Germ Cell Tumors Research Articles

Embryoid Bodies and Related Proliferations in Ovarian Germ Cell Tumors.

We investigated the frequency and associated pathology of embryoid bodies in ovarian tumors by evaluating neoplasms in which they are known to occur: 100 immature teratomas, 125 malignant mixed germ cell tumors, and 6 polyembryomas. Three immature teratomas contained a single relatively well-formed embryoid body, whereas these and 11 others showed foci we categorized as embryoid body remnants consisting of microscopic aggregates of embryonal or yolk sac-type epithelium associated with spaces consistent with yolk sac or amniotic cavity but lacking a classic embryoid body structure. Teratomas with these foci were all high grade. A well-formed embryoid body was found in only 1 malignant mixed tumor, but embryoid body remnants were present in 25%, invariably associated with foci of immature teratoma (100%) and often with yolk sac tumor (97%), embryonal carcinoma (35%), or both (32%). These foci usually took the form of round to oval aggregates, often well-circumscribed, for which the term "polyembryoma background" has been proposed. The polyembryomas were typically grossly hemorrhagic and occurred in patients from 9 to 43 years of age. The embryoid bodies in them generally grew in lobules within an edematous to occasionally myxoid stroma. Four tumors contained liver-like cells, 4 numerous glands likely recapitulating the allantois, 3 syncytiotrophoblast cells, 2 prominent cysts, and 2 striking vascular proliferations. This study indicates that (1) typical embryoid bodies are rare in immature teratomas but about 14% of them have embryoid body remnants. (2) Embryoid body remnants are seen in 25% of malignant mixed germ cell tumors with a teratomatous component and often proliferate to form yolk sac tumor and embryonal carcinoma. (3) Well-formed embryoid bodies growing in a confluent manner (polyembryoma) are rare, and minor foci of teratoma, yolk sac tumor, or embryonal carcinoma are almost always present, indicating that these are fundamentally malignant mixed germ cell tumors but the polyembryoma component is dominant and distinctive which, in our opinion, justifies its own nomenclature. (4) Embryoid bodies are not a feature of other germ cell tumors.

“A Study To Assess The Effectiveness Of Planned Teaching Programme On Ovarian Germ Cell Tumor Among Adolescent Girls In A Selected College At Udaipur.”

Background Of The Study Adolescence is a transitional stage of physical and mental development generally occurring between puberty and legal adulthood, but largely characterized as beginning and ending with the teenage stage. Reaching girls during adolescence is critical decisions made and behaviors established during this period affect their horizons later in life. Many serious diseases in adulthood have their roots in adolescence. Germ cell tumors include a diverse group of tumors that arise from primitive germinal cells in either the gonads (ovaries, testicles).Germ cell tumors can occur almost anywhere in the body and can be either benign or malignant. Ovarian germ cell tumors are abnormal mass of tissue that forms in germ (egg) cells in the ovary. These tumors usually occur in teenage girls or young women, usually affect just one ovary and can be benign. Ovarian germ cell tumors represent 15 to 20 % of all ovarian tumors. They are rapidly growing neoplasm that arises from primordial germ cells derived from the embryo gonad. Of all gynecological tumors, ovarian malignancies represent the greatest clinical challenge. Ovarian cancer is the second most common malignancy of the female reproductive system and one of the leading causes of death among gynaecologic malignancies. Ovarian cancer represents a major surgical challenge requiring intensive and often complex therapies. It has the highest fatality-to-case ratio of all the gynaecological malignancies. Proper education is absolutely necessary in order to improve the adolescents’ knowledge. Early detection of ovarian germ cell tumor is essential to decrease the chances of complications. The aim of this study was to determine the effectiveness of planned teaching programme on ovarian germ cell tumor among adolescent girls in a selected college at Udaipur

701P Multicenter analysis of first-line (1L) regimens (BEP vs VIP) in patients (pts) with non-seminomatous germ cell tumors (NSGCTs) who subsequently underwent high-dose chemotherapy (HDCT)

