Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001) and disease-free survival rates were 83%, 34% and 7% ( P < 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001), the initial stage of disease ( P < 0.001), the initial serum AFP level (p: 0.001), the initial β -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P < 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P &lt; 0.001) and disease-free survival rates were 83%, 34% and 7% ( P &lt; 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P &lt; 0.001), the initial stage of disease ( P &lt; 0.001), the initial serum AFP level (p: 0.001), the initial \u3b2 -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P &lt; 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

The autologous hematopoietic stem cell transplantation in adult patients with lymphoma: Turkish Bone Marrow Transplantation Registry results

Turkish Bone Marrow Transplantation Registry (TBMTR) was established in 1995. Since 1992, data of adult lymphoma patients from fifteen national transplantation centers were collected and analyzed by TBMTR. A total of 437 adult lymphoma patients (185 Hodgkin's and 252 non-Hodgkin's lymphoma) undergoing autologous hematopoietic stem cell transplantation (HSCT) were registered in TBMTR from 1992 to 2002. Peripheral blood as stem cell source was used in 94% of the transplantations. Non-TBI (total body irradiation) conditioning regimens were administered in 88% of the cases. The 100-day transplantation-related mortality (TRM) was 11% in relapsed and 11% in primary refractory Hodgkin's lymphoma patients whilst TRM was found to be 9% and 30% in non-Hodgkin's lymphoma patients in first remission and in primary refractory cases, respectively. Infection was the most common cause of TRM. 10-year and 5-year survival rates were 50% and 49% in relapsed cases and primary refractory cases with Hodgkin's lymphoma, respectively; while in non-Hodgkin's lymphoma patients 10-year survival rate was 65% in cases in first remission, 7-year survival rate was 50% in sensitive relapse, 2-year survival rate was 0% in resistant relapse and 3-year survival was 24% in primary refractory cases. In conclusion, TBMTR results are comparable to EBMT and IBMTR results. Therefore, autologous HSCT may provide long-term survival in patients with Hodgkin's lymphoma as well as in patients with non-Hodgkin lymphoma in first remission and in sensitive relapse

Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001) and disease-free survival rates were 83%, 34% and 7% ( P < 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001), the initial stage of disease ( P < 0.001), the initial serum AFP level (p: 0.001), the initial β -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P < 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

A case of advanced scalp angiosarcoma successfully treated with combination chemotherapy of adriamycin, cisplatin and ifosfamide

Scalp angiosarcoma is a rare and highly malignant tumour originating from endothelial cells of vessels and occurring predominantly in elderly men. Its prognosis is poor and the 5-year survival rate of patients is reported to be 12–33% [1]. Complete surgical excision with wide margins remains the cornerstone of therapy for localised tumours. Additional radiotherapy may provide improved local control. Given the rarity of this tumour, an optimum chemotherapy regimen has not yet been defined for metastatic cases. Here we report a case of scalp angiosarcoma with local recurrence and distant metastases which was successfully treated with a combination chemotherapy consisting of adriamycin, cisplatin, ifosfamide and mesna (APIM). A 24-year-old man presented to a plastic surgeon in January 2005 with a painless nodule on the scalp measuring 3 cm in diameter. Surgical total excision of the nodule was carried out, providing a negative surgical margin (2 cm). The diagnosis of angiosarcoma was confirmed pathologically. An X-ray of the scull, magnetic resonance imaging of the brain and computed tomography of the neck, thorax and abdomen revealed no evidence of local or distant metastases at the time of diagnosis. The patient was not given any adjuvant therapy. Five months after the surgery, the patient developed two new angiosarcoma lesions (1.5 and 2 cm in diameter) on different sites of the scalp. In addition, computed tomography of the neck and chest revealed conglomerate lymph nodes on the left side of the neck and five small metastatic nodules, up to 1.5 cm greatest dimension in bilateral lung fields