Abstract：
OBJECTIVE: To resolve the ongoing controversy surrounding the impact of teratoma (TER) in the primary among patients with metastatic testicular non-seminomatous germ-cell tumours (NSGCT).
METHODS: Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method.
RESULTS: Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001).
CONCLUSIONS: Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.
METHODS: Using the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium database, we compared the survival probabilities of patients with metastatic testicular GCT with TER (TER) or without TER (NTER) in their primaries corrected for known prognostic factors. Progression-free survival (5y-PFS) and overall survival at 5 years (5y-OS) were estimated by the Kaplan-Meier method.
RESULTS: Among 6792 patients with metastatic testicular NSGCT, 3224 (47%) had TER in their primary, and 3568 (53%) did not. In the IGCCCG good prognosis group, the 5y-PFS was 87.8% in TER versus 92.0% in NTER patients (p = 0.0001), the respective 5y-OS were 94.5% versus 96.5% (p = 0.0032). The corresponding figures in the intermediate prognosis group were 5y-PFS 76.9% versus 81.6% (p = 0.0432) in TER and NTER and 5y-OS 90.4% versus 90.9% (p = 0.8514), respectively. In the poor prognosis group, there was no difference, neither in 5y-PFS [54.3% in TER patients versus 55.4% (p = 0.7472) in NTER], nor in 5y-OS [69.4% versus 67.7% (p = 0.3841)]. NSGCT patients with TER had more residual masses (65.3% versus 51.7%, p < 0.0001), and therefore received post-chemotherapy surgery more frequently than NTER patients (46.8% versus 32.0%, p < 0.0001).
CONCLUSIONS: Teratoma in the primary tumour of patients with metastatic NSGCT negatively impacts on survival in the good and intermediate, but not in the poor IGCCCG prognostic groups.
摘要：
目的：为了解决围绕畸胎瘤（TER）在原发性转移性睾丸非精原细胞肿瘤（NSGCT）患者中的影响的争议。
方法：使用国际生殖细胞癌症协作组（IGCCCG）更新联盟数据库，我们比较了经已知预后因素校正后的睾丸转移性GCT患者与TER(TER)或无TER(NTER)的生存概率.通过Kaplan-Meier方法估计无进展生存期（5y-PFS）和5年总生存期（5y-OS）。
结果：在6792例转移性睾丸NSGCT患者中，3224（47%）在他们的小学有TER，和3568（53％）没有。在IGCCCG预后良好组，TER患者的5y-PFS为87.8%，NTER患者为92.0%(p=0.0001)，5y-OS分别为94.5%和96.5%(p=0.0032).在中期预后组中，TER和NTER的5y-PFS分别为76.9％和81.6％（p=0.0432），5y-OS分别为90.4％和90.9％（p=0.8514），分别。在预后不良组中，没有区别,5y-PFS均未出现[TER患者为54.3%，NTER患者为55.4%(p=0.7472)]，在5y-OS中也没有[69.4%对67.7%（p=0.3841）]。NSGCT患者有更多的残留肿块(65.3%对51.7%,p<0.0001),因此，接受化疗后手术的频率高于NTER患者(46.8%对32.0%，p<0.0001)。
结论：转移性NSGCT患者的原发肿瘤中的畸胎瘤对良好和中等生存率有负面影响。但在IGCCCG预后较差的组中没有。
方法：使用国际生殖细胞癌症协作组（IGCCCG）更新联盟数据库，我们比较了经已知预后因素校正后的睾丸转移性GCT患者与TER(TER)或无TER(NTER)的生存概率.通过Kaplan-Meier方法估计无进展生存期（5y-PFS）和5年总生存期（5y-OS）。
结果：在6792例转移性睾丸NSGCT患者中，3224（47%）在他们的小学有TER，和3568（53％）没有。在IGCCCG预后良好组，TER患者的5y-PFS为87.8%，NTER患者为92.0%(p=0.0001)，5y-OS分别为94.5%和96.5%(p=0.0032).在中期预后组中，TER和NTER的5y-PFS分别为76.9％和81.6％（p=0.0432），5y-OS分别为90.4％和90.9％（p=0.8514），分别。在预后不良组中，没有区别,5y-PFS均未出现[TER患者为54.3%，NTER患者为55.4%(p=0.7472)]，在5y-OS中也没有[69.4%对67.7%（p=0.3841）]。NSGCT患者有更多的残留肿块(65.3%对51.7%,p<0.0001),因此，接受化疗后手术的频率高于NTER患者(46.8%对32.0%，p<0.0001)。
结论：转移性NSGCT患者的原发肿瘤中的畸胎瘤对良好和中等生存率有负面影响。但在IGCCCG预后较差的组中没有。
