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Research ArticleClinical Studies

Predicting Long-term Survival After Lung Metastasectomy in Patients With Malignant Germ-cell Tumors

MIRCEA GABRIEL STOLERIU, GEORGIOS STATHOPOULOS, ELVIRA STACHER-PRIEHSE, CHRISTIAN KETSCHER, UWE GRÜTZNER, JAN FERTMANN, CHRISTIAN SCHNEIDER, RUDOLF HATZ, NICOLE STROBL and GERHARD PREISSLER
Anticancer Research September 2022, 42 (9) 4517-4527; DOI: https://doi.org/10.21873/anticanres.15954
MIRCEA GABRIEL STOLERIU
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
3Institute for Lung Biology and Disease, Comprehensive Pneumology Center, Munich, Germany;
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  • For correspondence: stoleriu@helmholtz-muenchen.de gerhard.preissler@rbk.de
GEORGIOS STATHOPOULOS
3Institute for Lung Biology and Disease, Comprehensive Pneumology Center, Munich, Germany;
4Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, Patras, Greece;
5Biomedical Sciences Research Center, Rio, Greece;
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ELVIRA STACHER-PRIEHSE
6Department of Pathology, Asklepios Pulmonary Hospital, Gauting, Germany;
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CHRISTIAN KETSCHER
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
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UWE GRÜTZNER
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
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JAN FERTMANN
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
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CHRISTIAN SCHNEIDER
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
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RUDOLF HATZ
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
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NICOLE STROBL
1Division of Thoracic Surgery Munich, Ludwig Maximilian University of Munich, Munich, Germany;
2Asklepios Lung Clinic, Asklepios Pulmonary Hospital, Gauting, Germany;
3Institute for Lung Biology and Disease, Comprehensive Pneumology Center, Munich, Germany;
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GERHARD PREISSLER
3Institute for Lung Biology and Disease, Comprehensive Pneumology Center, Munich, Germany;
7Department for Thoracic Surgery, RBK Lungenzentrum Stuttgart, Robert Bosch Hospital, Stuttgart, Germany
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  • For correspondence: stoleriu@helmholtz-muenchen.de gerhard.preissler@rbk.de
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Abstract

Background/Aim: The aim of the study was to identify predictors of long-term survival and propose an improved risk stratification in patients with pulmonary germ-cell metastases admitted for pulmonary metastasectomy. Patients and Methods: Thirty-four patients admitted to the Division of Thoracic Surgery Munich, Germany, from 04/1994 until 09/2017 were retrospectively analyzed. The impact of clinical parameters on survival was calculated using Kaplan–Meier, multivariate Cox regression analysis and receiver-operator curves. Results: Ten-year overall survival was 75.3%. Elevated American Society of Anesthesiologists score, metachronous metastasis, embryonal histology, intrathoracic lymph node involvement, brain metastases and thoracic wall infiltration were significant predictors of reduced survival. With the independent predictors (embryonal histology, metachronous metastasis and thoracic wall infiltration), a germinal non-seminomatous lung metastasis risk of death score (GLUMER) was calculated, accurately predicting survival (area under curve=0.8839, p=0.0023). Conclusion: In patients with pulmonary germ-cell metastases, intrathoracic lymph node involvement, embryonal carcinoma, metachronous metastasis and thoracic wall infiltration represent negative predictors of long-term survival. The GLUMER score might represent a promising tool for use in adapted follow-up care in high-risk patients.

Key Words:
  • Germ tumors
  • lung metastases
  • risk score
  • Received June 27, 2022.
  • Revision received July 22, 2022.
  • Accepted July 27, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (9)
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September 2022
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Predicting Long-term Survival After Lung Metastasectomy in Patients With Malignant Germ-cell Tumors
MIRCEA GABRIEL STOLERIU, GEORGIOS STATHOPOULOS, ELVIRA STACHER-PRIEHSE, CHRISTIAN KETSCHER, UWE GRÜTZNER, JAN FERTMANN, CHRISTIAN SCHNEIDER, RUDOLF HATZ, NICOLE STROBL, GERHARD PREISSLER
Anticancer Research Sep 2022, 42 (9) 4517-4527; DOI: 10.21873/anticanres.15954

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Predicting Long-term Survival After Lung Metastasectomy in Patients With Malignant Germ-cell Tumors
MIRCEA GABRIEL STOLERIU, GEORGIOS STATHOPOULOS, ELVIRA STACHER-PRIEHSE, CHRISTIAN KETSCHER, UWE GRÜTZNER, JAN FERTMANN, CHRISTIAN SCHNEIDER, RUDOLF HATZ, NICOLE STROBL, GERHARD PREISSLER
Anticancer Research Sep 2022, 42 (9) 4517-4527; DOI: 10.21873/anticanres.15954
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