Browsing by Author "Fankhauser, Christian Daniel"

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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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    Outcome of Men With Relapses After Adjuvant Bleomycin, Etoposide, and Cisplatin for Clinical Stage I Nonseminoma
    (American Society of Clinical Oncology, 2020-04) Fischer, Stefanie; Tandstad, Torgrim; Cohn-Cedermark, Gabriella; Thibault, Constance; Vincenzi, Bruno; Klingbiel, Dirk; Albany, Costantine; Necchi, Andrea; Terbuch, Angelika; Lorch, Anja; Aparicio, Jorge; Heidenreich, Axel; Hentrich, Marcus; Wheater, Matthew; Langberg, Carl W.; Ståhl, Olof; Fankhauser, Christian Daniel; Hamid, Anis A.; Koutsoukos, Konstantinos; Shamash, Jonathan; White, Jeff; Bokemeyer, Carsten; Beyer, Jörg; Gillessen, Silke; Medicine, School of Medicine
    Purpose: Clinical stage I (CSI) nonseminoma (NS) is a disease limited to the testis without metastases. One treatment strategy after orchiectomy is adjuvant chemotherapy. Little is known about the outcome of patients who experience relapse after such treatment. Patients and methods: Data from 51 patients with CSI NS who experienced a relapse after adjuvant bleomycin, etoposide, and cisplatin (BEP) from 18 centers/11 countries were collected and retrospectively analyzed. Primary outcomes were overall and progression-free survivals calculated from day 1 of treatment at first relapse. Secondary outcomes were time to, stage at, and treatment of relapse and rate of subsequent relapses. Results: Median time to relapse was 13 months, with the earliest relapse 2 months after start of adjuvant treatment and the latest after 25 years. With a median follow-up of 96 months, the 5-year PFS was 67% (95% CI, 54% to 82%) and the 5-year OS was 81% (95% CI, 70% to 94%). Overall, 19 (37%) of 51 relapses occurred later than 2 years. Late relapses were associated with a significantly higher risk of death from NS (hazard ratio, 1.10 per year; P = .01). Treatment upon relapse was diverse: the majority of patients received a combination of chemotherapy and surgery. Twenty-nine percent of patients experienced a subsequent relapse. At last follow-up, 41 patients (80%) were alive and disease-free, eight (16%) had died of progressive disease, and one patient (2%) each had died from therapy-related or other causes. Conclusion: Outcomes of patients with relapse after adjuvant BEP seem better compared with patients who experience relapse after treatment of metastatic disease but worse compared with those who have de-novo metastatic disease. We found a substantial rate of late and subsequent relapses. There seem to be three patterns of relapse with different outcomes: pure teratoma, early viable NS relapse (< 2 years), and late viable NS relapse (> 2 years).