背景:非精原细胞生殖细胞肿瘤(NSGCT)是年轻男性中罕见但最普遍的恶性肿瘤。骨转移(BMs)在这种肿瘤中非常罕见,和关于最初疾病表现的可用数据,生存结果,并且BMs的预后意义有限。方法:我们对2001年至2021年在我们的三级护理中心接受治疗的40例NSGCT患者进行了回顾性分析。根据诊断时或仅在复发时存在BM,将队列分为同步组(n=29)和异时组(n=11)。分别。我们评估了总生存期(OS),无进展生存期(PFS),疾病介绍,和治疗。结果:在中位随访93个月后,同步组5年PFS和OS分别为37.6%和53.9%,异期组分别为18.2%和36.4%,分别。在最初的诊断中,大多数患者被分为IGCCCG预后不良组(n=34,85%).BMs大多无症状(n=23,57.5%),涉及脊柱(n=37,92.5%),并且只有在疾病反应后才能变得可见(n=4,10%)。一线治疗后切除的骨病变的病理检查显示坏死(n=5,71.4%),畸胎瘤,或精原细胞瘤(均n=1,14.3%)。一开始复发,同步组8例患者未出现骨复发,而8例患者在最初受累的骨部位复发。结论:在NSGCT患者中,BMS通常以渐近方式出现,最初可能未被注意到。然而,与IGCCCG预后不良组相比,这些患者的预后可能较差.需要包括对照组在内的进一步研究来评估BM的独立预后意义。
Background: Non-seminomatous germ cell tumors (NSGCTs) represent a rare yet the most prevalent malignancy among young men. Bone metastases (BMs) are exceedingly uncommon in this neoplasm, and available data regarding the initial disease presentation, survival outcomes, and prognostic significance of BMs are limited. Methods: We conducted a retrospective analysis of 40 NSGCT patients with BMs treated between 2001 and 2021 in our tertiary care center. The cohort was stratified into synchronous (n = 29) and metachronous (n = 11) groups based on the presence of BM at diagnosis or only at relapse, respectively. We assessed overall survival (OS), progression-free survival (PFS), disease presentation, and treatments. Results: After a median follow-up of 93 months, the 5-year PFS and OS rates were 37.6% and 53.9% in the synchronous group and 18.2% and 36.4% in the metachronous group, respectively. At the initial diagnosis, most patients were classified into the IGCCCG poor prognostic group (n = 34, 85%). BMs were mostly asymptomatic (n = 23, 57.5%), involved the spine (n = 37, 92.5%), and could become visible only after disease response (n = 4, 10%). A pathological examination of resected bone lesions after first-line treatment revealed necrosis (n = 5, 71.4%), teratoma, or seminoma (both n = 1, 14.3%). At first relapse, eight patients in the synchronous group did not experience bone recurrence, while eight patients experienced recurrence at the initial affected bone site. Conclusions: In NSGCT patients, BMs often present asymptomatically and may initially be unnoticed. However, these patients may have a poorer prognosis compared to those in the IGCCCG poor prognostic group. Further studies including control groups are needed to assess the independent prognostic significance of BMs.