Related Experiment Video
Updated: Jun 2, 2026
Grade III Varicocele Surgical Treatment using Spermatic Vein-Superficial Abdominal Vein Shunt
Published on: August 23, 2024
Clinical Outcomes of Stage IIIC Poor-Risk Testicular Germ Cell Tumors: A Retrospective Analysis From a Tertiary Care
Maryam Imran1, Shehar Bano1, Afshan Khanum2
1Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Abstract:
Background Testicular germ cell tumors (TGCTs) are the most common malignancy in young men. While highly chemosensitive with excellent cure rates in early stages, outcomes remain suboptimal in advanced disease. This study evaluated clinical outcomes of patients with stage IIIC poor-risk TGCTs, a subgroup with limited survival data. Methods A retrospective review was conducted of 31 consecutive patients with stage IIIC poor-risk TGCTs treated between May 2021 and November 2023 at a tertiary care center. Clinical, pathological, treatment, and outcome data were analyzed. Results Thirty-one patients with stage IIIC poor-risk non-seminomatous TGCTs were included. Six patients (19.4%) died during first-line chemotherapy. Among the 25 patients who completed therapy, nine (36.0%) developed relapse. Mean progression-free survival (PFS) was 32.3 months, and mean overall survival (OS) was 31.1 months. Patients achieving tumor marker normalization after chemotherapy had markedly superior outcomes (mean PFS: 41.8 vs. 10.0 months; mean OS: 36.3 vs. 19.1 months). Brain metastases at diagnosis or on progression were associated with poor prognosis. Conclusion Patients presenting with poor performance status and visceral crisis are at high risk of early mortality during first-line chemotherapy. Tumor marker normalization strongly predicts improved survival, whereas persistent marker elevation and brain metastases are linked to unfavorable outcomes.
Insights
Outcomes for advanced testicular germ cell tumors (TGCTs) remain challenging. Tumor marker normalization after chemotherapy significantly improves survival in poor-risk TGCT patients, while brain metastases indicate a poor prognosis.
Area of Science:
- Oncology
- Urology
- Medical Malignancies
Background:
- Testicular germ cell tumors (TGCTs) are the most common cancer in young men.
- Early-stage TGCTs have high cure rates, but advanced stages have suboptimal outcomes.
- Limited survival data exists for stage IIIC poor-risk TGCT patients.
Purpose of the Study:
- To evaluate clinical outcomes in patients with stage IIIC poor-risk TGCTs.
- To identify prognostic factors influencing survival in this patient subgroup.
Main Methods:
- Retrospective review of 31 patients with stage IIIC poor-risk TGCTs.
- Data collected included clinical, pathological, treatment, and outcome information.
- Analysis of progression-free survival (PFS) and overall survival (OS).
Main Results:
- 19.4% of patients died during first-line chemotherapy.
- 36.0% of patients who completed therapy experienced relapse.
- Tumor marker normalization correlated with significantly better PFS and OS (41.8 vs. 10.0 months PFS; 36.3 vs. 19.1 months OS).
- Brain metastases at diagnosis or progression were associated with poor prognosis.
Conclusions:
- Patients with poor performance status and visceral crisis face high early mortality risk.
- Tumor marker normalization is a strong predictor of improved survival.
- Persistent marker elevation and brain metastases are linked to unfavorable outcomes in advanced TGCT.