Browsing by Author "Antonelli, Luca"

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    Oncological Follow-up Strategies for Testicular Germ Cell Tumours: A Narrative Review
    (Elsevier, 2022-09-07) Kaufmann, Ernest; Antonelli, Luca; Albers, Peter; Cary, Clint; Gillessen Sommer, Silke; Heidenreich, Axel; Oing, Christoph; Oldenburg, Jan; Pierorazio, Phillip Martin; Stephenson, Andrew J.; Fankhauser, Christian Daniel; Urology, School of Medicine
    Context: The aim of this review is to describe the proportion of testicular germ cell tumours (tGCTs) with recurrence, and the timing and anatomical sites of relapse across different disease stages and after different treatment options. We summarise published follow-up protocols and discuss current and future developments to personalise follow-up for patients with tGCT. Evidence acquisition: A systematic literature search was conducted and current guidelines and selected institutional follow-up protocols were reviewed. Evidence synthesis: Of 302 publications, we screened 68 full texts and included 29 studies; 22 of these were retrospective and seven were prospective in nature, contributing data for 20 570 patients. The number of patients included per study ranged from 119 to 2483. We compared the guideline follow-up protocols of the European Society for Medical Oncology, European Association of Urology, National Comprehensive Cancer Network, and American Urological Association, as well as institutional follow-up protocols. The protocols differed in terms of the number, time points, and type of follow-up investigations. Conclusions: Future research should assess how tGCT can be followed to ensure high adherence, define the role of miR-371a-3p microRNA during follow-up, and develop follow-up protocols after curative treatment in the metastatic setting. Patient summary: In this review of follow-up protocols for men with testis cancer, we observed different recommendations and discuss future research areas to improve follow-up for these patients.
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    Risk of residual cancer after complete response following first-line chemotherapy in men with metastatic non-seminomatous germ cell tumour and International Germ Cell Cancer Cooperative Group intermediate/poor prognosis: A multi-institutional retrospective cohort study
    (Elsevier, 2023-03) Antonelli, Luca; Ardizzone, Davide; Ravi, Praful; Bagrodia, Aditya; Mego, Michal; Daneshmand, Siamak; Nicolai, Nicola; Nazzani, Sebastiano; Giannatempo, Patrizia; Franza, Andrea; Heidenreich, Axel; Paffenholz, Pia; Saoud, Ragheed; Eggener, Scott; Ho, Matthew; Oswald, Nathaniel; Olson, Kathleen; Tryakin, Alexey; Fedyanin, Mikhail; Naoun, Natacha; Javaud, Christophe; Fizazi, Karim; King, Jennifer M.; Adra, Nabil; Douglawi, Antoin; Cary, Clint; Sweeney, Christopher; Fankhauser, Christian D.; Urology, School of Medicine
    Introduction Current guidelines recommend surveillance in metastatic non-seminomatous germ cell tumour patients treated with first-line-chemotherapy and a complete clinical response (normalisation of serum tumour markers and residual masses <1 cm). However, this recommendation is based on a series including patients with good prognosis according to International Germ Cell Cancer Cooperative Group prognostic group (IGCCCG-PG). The aim of this study was to analyse the proportion of residual teratoma and survival among patients with intermediate/poor IGCCCG-PG and a complete clinical response after first-line-chemotherapy. Material & methods This is a retrospective study of men with intermediate/poor IGCCCG-PG, who had a complete clinical response after first-line chemotherapy. Patients were either followed by surveillance or treated with post-chemotherapy retroperitoneal lymph node dissection (pcRPLND). Results Between 2009 and 2018, 143 men with intermediate (n = 83) or poor (n = 60) IGCCCG-PG were treated at 11 international centres. Among 33 patients treated with pcRPLND, the specimen showed teratoma and viable cancer in 16 (48%) and 4 (12%). During a median a 7-year follow-up, 20/110 (18%) patients managed with surveillance relapsed, of whom seven (6%) had a retroperitoneal-only relapse versus 2/33 patients managed with pcRPLND relapsed. No difference was observed regarding overall survival (OS) among men treated with pcRPLND or surveillance (5-year OS, 93% and 89%, p-value = 0.35). The median time-to-recurrence among men on surveillance was 1.3 years (range: 0.3–9.1), and the most common sites of relapses included retroperitoneum (11%), chest (5%), and bones (4%). Conclusions While most men with intermediate/poor IGCCCG-PG harbour teratoma/cancer in the retroperitoneum despite a complete response to first-line-chemotherapy, only 6% managed with surveillance relapsed in the retroperitoneum. There was no significant difference in OS between the two groups.