3585 - Prognosis of anaemia in disseminated testicular germ cell tumours. On behalf of the Spanish Germ Cell Cancer Group (SGCCG)

Background

Despite improvements in diagnosis and aggressive chemotherapy treatment, a proportion of young patients are still dying from germ cell cancer (GCC). We aim to identify additional prognostic factors that help to select patients that might benefit from new treatment strategies. Anaemia is prognostic in several tumours. Thus, our objective was to address the prognostic significance of anaemia in disseminated testicular GCC.

Methods

A multicentre, observational, retrospective study of patients with disseminated testicular GCC receiving first-line platinum-containing chemotherapy between 2000-2014, pooled from the Spanish Germ-Cell Cancer Group registry and another 3 tertiary hospitals. All patients with haemoglobin level available at diagnosis were selected for the analysis. We used the Cox-proportional hazard model to identify prognostic factors.

Results

665 consecutive patients from 18 centres were included for analysis. The patient distribution according to the International Germ Cell Cancer Collaboration Group (IGCCCG) classification was: 427, 125 and 113 patients for good, intermediate and poor risk categories, respectively. Hb < 10 g/dL (anaemia) was observed in 22 (3%) patients and was associated with worse PFS (p < 0.001) and OS (p < 0.001). Anaemia was more frequently observed in the poor prognostic group (good risk: 1.4%, intermediate risk: 2.6% and poor risk: 13.1%, p < 0.001), and in the multivariate analysis we observed an interaction between anaemia and the IGCCCG classification. We then analysed the prognostic significance of anaemia in each risk group. Anaemia remained as an independent prognostic factor in the poor risk group both for PFS (HR = 2.18, 95%CI: 1.02-4.64; p = 0.04) and for OS (HR = 3.29, 95%CI: 1.42-7.65; p = 0.006). No effect was observed in the good and intermediate risk group, although statistical power was limited in these subgroups due to the low number of patients with anaemia and events.

Conclusions

In our series, Hb < 10 g/dL at diagnosis was an independent prognostic factor in poor risk disseminated testicular GCC. Future collaborative studies in order to validate these finding in an independent cohort are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Spanish Germ Cell Cancer Group (SGCCG).

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.