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Conditional survival of patients with metastatic testicular germ-cell tumors (MT-GCT) treated with first-line curative therapy.
Poster Session B: Prostate Cancer; Urothelial Carcinoma; Penile, Urethral, and Testicular Cancers
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.
Abstracts by Jenny J. Ko:
Immediate-term Chemotherapy-Related Cognitive Impairment (CRCI) Following Administration of Intravenous (IV) Chemotherapy.Meeting: 2017 Cancer Survivorship Symposium | Abstract No: 146
Impact of modern treatment strategies on second cancer incidence for patients with early stage seminoma: A population-based study in British Columbia.Meeting: 2017 Genitourinary Cancers Symposium | Abstract No: 423
Presentations by Jenny J. Ko:
Conditional survival of patients with metastatic testicular germ-cell tumors (MT-GCT) treated with first-line curative therapy.Meeting: 2016 Genitourinary Cancers Symposium Abstract No: 472Session: Oral Abstract Session B: Urothelial Carcinoma; Penile, Urethral, and Testicular Cancers (Oral Abstract Session)