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Mini Oral session 1: GU tumours, non-prostate

512MO - Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: An analysis of the IGCCCG Update database


11 Sep 2022


Mini Oral session 1: GU tumours, non-prostate


Tumour Site

Malignant Germ-Cell Tumours of the Adult Male


Silke Gillessen


Annals of Oncology (2022) 33 (suppl_7): S233-S234. 10.1016/annonc/annonc1053


S. Gillessen1, J. Lauritsen2, N. Sauvé3, A. Tryakin4, D.M. Jiang5, R.A. Huddart6, D.Y.C. Heng7, A. Terbuch8, E. Winquist9, M. Chovanec10, M. Hentrich11, C.D. Fankhauser12, J. Shamash13, X. Garcia Del Muro14, D.J. Vaughn15, A. Heidenreich16, A. Jandari17, L. Collette18, J. Beyer19, K.G. Daugaard2

Author affiliations

  • 1 Department Of Medical Oncology, Università della Svizzera Italiana (USI) and Oncology Institute of Southern Switzerland (IOSI), 6501 - Bellinzona/CH
  • 2 Dept. Of Oncology, Rigshospitalet, 2100 - Copenhagen/DK
  • 3 Statistics Department, EORTC AISBL/IVZW - European Organisation for Research and Treatment of Cancer, 1200 - Brussels/BE
  • 4 Clinical Pharmacology And Chemotherapy Department, National Medical Research Center of Oncology named after N.N. Blokhin, 115478 - Moscow/RU
  • 5 Medical Oncology Dept., University Health Network - Princess Margaret Cancer Center, M5G 2M9 - Toronto/CA
  • 6 -, Institute of Cancer Research and Royal Marsden Hospital, Surrey SM2 5PT - Surrey/GB
  • 7 Oncology, Tom Baker Cancer Centre - University of Calgary, T2N 4N2 - Calgary/CA
  • 8 Internal Medicine Department, Oncology Division, LKH-Universitaetsklinikum Graz - Universitaetsklinik für Innere Medizin (UKIM), 8036 - Graz/AT
  • 9 Department Of Oncology, London Regional Cancer Program (LRCP) - London Health Science Center (LHSC), N6A 4L6 - London/CA
  • 10 Department Of Oncology, National Cancer Institute (Národny Onkologicky Ustav), 833 10 - Bratislava/SK
  • 11 Department Of Hematology/oncology, Rotkreuzklinikum München, 80634 - Munich/DE
  • 12 Urology Dept, Luzerner Kantonsspital, 6210 - Sursee/CH
  • 13 Dep, St. Bartholomew's Hospital - Barts Health NHS Trust, EC1A 7BE - London/GB
  • 14 Medical Oncology Dept., ICO - Institut Català d'Oncologia l'Hospitalet (Hospital Duran i Reynals), 08908 - L'Hospitalet de Llobregat/ES
  • 15 Division Of Hematology/oncology, Abramson Cancer Center - University of Pennsylvania, 19104 - Philadelphia/US
  • 16 Department Of Urology, Uro-oncology, Universitätsklinikum Köln (AöR), 50937 - Köln/DE
  • 17 Statistics, EORTC AISBL/IVZW - European Organisation for Research and Treatment of Cancer, 1200 - Brussels/BE
  • 18 Statistics Consulting Services And Research, International Drug Development Institute, 1340 - Louvain-la-Neuve/BE
  • 19 Department Of Medical Oncology, University Hospital Inselspital Bern, 3010 - Bern/CH


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Abstract 512MO


Between 60-70% of patients with germ-cell tumors (GCT) present with clinical stage I (CSI) disease. Active surveillance after orchiectomy is the preferred management but is associated with a 15 to 30% relapse rate. We compared the outcomes of patients relapsing from CSI to the ones of similar patients presenting with de novo metastatic disease.


We identified in the IGCCCG Updated database all patients with gonadal disseminated GCT who had complete information on initial tumor stage whether CSI or de novo metastatic. Patients relapsing from initial CSI were compared to patients with de novo metastatic GCT. Progression-free survival and overall survival at 5 years (5y-PFS and 5y-OS) were estimatedby the Kaplan-Meier method and compared with the hazard ratio (HR).


A total of 1014 seminoma (S) [298 (29.4%) relapsing from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NS) [626 (20.2%) relapsing from CSI, 2477 (79.8%) de novo] patients were identified. No statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease for S patients (5y-PFS 87.6% versus 88.5% and 5y-OS 93.2% versus 96.1%). For NS patients there was no difference in outcome between relapsing and de novo patients within the same IGCCCG group (HR=0.89; 95% CI: 0.70-1.12). IGCCCG group was more favorable in NS patients relapsing from CSI: (good risk: 82.1% vs 51.4%) and equal in S patients (good risk: 96.3% vs 96.4%). Nevertheless 112/626 (18%) NS and 11/298 (4%) S CSI patients relapsed with intermediate or poor IGCCCG group.


We found no differences in PFS or OS at 5 years in patients relapsing from initial CSI as compared to de novo metastatic patients within the same IGCCCG prognostic group. However, a substantial proportion of CSI patients relapsed with intermediate or poor prognostic features with a need of intensified treatment. The study underlines the importance of improving active surveillance techniques and schedules to detect recurrence as early as possible in CSI patients and to avoid unnecessary toxicity.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The International Germ Cell Cancer Collaborative Group (IGCCCG).




All authors have declared no conflicts of interest.

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