Abstract：
BACKGROUND: In 2021, the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium reported improved overall survival (OS) rates in a modern cohort of metastatic non-seminoma testis cancer patients within each of the IGCCCG prognosis groups (96% in good vs. 89% in intermediate vs. 67% in poor), compared to the previous IGCCCG publication (92% in good vs. 80% in intermediate vs. 48% in poor). We hypothesized that a similar survival improvement may apply to a contemporary North-American population-based cohort of non-seminoma testis cancer patients.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database (2010-2018) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of IGCCCG prognosis groups on overall mortality (OM).
RESULTS: Of 1672 surgically treated metastatic non-seminoma patients, 778 (47%) exhibited good vs. 251 (15%) intermediate vs. 643 (38%) poor prognosis. In the overall cohort, five-year OS rate was 94% for good prognosis vs. 87% for intermediate prognosis vs. 65% for poor prognosis. In multivariable Cox regression models predicting OM, intermediate (Hazard ratio [HR] 2.4, 95% confidence interval [CI] 1.4-3.9, P < 0.001) and poor prognosis group (HR 6.6, 95% CI 1.0-1.0, P < 0.001) were independent predictors of higher OM, relative to good prognosis group.
CONCLUSIONS: The survival improvement reported by the IGCCCG Update Consortium is also operational in non-seminoma testis cancer patients within the most contemporary SEER database. This observation indicates that the survival improvement is not only applicable to centres of excellence, but also applies to other institutions at large.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database (2010-2018) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of IGCCCG prognosis groups on overall mortality (OM).
RESULTS: Of 1672 surgically treated metastatic non-seminoma patients, 778 (47%) exhibited good vs. 251 (15%) intermediate vs. 643 (38%) poor prognosis. In the overall cohort, five-year OS rate was 94% for good prognosis vs. 87% for intermediate prognosis vs. 65% for poor prognosis. In multivariable Cox regression models predicting OM, intermediate (Hazard ratio [HR] 2.4, 95% confidence interval [CI] 1.4-3.9, P < 0.001) and poor prognosis group (HR 6.6, 95% CI 1.0-1.0, P < 0.001) were independent predictors of higher OM, relative to good prognosis group.
CONCLUSIONS: The survival improvement reported by the IGCCCG Update Consortium is also operational in non-seminoma testis cancer patients within the most contemporary SEER database. This observation indicates that the survival improvement is not only applicable to centres of excellence, but also applies to other institutions at large.
摘要：
背景：2021年，国际生殖细胞癌症协作组（IGCCCG）更新联盟报告，在每个IGCCCG预后组中，转移性非精原细胞瘤睾丸癌症患者的现代队列中，总生存率（OS）提高了（96％良好与89%在中级与67%的穷人)，与之前的IGCCCG出版物相比(92%的好与80%在中间与差的48%)。我们假设，类似的生存改善可能适用于当代北美基于人群的非精原细胞瘤睾丸癌症患者队列。
方法：监测，流行病学,并使用最终结果（SEER）数据库（2010-2018年）。Kaplan-Meier图和多变量Cox回归模型测试了IGCCCG预后组对总死亡率（OM）的影响。
结果：在1672例经手术治疗的转移性非精原细胞瘤患者中，778（47％）表现良好251（15%）中级vs.643(38%)预后差。在整个队列中，预后良好的五年OS率为94%，与87％的中期预后与65%为预后不良。在预测OM的多变量Cox回归模型中，中间（危险比[HR]2.4，95％置信区间[CI]1.4-3.9，P<0.001）和不良预后组（HR6.6，95％CI1.0-1.0，P<0.001）是高OM的独立预测因子，相对于预后良好组。
结论：IGCCCG更新联盟报告的生存改善在最现代的SEER数据库中的非精原细胞瘤睾丸癌症患者中也是有效的。这一观察表明，生存改善不仅适用于卓越中心，但也适用于其他机构。
方法：监测，流行病学,并使用最终结果（SEER）数据库（2010-2018年）。Kaplan-Meier图和多变量Cox回归模型测试了IGCCCG预后组对总死亡率（OM）的影响。
结果：在1672例经手术治疗的转移性非精原细胞瘤患者中，778（47％）表现良好251（15%）中级vs.643(38%)预后差。在整个队列中，预后良好的五年OS率为94%，与87％的中期预后与65%为预后不良。在预测OM的多变量Cox回归模型中，中间（危险比[HR]2.4，95％置信区间[CI]1.4-3.9，P<0.001）和不良预后组（HR6.6，95％CI1.0-1.0，P<0.001）是高OM的独立预测因子，相对于预后良好组。
结论：IGCCCG更新联盟报告的生存改善在最现代的SEER数据库中的非精原细胞瘤睾丸癌症患者中也是有效的。这一观察表明，生存改善不仅适用于卓越中心，但也适用于其他机构。
