell tumors. Curr Opin Oncol; 2009 May;21(3):254-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Update on testicular germ cell tumors.
  • PURPOSE OF REVIEW: This overview discusses several important developments in testicular germ cell tumors in the past year.
  • RECENT FINDINGS: Genomic studies are examining gene expression as possible markers for disease relapse and chemotherapy resistance.
  • Retroperitoneal lymph node dissection remains a prominent treatment modality, although the sequencing and extent of surgical intervention is controversial.
  • Platinum-based chemotherapy remains the gold standard for treatment of systemic disease.
  • Poor risk, platinum-refractory and late relapse disease states continue to be challenging entities in terms of optimizing therapy and outcome.
  • SUMMARY: Significant challenges remain for treatment of certain categories of testicular germ cell tumors.
  • Treatment and surveillance paradigms continue to be defined and refined as research in these areas continues.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal. Testicular Neoplasms
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm. Humans. Male. Recurrence. Risk Factors

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  • (PMID = 19363342.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 23
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99. Llarena Ibarguren R, Azurmendi Arín I, García-Olaverri Rodríguez J, Olano Grasa I, Canton Aller E, Pertusa Peña C: [Neurological metastases secondary to germ cell testicular tumor]. Arch Esp Urol; 2008 Oct;61(8):939-43
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  • [Title] [Neurological metastases secondary to germ cell testicular tumor].
  • [Transliterated title] Metástasis neurológicas secundarias a tumor testicular germinal.
  • OBJECTIVE: Neurological metastases secondary to urological tumors account for 12% overall.
  • The ones derived from germ cells testicular tumors are exceptional in the age of cisplatin.
  • METHODS: We report one case of mixed germ cell tumor in a 49-year-old male patient treated with systemic chemotherapy during 18 months before presenting with severe central and peripheral neurological symptoms leading to death due to massive cerebral hemorrhage.
  • RESULTS: We describe three types of presentation of cerebral metastases in patients with testicular cancer.
  • Type I present synchronically with the primary tumor.
  • Type 2 are diagnosed after a period of remission after conventional cytostatic treatment.
  • Type 3 metastases are diagnosed during the course of the disease and its treatment.
  • CONCLUSIONS: Except unique metastases classified in groups 1 and 2, which are susceptible of surgery or radiosurgery, in which in response may be expected; the rest of lesions secondary to germ cell tumors have an ominous prognosis and outcomes, with short survivals.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / secondary. Nervous System Neoplasms / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Fatal Outcome. Humans. Male. Middle Aged

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  • (PMID = 19040166.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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100. Forquer JA, Harkenrider M, Fakiris AJ, Timmerman RD, Cavaliere R, Henderson MA, Lo SS: Brain metastasis from non-seminomatous germ cell tumor of the testis. Expert Rev Anticancer Ther; 2007 Nov;7(11):1567-80
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  • [Title] Brain metastasis from non-seminomatous germ cell tumor of the testis.
  • Brain metastasis occurs rarely in patients with testicular cancer in the modern era where cisplatin-based chemotherapy regimens are used.
  • The vast majority of testicular cancer cases with brain metastasis reported in the literature involve nonseminomatous germ cell tumor and this subtype will be the focus of this review.
  • This article reviews the literature of the diagnosis and management of brain metastasis from nonseminomatous germ cell tumor of the testis.
  • [MeSH-major] Brain Neoplasms / secondary. Germinoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Humans. Male

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  • (PMID = 18020925.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 59
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