Dataset Information

Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours.

ABSTRACT:

Background

MiR-371a-3p predicts the presence of a macroscopic non-teratomatous germ cell tumour (GCT). We hypothesised that miR-371a-3p can also detect recurrence during active surveillance (AS) of stage I GCT.

Methods

We prospectively collected serum samples of 33 men. Relative expression of serum miR-371a-3p levels was determined at each follow-up visit using real-time quantitative reverse transcription-polymerase chain reaction.

Results

Recurrence was detected using standard follow-up investigations in 10/33 patients (30%) after a median of 7 months. Directly after orchiectomy, miR-371a-3p levels were not elevated in any of the 15 patients with available post-orchiectomy samples. However, all ten recurring patients exhibited increasing miR-371a-3p levels during follow-up, while miR-371a-3p levels remained non-elevated in all but one patient without recurrence. MiR-371a-3p detected recurrences at a median of 2 months (range 0-5) earlier than standard follow-up investigations.

Conclusions

MiR-371a-3p levels immediately post orchiectomy are not predictive for recurrences and unfortunately cannot support decision-making for AS vs. adjuvant treatment. However, miR-371a-3p detects recurrences reliably and earlier than standard follow-up investigations. If this can be confirmed in larger cohorts, monitoring miR-371a-3p could replace surveillance imaging in seminomatous GCT and reduce the amount of imaging in non-seminomatous GCT. Earlier detection of disease recurrence may also reduce the overall treatment burden.

SUBMITTER: Fankhauser CD

PROVIDER: S-EPMC9023438 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours.

Fankhauser Christian D CD Christiansen Ailsa J AJ Rothermundt Christian C Cathomas Richard R Wettstein Marian S MS Grossmann Nico C NC Grogg Josias B JB Templeton Arnoud J AJ Hirschi-Blickenstorfer Anita A Lorch Anja A Gillessen Silke S Moch Holger H Beyer Joerg J Hermanns Thomas T

British journal of cancer 20211215 8

<h4>Background</h4>MiR-371a-3p predicts the presence of a macroscopic non-teratomatous germ cell tumour (GCT). We hypothesised that miR-371a-3p can also detect recurrence during active surveillance (AS) of stage I GCT.<h4>Methods</h4>We prospectively collected serum samples of 33 men. Relative expression of serum miR-371a-3p levels was determined at each follow-up visit using real-time quantitative reverse transcription-polymerase chain reaction.<h4>Results</h4>Recurrence was detected using stan ...[more]

PMID: 34912073

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Project description:BackgroundWe have recommended active surveillance as the preferred management option for clinical stage I (CSI) testicular germ cell tumors (GCTs) since 1980. Over time, the recommended intensity of surveillance has decreased; however, the impact on relapse detection has not been investigated.ObjectiveTo examine relapse rate, time to relapse, extent of disease, and burden of treatment at relapse across decreasing surveillance intensity over time.Design setting and participantsCSI GCT patients under active surveillance from 1981 to 2021 were included in this study.Outcome measurements and statistical analysisThrough four major iterations in both nonseminomatous (NSGCT) and seminoma surveillance schedules, visit frequency, blood testing, and imaging have been decreased successively. Low-dose, noncontrast computed tomography (CT) scans were adopted in 2011. Categorical variables and time to relapse were compared using chi-square and Fisher's exact or Kruskal-Wallis test, respectively.Results and limitationsA total of 1583 consecutive patients (942 with seminoma and 641 with NSGCT) were included. In seminoma, chest x-rays were reduced from 13 to one and CT scans were reduced from 20 to ten. Relapse rate, time to relapse, N or M category, and International Germ Cell Cancer Collaborative Group (IGCCCG) classification did not change. In NSGCT, chest x-rays were reduced from 27 to zero and CT scans were reduced from 11 to five. Relapse rate (from 46.2% to 21.2%, p = 0.002) and the median time to relapse (from 6.54 to 4.47 mo, p = 0.025) decreased. No difference in relapsed disease burden was identified by N, M, and S category or IGCCCG classification. Treatment burden at relapse and GCT cancer deaths remained similar for seminoma and NSGCT. Limitations include the retrospective design and large time period covered.ConclusionsDespite considerable reductions in surveillance intensity, we did not observe an increase in disease extent, treatment burden, or GCT cancer deaths upon relapse. These results support that our current lower-intensity active surveillance schedules are safe for managing CSI GCT.Patient summaryOur current reduced-intensity surveillance schedules for clinical stage I germ cell tumors appear to be safe.

Dataset Information

Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours.

Background

Methods

Results

Conclusions

Publications

Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours.

Similar Datasets

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