701P Multicenter analysis of first-line (1L) regimens (BEP vs VIP) in patients (pts) with non-seminomatous germ cell tumors (NSGCTs) who subsequently underwent high-dose chemotherapy (HDCT)

706P Stereotactic radiosurgery (SRS) in brain metastases (BMs) from non-seminomatous germ cell tumours (NSCGTs)

706P Stereotactic radiosurgery (SRS) in brain metastases (BMs) from non-seminomatous germ cell tumours (NSCGTs)

Cut-offs for relapse detection in men with stage I testicular germ cell tumors during active surveillance within a prospective multicentre cohort study using either raw or housekeeper normalized miR-371a-3p serum levels

PurposeMiR-371a-3p represents a novel liquid biomarker that detects all histologies of germ-cell tumors (GCT) except teratoma. However, it is currently unclear whether miR-371a-3p results obtained directly from RT-PCR (raw Cq) or normalized for housekeeper genes and transformed into the relative quantity (RQ) value should be used and at what cut-off level. The purpose of this research was to evaluate, which values should be used, and a potential cut-off level for relapse-detection to inform subsequent studies. Materials and MethodsWe applied a CE-certified qRT-PCR test to measure miR-371a-3p at each follow-up visit during active surveillance in 34 men with stage I testicular GCT. MiR-371a-3p levels were calculated by the ΔΔ method. ResultsAbout 18 Patients had pure seminoma and 16 had mixed or nonseminomatous testicular GCT. Recurrences were detected in 10 patients and were correctly identified by both raw and housekeeper-normalized miR-371a-3p serum levels. The raw Cq, with a cut-off value of <28, resulted in only 1 false positive (3%), whereas RQ, with a cut-off value of >15, produced 6 false positive results (17%). Most of these false positive results normalized in subsequent measurements. The RQ approach detected recurrence in 1 patient 6 months earlier than the raw Cq approach. ConclusionOur preliminary data suggest that this CE-certified assay, using previously suggested cut-off values, is a promising method for detecting disease recurrence, provided a confirmatory second test is conducted to identify false positive results. To avoid unnecessary scans or overtreatment, we are currently validating this assay and cut-offs in a prospective cohort study.

707P Paclitaxel, ifosfamide and cisplatin (TIP) in patients (pts) with poor prognosis nonseminomatous germ cell tumor (NSGCT) with unfavourable serum tumor markers (STM) decline: A phase II study

707P Paclitaxel, ifosfamide and cisplatin (TIP) in patients (pts) with poor prognosis nonseminomatous germ cell tumor (NSGCT) with unfavourable serum tumor markers (STM) decline: A phase II study

Imaging of thymic epithelial tumors-a clinical practice review.

This review article comprehensively examines the diagnostic approach to thymic epithelial tumors (TETs) and other mediastinal masses, focusing on imaging modalities and differential diagnosis. Beginning with a discussion on traditional and contemporary classification systems for mediastinal tumors, including the Japanese Association for Research on the Thymus (JART) and International Thymic Interest Group (ITMIG) classifications, it highlights the shift towards computed tomography (CT)-based categorizations. Emphasis is placed on the importance of distinguishing between solid and cystic lesions in the anterior mediastinum, with detailed insights into imaging characteristics and histological features of various TET subtypes such as thymomas, thymic carcinomas, and thymic neuroendocrine tumors (NETs). The review also elucidates common differential diagnoses, including lymphomas and germ cell tumors, providing guidance on key imaging findings and considerations for accurate diagnosis. Furthermore, it underscores the significance of patient background and blood tests in differential diagnosis, discussing age-related prevalence patterns and tumor marker assessment. After addressing the diagnostic challenges posed by thymic cysts offering insights into their radiological features, management considerations, and potential complications, this review extends to other rare mediastinal lesions highlighting the need for a comprehensive evaluation for accurate identification and management of these tumors. Finally, as illustrative examples, we present six cases highlighting various aspects of anterior mediastinal tumors, including TET. These cases provide valuable insights into the diagnostic challenges, imaging characteristics, and management considerations encountered in clinical practice. The cases presented herein do not all illustrate typical images, courses, and diagnoses. However, they each contain significant implications. Thus, we present them with the belief that they will aid in understanding the intricate nuances of image diagnosis in actual clinical practice.

