Mp01-13 Long Term Follow-Up and Outcomes of Regressed (“Burnt Out”) Primary Testicular Germ Cell Tumors

You have accessJournal of UrologyPenile & Testicular Cancer I (MP01)1 May 2024MP01-13 LONG TERM FOLLOW-UP AND OUTCOMES OF REGRESSED ("BURNT OUT") PRIMARY TESTICULAR GERM CELL TUMORS Fady J. Baky, Nicole Liso, Brandon Williams, Samuel Funt, Satish Tickoo, Darren Feldman, Victor Reuter, Joel Sheinfeld, and Richard Matulewicz Fady J. BakyFady J. Baky , Nicole LisoNicole Liso , Brandon WilliamsBrandon Williams , Samuel FuntSamuel Funt , Satish TickooSatish Tickoo , Darren FeldmanDarren Feldman , Victor ReuterVictor Reuter , Joel SheinfeldJoel Sheinfeld , and Richard MatulewiczRichard Matulewicz View All Author Informationhttps://doi.org/10.1097/01.JU.0001008660.87408.90.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Regressed or "burnt out" testicular germ cell tumors (GCT) are a rare clinical entity. Patients may present with symptoms of metastatic disease in the absence of a clinically detected primary testicular tumor or patients may undergo orchiectomy for a testicular mass with histologic findings of no viable GCT (only scar). We describe our 30+ year experience with this unique set of patients. METHODS: Our prospectively maintained testicular cancer clinical database was queried for patients who had radical orchiectomy from 1990-2023 with "burned-out" or regressed primary testicular tumor without invasive GCT on final pathology. Patients exposed to systemic chemotherapy prior to orchiectomy were excluded. All specimens were reviewed by a dedicated genitourinary pathologist at diagnosis. Patient and disease characteristics as well as pathologic and clinical outcomes are reported using descriptive statistics. RESULTS: We identified 57 patients without prior chemotherapy found to have "burned-out" at radical orchiectomy. Seventeen patients had only scar (n=12) or germ cell neoplasia in situ (n=5) found with no other clinical evidence of disease. The other 40 patients were clinical stage IIA or greater. All seventeen patients without evidence of advanced disease were primarily managed with surveillance, with a 5-year relapse-free survival (RFS) of 88% (95% CI: 39%, 98%). All patients with Stage IIA+disease underwent treatment with either primary RPLND (pRPLND, n=4) or first-line chemotherapy (n=36). All four who had pRPLND were found to have seminoma in the retroperitoneum. There were no relapses among these patients. Twenty-four patients underwent post-chemotherapy RPLND. The RFS for patients managed with chemotherapy was 94% (95% CI: 77,98) at 2 years and 86% (95% CI: 66,94) at 5 years. Six patients required second-line chemotherapy, TIP (n=2) or TICE (n=4). There was one death attributable to testis cancer in a patient with poor risk disease. CONCLUSIONS: To our knowledge, this is the largest series of "burned-out" GCT ever reported. Patients with burnt out or regressed primary tumors often present with advanced disease, possibly due to lack of clinical signs or symptoms from the primary tumor. Among patients without metastatic disease at presentation, surveillance was associated with a low risk of recurrence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e7 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fady J. Baky More articles by this author Nicole Liso More articles by this author Brandon Williams More articles by this author Samuel Funt More articles by this author Satish Tickoo More articles by this author Darren Feldman More articles by this author Victor Reuter More articles by this author Joel Sheinfeld More articles by this author Richard Matulewicz More articles by this author Expand All Advertisement PDF downloadLoading ...