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Germ cell tumors
About: Germ cell tumors is a research topic. Over the lifetime, 5551 publications have been published within this topic receiving 143124 citations.
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TL;DR: An easily applicable, clinically based, prognostic classification for GCT has been agreed on between all the major clinical trial groups who are presently active worldwide and should be used in clinical practice and in the design and reporting of clinical trials to aid international collaboration and understanding.
Abstract: Purpose: Cisplatin-containing chemotherapy has dramatically improved the outlook for patients with metastatic germ cell tumors (GCT), and overall cure rates now exceed 80%. To make appropriate risk-based decisions about therapy and to facilitate collaborative trials, a simple prognostic factor-based staging classification is required. Materials: Collaborative groups from 10 countries provided clinical data on patients with metastatic GCT treated with cisplatin-containing chemotherapy. Multivariate analyses of prognostic factors for progression and survival were performed and models were validated on on independent data set. Results: Data were available on 5,202 patients with nonseminomatous GCT (NSGCT) and 660 patients with seminoma. Median follow-up time was 5 years, For NSGCT the following independent adverse factors were identified: mediastinal primary site; degree of elevation of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactic dehydrogenase (LDH); and presence of nonpulmonary visceral metastases (NPVM), such as liver, bone, and brain. For seminoma, the predominant adverse feature was the presence of NPVM. integration of these factors produced the following groupings: good prognosis, comprising 60% of GCT with a 91% (89% to 93%) 5-year survival rate; intermediate prognosis, comprising 26% of GCT with a 79% (75% to 83%) 5-year survival rate; and poor prognosis, comprising 14% of GCT (all with NSGCT) with a 48% (42% to 54%) 5-year survival rate. Conclusion: An easily applicable, clinically based, prognostic classification for GCT has been agreed on between all the major clinical trial groups who are presently active worldwide. This should be used in clinical practice and in the design and reporting of clinical trials to aid international collaboration and understanding. (C) 1997 by American Society of Clinical Oncology.
1,209 citations
TL;DR: It is concluded that etoposide with cisplatin and bleomycin is superior to vinblastine with cisPlatin and Bleomycin in the treatment of disseminated germ-cell tumors because of diminished neuromuscular toxicity and, among patients with advanced disease, better efficacy.
Abstract: Standard chemotherapy for disseminated germ-cell tumors includes a combination of cisplatin, vinblastine, and bleomycin, but this regimen produces substantial neuromuscular toxicity. In a randomized clinical trial in 261 men with disseminated germ-cell tumors, we substituted etoposide for the vinblastine in this regimen in half the patients to compare the efficacy and toxicity of the two treatments. Among 244 patients who could be evaluated for a response, 74 percent of those receiving the regimen including vinblastine and 83 percent of those receiving the regimen including etoposide became disease-free with or without subsequent surgery (P not significant). Among the 157 patients with high tumor volume, 61 percent became disease-free on the regimen that included vinblastine, as compared with 77 percent on the regimen that included etoposide (P less than 0.05). Survival among the patients who received etoposide was higher (P = 0.048). The regimens were similar in terms of myelosuppressive effects and pulmonary toxicity. However, the etoposide regimen caused substantially fewer paresthesias (P = 0.02), abdominal cramps (P = 0.0008), and myalgias (P = 0.00002). We conclude that etoposide with cisplatin and bleomycin is superior to vinblastine with cisplatin and bleomycin in the treatment of disseminated germ-cell tumors because of diminished neuromuscular toxicity and, among patients with advanced disease, better efficacy.
1,101 citations
TL;DR: It now appears that type I and type II ovarian tumors develop independently along different molecular pathways and that both types develop outside the ovary and involve it secondarily, leading to the conclusion that the only true primary ovarian neoplasms are gonadal stromal and germ cell tumors analogous to testicular tumors.
983 citations
TL;DR: The incidence of brain metastases is increasing with the availability of improved imaging techniques which aid early diagnosis, and effective systemic treatment regimens which prolong life, thus allowing cancer to disseminate to the brain.
Abstract: Brain metastases are one of the most common neurologic complications of cancer. The incidence is 9%–17% based on various studies, although the exact incidence is thought to be higher. The incidence is increasing with the availability of improved imaging techniques which aid early diagnosis, and effective systemic treatment regimens which prolong life, thus allowing cancer to disseminate to the brain. Lung cancer, breast cancer, and melanoma are the most frequent to develop brain metastases, and account for 67%–80% of all cancers. Most patients with brain metastases have synchronous extracerebral metastases. Some patients present with no known primary cancer diagnosis. In children, brain metastases are rare; germ cell tumors, sarcomas, and neuroblastoma are the common offenders.
894 citations
Book•
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01 Jan 1999
TL;DR: 17. Wilms' Tumor and Other Childhood Renal Neoplasms N.Y. Wilson, C.M. Garner, et al.
Abstract: 17. Ovarian Cancer A.P. Wilson, C.M. Garner. 18. Cervical Cancer S.Y. Sharp, L.R. Kelland. 19. Endometrial Cancer P.G. Satyaswaroop. 20. Breast Cancer R.L. Sutherland, et al. 21. Paired Breast Cancer Cell Lines I.I. Wistuba, et al. 22. Ovarian Germ Cell Tumors M. Sawada, T. Miki. 23. Testicular Germ Cell Tumors M.F. Pera. 24. Choriocarcinoma V. Ganapathy, et al. 25. Thymomas and Thymic Cancers H.K. Muller-Hermelink, A. Marx. 26. Kaposi's Sarcoma C. Boshoff. 27. Brain Tumors F. Ali-Osman. 28. Head and Neck Cancers C.D. Lansford, et al. 29. Gastric Cancer T. Suzuki, M. Sekiguchi. 30. Colorectal Cancer M.G. Brattain, et al. 31. Prostate Cancer J.M. Kozlowski, J.A. Sensibar. 32. Liver Cancer M. Namba, et al. 33. Wilms' Tumor and Other Childhood Renal Neoplasms N.A. Brownlee, et al. 34. Retinoblastoma B.L. Gallie, et al.
842 citations