A prospective registry study of the epidemiology and management of childhood cancer in the Gambia-The first year experience.

Globally, over 180,000 children develop cancers yearly, with about 80% residing in low- or middle-income countries where cancer-associated mortality is also high. In The Gambia, cumulative incidence rate of 27.6 childhood cancers/million population was reported between 2002 and 2011. The current study appraised newly-established pediatric oncological services in The Gambia. In this prospective registry study, children with cancer who presented at the pediatric units, Edward Francis Small Teaching Hospital, Banjul, between November 2022 and October 2023 were assessed. Data on sociodemographic variables, mode of admission and presentation, tumor type, diagnostic methods, and challenges such as laboratory support, treatment, use of blood/blood products; and eventual outcome were analyzed. The median (interquartile range, IQR) age at presentation of the 44 children was 36.0 (22.3-117.0) months. Wilms tumor was the most common tumor 12 (27.3%); followed by leukemia 11 (25.0%); germ cell tumor 8 (18.2%); lymphoma 6 (13.6%); retinoblastoma 4 (9.1%); rhabdomyosarcoma 2 (4.5%) and one central nervous system tumor (2.3%). The median(IQR) duration of symptoms before presentation was 48 (21-90) days, presentation to diagnosis 7.5 (3-20.8) days, and first symptom to diagnosis 62.5 (32-126.8) days. Treatment refusal and abandonment rates were 20.5% and 13.6%, respectively. Families of 93.8% of children could not procure cytotoxic drugs due to nonavailability, high cost, or both. Adequate laboratory monitoring was only available in 6.8%, and none had platelet concentrate transfusion or radiotherapy. The nine (20.5%) who completed treatment are currently being followed up, 10(22.7%) are still receiving chemotherapy, while 2(4.5%) were referred. Eight (18.2%) died, predominantly from metastasis (75%) and severe drug toxicities (25%). Late presentation and diagnosis, poverty, unavailability of drugs, suboptimal or lack of laboratory testing, blood product, adjuvant medications, and psychosocial supports contributed to high treatment refusal, abandonment, and mortality. These daunting challenges can be ameliorated with regular community sensitization, frequent cancer auditing, and strong political will.

700P Detection of circulating tumor DNA and chromosome 3p25.3 gain in relapsed/refractory germ cell tumors and impact of salvage high-dose chemotherapy: Results from the Italian Germ Cell Cancer Group 04 study

700P Detection of circulating tumor DNA and chromosome 3p25.3 gain in relapsed/refractory germ cell tumors and impact of salvage high-dose chemotherapy: Results from the Italian Germ Cell Cancer Group 04 study

Assessment of the O-RADS scoring system for the differentiation of different types of ovarian neoplasms: A modified approach with non-DCE-MRI

