Treatment Option Overview
Good Prognosis
Intermediate Prognosis
Poor Prognosis
Testicular cancer is broadly divided into seminoma and nonseminoma for
treatment planning because seminomatous types of testicular cancer are more
sensitive to radiation therapy. Nonseminomatous testicular tumors include yolk
sac tumors.
An international germ cell tumor prognostic classification has been developed
based on a retrospective analysis of 5,202 patients with metastatic
nonseminomatous and 660 patients with metastatic seminomatous germ cell
tumors.[1] All patients received treatment with cisplatin- or carboplatin-containing therapy as their first chemotherapy course. The prognostic
classification, shown below, was agreed on in 1997 by all major clinical
trial groups worldwide. It should be used for reporting clinical trial
results of patients with germ cell tumors.
A meta-analysis of treatment outcomes for patients with advanced nonseminoma suggested that 5-year survival rates have improved for those patients with a poor prognosis during the period of 1989 to 2004.[2] In addition to improved therapy, the improvement seen in these survival rates could be due to publication bias, changes in patient selection in reported clinical trials, or more sensitive staging methods that could migrate less advanced stages to more advanced stage categories (i.e., stage migration).
Good Prognosis
Nonseminoma:
Seminoma:
Intermediate Prognosis
Nonseminoma:
Seminoma:
Poor Prognosis
Nonseminoma:
Seminoma:
- No patients are classified as poor prognosis.
References
-
International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 15 (2): 594-603, 1997.
[PUBMED Abstract]
-
van Dijk MR, Steyerberg EW, Habbema JD: Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer 42 (7): 820-6, 2006.
[PUBMED Abstract]
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