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Clinical characteristics and survival outcomes of elderly patients with de novo metastatic germ cell tumors.
- Source :
-
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2024 Jul; Vol. 31 (7), pp. 804-812. Date of Electronic Publication: 2024 May 01. - Publication Year :
- 2024
-
Abstract
- Objectives: To determine the outcomes for elderly patients with de novo metastatic germ cell tumors and the influence of patient age on adherence to standard chemotherapy.<br />Methods: A total of 150 patients who were initially diagnosed with metastatic germ cell tumors and treated at our institution between 2007 and 2021 were included. Patients were classified according to three age groups: aged <40, 40-49, and ≥50 years. Clinicopathological features, adherence to standard first-line chemotherapy, overall survival, and disease-free survival were compared between these groups. We also analyzed the outcomes of patients who received low-intensity induction chemotherapy due to adverse events and/or comorbidities.<br />Results: There was no significant difference in any of the survival outcomes and in the rate of adherence to standard first-line chemotherapy between the three age groups, although elderly patients with intermediate/poor prognosis group tended to receive less-intense chemotherapies. The rate of febrile neutropenia as a chemotherapy-related adverse event was significantly higher in patients aged ≥50 years. No statistical significance in survival outcomes was detected between the group of patients who received relatively low-intensity induction chemotherapy and those who received adequately intensive planned chemotherapy.<br />Conclusions: The adherence rate of standard fist-line chemotherapy of elderly patients is almost comparable to that of younger patients, although some adverse events should be carefully managed. Even elderly patients with metastatic germ cell tumors can aim for equivalently good survival outcome like younger populations, with effort to adhere to standard chemotherapy.<br /> (© 2024 The Japanese Urological Association.)
- Subjects :
- Humans
Male
Middle Aged
Adult
Age Factors
Retrospective Studies
Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Disease-Free Survival
Induction Chemotherapy methods
Neoplasm Metastasis
Prognosis
Young Adult
Neoplasms, Germ Cell and Embryonal mortality
Neoplasms, Germ Cell and Embryonal secondary
Neoplasms, Germ Cell and Embryonal drug therapy
Neoplasms, Germ Cell and Embryonal therapy
Neoplasms, Germ Cell and Embryonal pathology
Testicular Neoplasms mortality
Testicular Neoplasms pathology
Testicular Neoplasms drug therapy
Testicular Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2042
- Volume :
- 31
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- International journal of urology : official journal of the Japanese Urological Association
- Publication Type :
- Academic Journal
- Accession number :
- 38693651
- Full Text :
- https://doi.org/10.1111/iju.15470