156396-172

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

Category: 
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: 

472

Poster Board Number: 
Poster Session B Board #B6
Citation: 
J Clin Oncol 34, 2016 (suppl 2S; abstr 472)
Author(s): 
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

Abstract: 

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.