Abstract 792P
Background
Two recent reports detail conflicting data regarding the outcomes of patients with metastatic NSGCT (mNSGCT) and teratoma in the primary. We therefore assessed this association in an independent hospital registry.
Methods
Clinical-pathological data of mNSGCT patients whose primary tumors were available for histologic review and who underwent cisplatin based chemotherapy between 1992-2014 were retrospectively collected from the IRB approved Dana Farber Cancer Institute (DFCI) GCT database. We stratified NSGCT patients by the presence or absence of teratoma in the primary tumor (T+ vs T-). Demographic, clinical and pathological characteristics were analyzed using X2 test for categorical variables and T test for continuous variables. Kaplan-Meier methods estimated survival.
Results
A total of 405 patients were included with a median follow-up of 8 years. 188 (46%) patients had teratoma in the primary tumor. Median ages were 28 (range, 14-67) and 30 years (range, 14-59) in T+ in T- groups respectively. The T+ group was more likely to have a testicular primary (98% vs 87%, p=0.001). There were no major differences in IGCCCG risk between the two groups, good: 118 (63%) versus 137 (63%); intermediate: 33 (18%) versus 35 (16%); poor: 35 (19%) versus 40 (18%), p=0.79. There was no significant difference in 10-year survival between T+ and T- patients 83% (95%CI: 77% - 89%) vs. 85% (95% CI: 80% - 91%). First line chemotherapy consisted of bleomycin, etoposide and cisplatin (BEP) in 84% and 85% of each group. The T+ group had more post-chemotherapy retroperitoneal lymph node dissections and other local resections n=126, 67% (95% CI: 59% - 74%) compared to the T- group n=94, 43% (95% CI: 37%-50%). Beyond 10 years, 8 patients with T+ died, 2 of progressive teratoma, 3 somatic transformation and 3 unknowns compared with 2 patients with T- who died for non-teratoma GCT.
Conclusions
The presence of teratoma in the primary tumor was not an adverse prognostic factor in a series of 405 patients with mNSGCT with a median follow-up of 8 years treated in the modern era with predominantly BEP. Longer follow-up beyond 10 years is needed to see if there is an increased incidence of teratoma related deaths in patients with T+.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.