Epidemiology of male seminomatous and nonseminomatous germ cell tumors and response to first‑line chemotherapy from a tertiary cancer center in India.
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Date
2016-04
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Abstract
INTRODUCTION: Unlike the developed countries, there is a lack of good epidemiologic data for testicular germ cell tumors (GCTs) in India with
majority presenting in advanced stage. This study aims to elaborate on the epidemiology of testicular GCTs and response to standard first‑line
chemotherapy (CT). METHODS: GCTs treated at our center from January 2013 to June 2014 were retrospectively analyzed. Patients underwent
orchidectomy either outside or at our hospital. Based on stage and risk group, standard CT (bleomycin, etoposide, and cisplatin/etoposide and
cisplatin/carboplatin AUC7) and radiotherapy were given as appropriate. Response was calculated based on the Response Evaluation Criteria
in Solid Tumors. Statistical analysis was performed using SPSS 18 software. RESULTS: Fifty nonseminomatous germ cell tumor (NSGCT) and
36 of SGCT cases were studied. 30%, 46%, and 64% of NSGCT and 11%, 28%, and 22% of SGCT had N2, N3, and M1 diseases, respectively.
The mean nodal size was 7 cm (1.5–19) in NSGCT and 5.5 cm (1.3–11) in SGCT. As per the International Germ Cell Cancer Collaborative Group
classification, in patients with metastatic disease, 9% of NSGCT were good, 53% were intermediate, and 38% were poor risk whereas 75% of
SGCT were good and 25% were intermediate risk. Following CT among NSGCT, 5% and 71% had radiologic complete response (CR) and partial
response (PR), respectively. Among SGCT, 46% and 38% had radiologic CR and PR, respectively. 22%, 53%, and 13% of NSGCT and 12%,
24%, and 20% of SGCT developed febrile neutropenia, Grade 3 or 4 hematological and nonhematological toxicities, respectively, after standard
chemotherapy. CONCLUSIONS: GCTs in India present with high nodal and high‑risk diseases wherein the standard first‑line CT may not be adequate
as curative therapy; however, significant chemotoxicity is also a hindrance.
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Keywords
Chemotherapy outcomes, epidemiology in India, germ cell tumor
Citation
Joshi A, Zanwar S, Shetty N, Patil V, Noronha V, Bakshi G, Prakash G, Menon S, Prabhash K. Epidemiology of male seminomatous and nonseminomatous germ cell tumors and response to first‑line chemotherapy from a tertiary cancer center in India. Indian Journal of Cancer. 2016 Apr-June; 53(2): 313-316.