Germ cell tumours of the testis: clinical features, treatment outcome and prognostic factors.

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dc.contributor.authorBhutani, Manishaen_US
dc.contributor.authorKumar, Laliten_US
dc.contributor.authorSeth, Amleshen_US
dc.contributor.authorThulkar, Sen_US
dc.contributor.authorVijayaraghavan, Men_US
dc.contributor.authorKochupillai, Ven_US
dc.date.accessioned2002-01-22en_US
dc.date.accessioned2009-06-03T06:51:14Z
dc.date.available2002-01-22en_US
dc.date.available2009-06-03T06:51:14Z
dc.date.issued2002-01-22en_US
dc.description.abstractBACKGROUND: The prognosis of patients with germ cell tumours of the testis has Improved over the past two decades following cisplatinum-based chemotherapy. Currently, staging and risk assessment of the disease is crucial in order to provide curative therapy for patients with poor risk features and not over-treat good risk patients. METHODS: We reviewed the case records of 71 men diagnosed to have germ cell tumours between January 1993 and October 1999. Their clinical characteristics, staging, treatment outcome and prognostic factors for response and survival were analysed. RESULTS: The median age of the patients was 30 years (range: 3-65 years); 69% were in the third and fourth decades. Sixty-one patients (86%) had a primary testicular tumour while in 10 (14%) the tumour was extragonadal. Histopathologically, 53 patients (75%) had non-seminomatous germ cell tumours and 15 (21%) had a seminoma. Twenty-seven patients (62%) had evidence of metastatic disease at the time of diagnosis. On prognostication, non-seminomatous germ cell tumour patients could be divded into good, intemediate and poor prognostic groups comprising 41%, 17% and 40% of patients, respectively. All patients with a seminoma were in the good prognostic subgroup. Fifty-eight patients were evaluable for response. Overall, 91% of patients responded: complete response 71% and partial response 20%. Complete response rates were signiflcantly higher for the good risk (95%) compared to the intermediate (49%) and poor risk (47%) categories (p< 0.003). At a median follow up of 26 months, the 2-year overall and progression-free survival for all patients was 70% and 57%, respectively. The predictors for decreased overall and progression-free survival were age >35 years, presence of poor risk features and mediastinal primary disease. CONCLUSION: The outcome for germ cell tumours in men with good risk is excellent. A protocol consisting of bleomycin, etoposide and cisplatin is effective. Tailoring of chemotherapy In good risk patients to minimize toxicity and Improving results in poor risk patients are areas that need further work.en_US
dc.description.affiliationAll India Institute of Medical Sciences, New Delhi.en_US
dc.identifier.citationBhutani M, Kumar L, Seth A, Thulkar S, Vijayaraghavan M, Kochupillai V. Germ cell tumours of the testis: clinical features, treatment outcome and prognostic factors. National Medical Journal of India. 2002 Jan-Feb; 15(1): 18-21en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/119321
dc.language.isoengen_US
dc.source.urihttps://www.nmji.inen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshGerminoma --diagnosisen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrognosisen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTesticular Neoplasms --diagnosisen_US
dc.titleGerm cell tumours of the testis: clinical features, treatment outcome and prognostic factors.en_US
dc.typeJournal Articleen_US
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