Japanese Journal of Clinical Oncology Advance Access originally published online on March 4, 2008
Japanese Journal of Clinical Oncology 2008 38(4):281-287; doi:10.1093/jjco/hyn009
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© The Author (2008). Published by Oxford University Press. All rights reserved
Survival of Metastatic Germ Cell Cancer Patients Assessed by International Germ Cell Consensus Classification in Japan
1 Department of Urology, Tohoku University Graduate School of Medicine, Sendai
2 Urology Division, National Cancer Center Hospital, Tokyo
3 Department of Urology, Kyoto University Graduate School of Medicine, Kyoto
4 Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba
5 Department of Urology, Sapporo Medical University School of Medicine, Sapporo
6 Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka
7 Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
For reprints and all correspondence: Yoichi Arai, Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. E-mail: yarai{at}uro.med.tohoku.ac.jp
Received December 2, 2007; accepted January 29, 2008
Background: As a risk classification system of metastatic germ cell tumors, the International Germ Cell Consensus (IGCC) classification was proposed in 1997 and has received broad approval. Since the IGCC classification was based on patients treated between 1975 and 1990, we aimed to investigate whether survival has improved for more recently treated Japanese patients.
Methods: We analyzed 296 patients with metastatic germ cell tumors treated at seven hospitals in Japan between 1990 and 2001. These cases are classified as good, intermediate or poor prognosis groups by the IGCC classification. The 5-year progression-free and the 5-year overall survivals were calculated for each prognosis group.
Results: The median follow-up period of all patients was 53 months. In 227 non-seminomatous germ cell tumor cases, the 5-year progression-free survival (95% confidence interval) for good (n = 55), intermediate (n = 106) and poor (n = 66) prognosis was 96% (91–100), 71% (62–80) and 52% (39–65) (P < 0.001), respectively. The 5-year overall survival was 94% (88–100), 81% (73–89) and 61% (49–73) (P < 0.001), respectively. In 69 seminoma cases, the 5-year progression-free survival for good (n = 64) and intermediate (n = 5) prognosis was 78% (67–89) and 80% (45–100) (P = 0.98), respectively. The 5-year overall survival was 90% (82–99) and 80% (45–100) (P = 0.49), respectively.
Conclusions: There was a trend of increase in survival for any risk groups and, in particular, large increase in survival for patients with a poor prognosis. This increase is most likely attributed to more effective chemotherapy regimens and more extensive care in the experienced institutes.
Key Words: chemotherapy • etoposide • IGCC classification • prognosis • germ cell tumor