PurposeThe O-RADS MRI score stratifies adnexal mass risk with characteristics of T1-weighted, T2-weighed and dynamic contrast-enhanced (DCE) images. We explored a modified approach to evaluate the value of incorporation DWI/ADC with non-DCE-MRI in ORADS scoring system, and to assess the diagnostic performance and interreader consistency in differentiating ovarian neoplasm with different types. MethodsThis retrospective study included 218 women who underwent pelvic MRI with 221 ovarian tumors between January 2017 and December 2021. Two radiologists independently assessed each lesion using the original and modified O-RADS approach (incorporating DWI/ADC with non-DCE). Cohen's weighted-kappa and ROC analyses were employed to assess interreader consistency and diagnostic efficiency across all lesions and three ovarian neoplasms categories. ResultsThe area under the ROC curve (AUC) of the original protocol was 0.945 for all lesions and 0.947, 0.992, and 0.758 for the epithelial cell, germ cell and sex cord-stromal neoplasms. The modified approach achieved AUCs of 0.959 for all lesions and 0.962, 0.997, and 0.837 for the three categories. The interreader agreement was ‘excellent’ for all lesions and ‘good’ for the subgroups with the original protocol, improving to ‘excellent’ for all categories with the modified approach. ConclusionA modified O-RADS incorporating DWI/ADC with non-DCE MRI yields high diagnostic performance in differentiation of different types of ovarian neoplasms. It further improves consistency in subgroup interpretation. The modified approach can serve as an effective diagnostic tool without DCE, further promoting its adoption in primary hospitals.

Long-term Clinical Outcomes of Patients With Negative Pathology (pN0) at Primary Retroperitoneal Lymph Node Dissection

BackgroundPatients who undergo primary retroperitoneal lymph node dissection (pRPLND) for early-stage testicular cancer and have no cancer (pN0) found in the retroperitoneum are believed to have an excellent prognosis. However, some experience relapse, potentially due to limitations of current staging methods. We aim to describe long-term outcomes and relapse patterns among a contemporary cohort of patients found to be pN0 at pRPLND to identify opportunities for improved diagnostic approaches and optimal patient selection. MethodsWe reviewed our prospectively maintained database for patients who underwent pRPLND for nonseminomatous germ cell tumors at our tertiary cancer center during the period from January 1, 2000, through September 30, 2023 (n = 628). We excluded 282 patients with node-positive pathology for a final analytic cohort of 346 patients. Our primary outcome was recurrence-free survival (RFS). Secondary outcomes included timing and location of recurrence. ResultsOf 346 included patients with pN0 pathology, 23 experienced relapse with a 2-year RFS rate of 93% (95% confidence interval: 90, 96). Most recurrences (70%) occurred in the lungs and within 6 months of pRPLND. Serum tumor markers were positive in 43% of patients at the time of relapse. All patients who relapsed were treated with salvage chemotherapy; 6 patients required additional surgical procedures. There was no testis cancer–related deaths. ConclusionsTwo-year RFS for patients with pN0 pRPLND pathology is excellent. All recurrences were outside of the retroperitoneum, suggesting subclinical distant metastases at time of surgery and the benefits of a bilateral template dissection. Improved diagnostics may help better identify patients with disease within or outside of the retroperitoneum prior to pRPLND, helping guide treatment decisions.

695P Assessment of the utility of CT scans in the long-term follow-up of metastatic non-seminomatous germ cell tumours (mNSGCT): The Late CT study

695P Assessment of the utility of CT scans in the long-term follow-up of metastatic non-seminomatous germ cell tumours (mNSGCT): The Late CT study

Editorial Comment on “Long-term Outcomes of Regressed or ‘Burnt Out’ Primary Testicular Germ Cell Tumors”

Editorial Comment on “Long-term Outcomes of Regressed or ‘Burnt Out’ Primary Testicular Germ Cell Tumors”

CN68 From surviving cancer to getting on with life: Adult testicular germ cell tumor survivors’ perspectives on transition from follow-up care to long-term survivorship

CN68 From surviving cancer to getting on with life: Adult testicular germ cell tumor survivors’ perspectives on transition from follow-up care to long-term survivorship

705P Subsequent malignant neoplasms (SMN) in patients with germ cell tumor of the testis (TGCT): Implications on a genetic vs stem cell origin of cancers

705P Subsequent malignant neoplasms (SMN) in patients with germ cell tumor of the testis (TGCT): Implications on a genetic vs stem cell origin of cancers

703P Survival of Hispanic germ cell tumor patients at a single academic institution vs. SEER

703P Survival of Hispanic germ cell tumor patients at a single academic institution vs. SEER

