Update on late relapse of germ cell tumor

A clinical and molecular analysis

David W. George, Richard S. Foster, Robert A Hromas, Kent A. Robertson, Gail H. Vance, Thomas M. Ulbright, Troy A. Gobbett, Devan J. Heiber, Nyla A. Heerema, Heather C. Ramsey, Virginia C. Thurston, Sin Ho Jung, Jianzhao Shen, David E. Finch, Mark R. Kelley, Lawrence H. Einhorn

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

Purpose: Analysis of patients with late relapse (LR) of germ cell tumor (GCT) with reports on clinical characteristics, outcomes, and molecular and cytogenetic features. Patients and Methods: Eighty-three patients evaluated at Indiana University from 1993 through 2000 for relapse of GCT more than 2 years from initial therapy were reviewed. Available specimens were investigated for expression of the transcription regulator FoxD3 and apurinic/apyrimidinic endonuclease and the presence of chromosome 12 abnormalities. Results: Median interval from initial presentation to LR was 85 months. Forty-three of 49 LR patients who underwent surgery were rendered disease free (NED), and 20 (46.5%) remain continuously NED. Thirty-two patients received chemotherapy, but only six (18.8%) obtained a complete remission. Five of these patients remain continuously NED after chemotherapy alone, including three who were chemotherapy naïve. Eighteen of these 32 patients were successfully rendered NED by postchemotherapy surgery, and 12 remain continuously NED. Two patients continue on observation with no treatment for their LR. Overall, 69 of the 81 treated patients (85.2%) ultimately achieved an NED state, and 38 (46.9%) remain continuously NED with median follow-up from LR therapy of 24.5 months (range, 1 to 83 months), whereas nine other patients are currently NED after therapy for subsequent relapses. Because of the small numbers of specimens tested, we were unable to draw any definitive conclusions from the molecular and cytogenetic analyses. Conclusion: GCT patients require lifetime follow-up. At the time of LR, surgical resection alone remains our preferred therapy.

Original languageEnglish (US)
Pages (from-to)113-122
Number of pages10
JournalJournal of Clinical Oncology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

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Germ Cell and Embryonal Neoplasms
Recurrence
Drug Therapy
DNA-(Apurinic or Apyrimidinic Site) Lyase
Therapeutics
Chromosomes, Human, Pair 12
Cytogenetic Analysis
Cytogenetics
Chromosome Aberrations
Observation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

George, D. W., Foster, R. S., Hromas, R. A., Robertson, K. A., Vance, G. H., Ulbright, T. M., ... Einhorn, L. H. (2003). Update on late relapse of germ cell tumor: A clinical and molecular analysis. Journal of Clinical Oncology, 21(1), 113-122. https://doi.org/10.1200/JCO.2003.03.019

Update on late relapse of germ cell tumor : A clinical and molecular analysis. / George, David W.; Foster, Richard S.; Hromas, Robert A; Robertson, Kent A.; Vance, Gail H.; Ulbright, Thomas M.; Gobbett, Troy A.; Heiber, Devan J.; Heerema, Nyla A.; Ramsey, Heather C.; Thurston, Virginia C.; Jung, Sin Ho; Shen, Jianzhao; Finch, David E.; Kelley, Mark R.; Einhorn, Lawrence H.

In: Journal of Clinical Oncology, Vol. 21, No. 1, 01.01.2003, p. 113-122.

Research output: Contribution to journalArticle

George, DW, Foster, RS, Hromas, RA, Robertson, KA, Vance, GH, Ulbright, TM, Gobbett, TA, Heiber, DJ, Heerema, NA, Ramsey, HC, Thurston, VC, Jung, SH, Shen, J, Finch, DE, Kelley, MR & Einhorn, LH 2003, 'Update on late relapse of germ cell tumor: A clinical and molecular analysis', Journal of Clinical Oncology, vol. 21, no. 1, pp. 113-122. https://doi.org/10.1200/JCO.2003.03.019
George, David W. ; Foster, Richard S. ; Hromas, Robert A ; Robertson, Kent A. ; Vance, Gail H. ; Ulbright, Thomas M. ; Gobbett, Troy A. ; Heiber, Devan J. ; Heerema, Nyla A. ; Ramsey, Heather C. ; Thurston, Virginia C. ; Jung, Sin Ho ; Shen, Jianzhao ; Finch, David E. ; Kelley, Mark R. ; Einhorn, Lawrence H. / Update on late relapse of germ cell tumor : A clinical and molecular analysis. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 1. pp. 113-122.
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T2 - A clinical and molecular analysis

AU - George, David W.

AU - Foster, Richard S.

AU - Hromas, Robert A

AU - Robertson, Kent A.

AU - Vance, Gail H.

AU - Ulbright, Thomas M.

AU - Gobbett, Troy A.

AU - Heiber, Devan J.

AU - Heerema, Nyla A.

AU - Ramsey, Heather C.

AU - Thurston, Virginia C.

AU - Jung, Sin Ho

AU - Shen, Jianzhao

AU - Finch, David E.

AU - Kelley, Mark R.

AU - Einhorn, Lawrence H.

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N2 - Purpose: Analysis of patients with late relapse (LR) of germ cell tumor (GCT) with reports on clinical characteristics, outcomes, and molecular and cytogenetic features. Patients and Methods: Eighty-three patients evaluated at Indiana University from 1993 through 2000 for relapse of GCT more than 2 years from initial therapy were reviewed. Available specimens were investigated for expression of the transcription regulator FoxD3 and apurinic/apyrimidinic endonuclease and the presence of chromosome 12 abnormalities. Results: Median interval from initial presentation to LR was 85 months. Forty-three of 49 LR patients who underwent surgery were rendered disease free (NED), and 20 (46.5%) remain continuously NED. Thirty-two patients received chemotherapy, but only six (18.8%) obtained a complete remission. Five of these patients remain continuously NED after chemotherapy alone, including three who were chemotherapy naïve. Eighteen of these 32 patients were successfully rendered NED by postchemotherapy surgery, and 12 remain continuously NED. Two patients continue on observation with no treatment for their LR. Overall, 69 of the 81 treated patients (85.2%) ultimately achieved an NED state, and 38 (46.9%) remain continuously NED with median follow-up from LR therapy of 24.5 months (range, 1 to 83 months), whereas nine other patients are currently NED after therapy for subsequent relapses. Because of the small numbers of specimens tested, we were unable to draw any definitive conclusions from the molecular and cytogenetic analyses. Conclusion: GCT patients require lifetime follow-up. At the time of LR, surgical resection alone remains our preferred therapy.

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