| Sumario: | Simple Summary: Germ cell tumors are uncommon malignancies that mainly occur in adolescents and young men. The primary tumor may arise in the testis or at extragonadal sites, most commonly in the mediastinum or retroperitoneum. Because of their marked sensitivity to platinum-based chemotherapy, most patients can be cured. Nevertheless, a minority experience disease recurrence after initial treatment and require further systemic therapy. This retrospective, single-center study explored potential predictors of first-line progression-free survival. The analysis indicated that disease extent, baseline serum tumor marker levels, treatment delivery, and early biochemical changes after the first chemotherapy cycle may influence clinical outcomes and help identify patients at greater risk of progression. Background: Testicular germ cell tumors are usually highly responsive to platinum-based treatment. However, outcomes remain heterogeneous. This exploratory retrospective study assessed factors associated with first-line progression-free survival and with the need for second-line systemic therapy. Methods: We reviewed 41 patients treated for testicular germ cell tumors at a single oncology center. Clinical, pathological, metastatic, treatment-related, and biochemical variables were extracted from medical records. First-line progression-free survival was evaluated using exploratory univariable Cox regression. Variables associated with second-line treatment were assessed using exploratory univariable analyses. Results: The median age was 37 years and most of the patients had non-seminomatous histology. A greater mean decline of initially elevated serum markers after the first chemotherapy cycle was associated with longer first-line progression-free survival in both the overall cohort and the non-seminomatous subgroup. The need for second-line systemic treatment was associated with stage III disease, metastasis at diagnosis, and elevated baseline serum tumor markers. Conclusions: In this cohort, baseline disease burden and marker elevation were the clearest adverse clinical signals. Moreover, early marker decline may add information about treatment sensitivity and tailor follow-up.
|
|---|