Info

Adapted from Bredael JJ et al2; Williams SD, Einhorn LH.19

MSKCC = Memorial Sloan-Kettering Cancer Center; NR = Not reported.

*Autopsy was diagnostic basis.

tClinical and radiologic diagnostic basis.

Adapted from Bredael JJ et al2; Williams SD, Einhorn LH.19

MSKCC = Memorial Sloan-Kettering Cancer Center; NR = Not reported.

*Autopsy was diagnostic basis.

tClinical and radiologic diagnostic basis.

1. The incidence rises from 2% in those without pulmonary metastases to approximately 10% in patients with pulmonary metastases.

2. Patients staged as high risk according to Indiana University or International Germ Cell Consensus Classification criteria have a greater than 15% chance of cerebral metastases.

3. Patients with a serum beta-human chorionic gonadotropin (p-hCG level > 10,000 IU/mL have a reported 26% rate of incidence (compared with 1.8% for those with lower levels).

The salient findings based on the Indiana Uni versity classification have been confirmed in subse quent larger compilations used to formulate prog nostic classifications, such as the Medical Research

Council Testicular Cancer Working Party14 and the

International Germ Cell Consensus Group.15

In subsequent series of patients with poor risk characteristics or of patients with chemorefractory

GCTs, the risk of brain metastases ranges from 6 to

27% (see Table 17-1). In each series reported, the risk of brain metastases in these groups exceeds the risk of brain metastases in patients with a better prognosis who were treated at the same institution or in the same cooperative trial group.16-20 Patients with extrago-

nadal GCTs, particularly those tumors arising from the mediastinum, have a lower incidence of brain metastases, compared to participants in contempora neous series of patients with testicular GCTs, with a reported incidence of 0 to 7.5% (see Table 17-1). The reasons for this are unclear, but the lower incidence may be due to a lower incidence of choriocarcinoma at this site, coupled with the fact that mediastinal GCTs are often resistant to chemotherapy and may cause early death from local progression.20-22 Thus, there is a lower biologic preponderance for CNS metastases based on cell type (see below) and less time for such metastases to develop.

Was this article helpful?

0 0
10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment