Conditional survival of patients with metastatic testicular germ-cell tumors (MT-GCT) treated with first-line curative therapy.

Genitourinary Cancer
Session Type and Session Title: 
Oral Abstract Session B: Urothelial Carcinoma; Penile, Urethral, and Testicular Cancers
Poster Session B: Prostate Cancer; Urothelial Carcinoma; Penile, Urethral, and Testicular Cancers
Abstract Number: 


Poster Board Number: 
Poster Session B Board #B6
J Clin Oncol 34, 2016 (suppl 2S; abstr 472)
Jenny J. Ko, Brandon David Bernard, Ben Tran, Haocheng Li, Tehmina Asif, Igor Stukalin, Margaret Lee, Daphne Day, Nimira S. Alimohamed, Christopher Sweeney, Philippe L. Bedard, Daniel Yick Chin Heng; BC Cancer Agency, Abbotsford Centre, Abbotsford, BC, Canada; Dana-Farber Cancer Institute, Boston, MA; Epworth Freemasons Hospital, East Melbourne, Australia; Departments of Oncology and Community Health Sciences, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, AB, Canada; Saskatoon Cancer Centre, Saskatoon, SK, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Royal Melbourne Hospital, Melbourne, Australia; Royal Melbourne Hospital, Surrey Hills, Australia; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada

Abstract Disclosures


Background: The IGCCCG risk stratification prognosticates survival outcomes in metastatic testicular germ cell tumour (MT-GCT), but how the initial risk changes over time for those who survived since curative treatment (conditional survival) is unknown. We evaluated conditional survival in patients with MT-GCT who were eligible for first-line therapy. Methods: We included patients who were eligible for first-line therapy for MT- GCT at 5 tertiary cancer centres from 1990 to 2012. We assessed 2-year (Y) conditional overall (COS) and disease-free survival (CDFS) at a given timepoint, defined as the probability of surviving, or surviving and disease-free, respectively, for an additional 2Y at a given timepoint since the start of first-line treatment. Outcomes were stratified by IGCCCG risk criteria, pathology and age. Results: For all patients (n = 942, favourable 63%/intermediate 19%/poor 16%), median follow-up was 99 months (m) (IQR 56-141); 2YCOS increased from 92% (95% CI 91%–94%) at baseline to 98% (95% CI 97%–99%) at 24m, and 2Y CDFS increased from 83% (95% CI: 81%-86%) at baseline to 98% (95% CI 97%-99%) at 24m after diagnosis. 2YCOS changed little in the IGCCCG favourable and intermediate groups, but in the poor-risk group, improved from 71% (95% CI 64%–78%) at 0m to 93% (95% CI 89%-98%) at 24m. 2Y CDFS for favourable risk group improved significantly at 12m (91% baseline vs. 95% at 18m); intermediate, at 12m (84% baseline vs. 95% at 12m); poor, at 12 m (55% baseline vs. 85% at 12m). Baseline IGCCCG risk stratification was not associated with long-term COS or CDFS for patients who survived to > 2Y post therapy. No significant differences in COS and CDFS were noted between seminoma and non-seminoma, while older patients ( > = 40) had inferior 2Y COS from 0-18m but no differences were noted after 18m. Conclusions: Our data suggest that the concept of conditional survival applies to patients with MT-GCT treated with curative therapy. A poor-risk patient, after 2Y of survival, had the same probability of relapse and survival as a favourable/intermediate risk patient.