704P Characteristics and palliative management of patients with cisplatin-refractory germ cell tumours: A Global Germ Cell Cancer Collaborative Group (G3) retrospective registry study

704P Characteristics and palliative management of patients with cisplatin-refractory germ cell tumours: A Global Germ Cell Cancer Collaborative Group (G3) retrospective registry study

PE078 Robotic assisted retroperitoneal lymph node dissection: Defining selection parameters: A B-SAFE approach from the Anglican germ cell cancer collaborative group

PE078 Robotic assisted retroperitoneal lymph node dissection: Defining selection parameters: A B-SAFE approach from the Anglican germ cell cancer collaborative group

694P Sequential high-dose-chemotherapy with 4 cycles paclitaxel, ifosfamide, carboplatin, etoposide (P-ICE) in relapsed/refractory male germ cell cancer: Final results with 15.8 years follow-up

694P Sequential high-dose-chemotherapy with 4 cycles paclitaxel, ifosfamide, carboplatin, etoposide (P-ICE) in relapsed/refractory male germ cell cancer: Final results with 15.8 years follow-up

The expression of programmed cell death ligand 1 (PD-L1) involves in the clinicopathologic characteristics and prognostic implications of testicular germ cell tumor (TGCT): a systematic review and meta-analysis.

Testicular germ cell tumor (TGCT) is a type of tumor with relatively lower incidence but being more prevalent in young men. The expression of programmed cell death ligand 1 (PD-L1) serves as a potential biomarker for predicting the survival outcomes of other tumors. Some studies discovered higher prevalence of PD-L1 in TGCT patients who achieved favorable treatment outcomes, while other studies showed lower or absent expression of PD-L1 in TGCT with the better prognosis as well. Therefore, in order to address this controversy and clarify the association between the expression of PD-L1 and pathological features and prognosis of TGCT, this meta-analysis was conducted. A comprehensive literature search was performed using following search terms: "testis", "testicle", "testicular", "cancer", "carcinoma", "tumor", "neoplasm", "programmed cell death ligand 1", "programmed death ligand 1", "PD-L1", "PDL1", "B7 homolog 1", "B7-H1", "B7H1" and "CD274". Relevant studies were retrieved according to the inclusion criteria from reputable databases including PubMed, Embase, Web of Science, Cochrane Library and China National Knowledge Infrastructure (CNKI). These studies investigated the expression of PD-L1 in both tumor cells and tumor infiltrating immune cells (TIICs) in TGCT. The overall proportion of PD-L1 positivity was assessed using R programming. Pooled hazard ratio (HR) and odds ratio (OR) with corresponding 95% confidence interval (CI) were calculated using Revman software to evaluate the involvement of PD-L1 expression in TGCT. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality assessment of included studies. Sensitivity analysis and publication bias evaluation were subsequently performed. A total of eight eligible studies compromising 1,589 patients diagnosed with TGCT were finally included in this study. PD-L1 positivity was detected in 31% and 41% of TGCT patients' tumor cells and TIICs, respectively. The pooled data demonstrated a significant association between elevated PD-L1 expression levels in TIICs and a favorable prognosis characterized by the reduced disease progression and relapse events (HR =0.21, 95% CI: 0.13-0.33). Furthermore, PD-L1+ TIICs exhibited higher prevalence rates in seminoma (OR =2.11, 95% CI: 1.57-2.84) and embryonal carcinoma (OR =6.23, 95% CI: 2.42-16.02) patients. Notably, PD-L1 expression in TIICs displayed a tendency to increase in TGCT patients with lower stages or without lymph node metastasis. PD-L1 expression was observed in choriocarcinoma tumor cells, while yolk sac tumor and teratoma tumor cells exhibited lower or absent expression of PD-L1. Conversely, PD-L1 expression in TIICs was associated with seminoma and embryonal carcinoma, which was more commonly observed in TGCT patients with lower stages and better prognosis, thereby providing a theoretical foundation for the application of immunotherapy in relapsed/refractory TGCT patients.