Portal de investigación
Risk factors and causes of early death in germ cell tumors: a Global Society for Rare GU tumors study
Fecha de publicación:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Mego M.
- Israelyan E.
- Hamilton R.J.
- Heidenreich A.
- Basso U.
- Giannatempo P.
- Buchler T.
- Dieckmann K.-P.
- Huddart R.
- Vincenzi B.
- Park K.
- Tryakin A.
- Amiri A.
- Malcharkova P.
- Claps M.
- Miletic M.
- Chaloupkova L.
- Angerer M.
- Spiess P.E.
- De Giorgi U.
Grupos
Abstract
Background: Germ cell tumors (GCTs) are highly curable, yet a subset of patients with metastatic disease experience early death (ED) soon after starting first-line chemotherapy. These patients are underrepresented in trials, and risk factors remain unclear. Methods: We performed a retrospective multicenter cohort study including adults ( = 18 years) with metastatic GCT who died within 3 months of completing their last cycle of first-line chemotherapy. Primary outcomes were cause and timing of death; secondary endpoints included clinical predictors of acute respiratory failure (ARF) and very early death ( = 30 days). Results: Among 102 patients (1.7% of treated cases), 69.6% had non-seminoma, 83.3% testicular primaries, and 67.6% poor-risk disease. Median time to death was 28 days (range, 2–179). Leading causes were ARF (34.1%), disease progression (16.7%), septic shock (15.7%), hemorrhage (12.7%), and cardiovascular events (4.0%). ARF correlated with > 50% lung involvement, dyspnoea, and haemoptysis, but not choriocarcinoma histology or bleomycin use. Mostly, ED (51%) was associated with liver metastases, massive lung involvement, ß-hCG > 50,000 mIU/mL, ECOG 2–3, elevated neutrophil/lymphocyte ratio, and need for intensive care (all P < 0.05). Conclusions: Early death in metastatic GCT, though rare, remains a critical clinical issue. Early identification, adapted induction regimens, and optimized supportive care may help prevent avoidable mortality. © The Author(s) 2026.
Datos de la publicación
- ISSN/ISSNe:
- 0007-0920, 1532-1827
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 42231028
- Enlace a otro recurso:
- www.scopus.com
- Factor de Impacto:
- 2,272 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BRITISH JOURNAL OF CANCER SPRINGERNATURE
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- No hay documentos
Filiaciones
Cita
Mego M,Israelyan E,Hamilton RJ,Heidenreich A,Basso U,Giannatempo P,Buchler T,Dieckmann K-P,Huddart R,Vincenzi B,Park K,APARICIO J,Tryakin A,Amiri A,Malcharkova P,Claps M,Miletic M,Chaloupkova L,Angerer M,Spiess PE,De Giorgi U. Risk factors and causes of early death in germ cell tumors: a Global Society for Rare GU tumors study. Br. J. Cancer. 2026. 135. (5):p. 728-735. IF:7,800. (1).