Year: 2025
Type: article
Study design: Observational Study
Abstract: Background/Objectives: Metastatic testicular germ cell tumor (mGCT) is a highly curable disease with first-line cisplatin-based combination chemotherapy. This study aims to evaluate the clinicopathological characteristics and survival outcomes of patients with metastatic testicular cancer in a nationwide multicenter cohort. Methods: This multicenter retrospective cohort study included 316 male patients diagnosed with mGCT who were treated with first-line cisplatin-based chemotherapy across 10 institutions in Turkey between 2011 and 2024. Clinical and pathological data, including International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification, treatment details, and survival outcomes, were analyzed. Results: The median age of the cohort was 28 years, and 76.3% of patients were diagnosed with non-seminoma. According to IGCCCG risk stratification, 53.2% had good-risk, 25.3% intermediate-risk, and 21.5% poor-risk disease. Median follow-up was 38.4 months. Among patients with seminoma, the 5-year overall survival (OS) rate was 100% in the good-risk group and 87.5% in the intermediate-risk group. In patients with non-seminoma, 5-year OS rates were 96.6%, 86.9%, and 65.1% in the good-, intermediate-, and poor-risk groups, respectively. Among 125 patients who received salvage treatment, high-dose chemotherapy (HDCT) significantly improved survival in the International Prognostic Factors Study Group (IPFSG) very high-risk group (3-year OS: 55.0% vs. 16.3% with conventional-dose chemotherapy (CDCT), p = 0.007). Conclusions: This study provides the first large-scale nationwide dataset on mGCT outcomes in Turkey, demonstrating overall survival rates comparable to international cohorts. The findings emphasize the importance of a multidisciplinary approach, adherence to treatment guidelines, and optimal surgical interventions in improving patient outcomes.
Source: Medicina
Authors: Gul Sema Yildiran Keskin, Ozge Yetginoglu, Sertac Vurgun, Evrican Zin Guzel, Fariz Emrah Ozkan, Mesut Yilmaz, Cem Murat Soylemez, Yesim Agyol, Sinem Akbas, Muhammed Fatih Sagiroglu, Gizem Yildirim, Huseyin Salih Semiz, Ali Murat Tatli, Ferhat Ekinci, Ramazan Cosar, Ramazan Acar, Musa Baris Aykan, Ismail Erturk, Nuri Karadurmus
Institutions: Gülhane Eğitim ve Araştırma Hastanesi, Dokuz Eylül University, Akdeniz University, Manisa Celal Bayar University, Afyonkarahisar Sağlık Bilimleri Üniversitesi, Sakarya Eğitim ve Araştırma Hastanesi, İzmir Şehir Hastanesi, Marmara University, Koç University, Gaziantep Şehir Hastanesi, Ufuk University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,654
OpenAlex ID: W4410598303