{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:36:28Z","timestamp":1786977388488,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T00:00:00Z","timestamp":1366329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2013,7,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Germ cell tumors (GCTs) primarily affect adolescent and young adult men. Detailed clinical and treatment characteristics in older men are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with GCT seen over a 20\u2010year period at Memorial Sloan\u2010Kettering Cancer Center were identified. Primary tumor site and histology were compared for patients aged\u2009\u2265\u200950 years at diagnosis versus younger men. For patients aged\u2009\u2265\u200950, individual chart review was performed and treatment delays, changes, and toxicities were recorded for those treated with first\u2010line chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 4235 diagnoses of GCT, 3999 (94.4%) were made at age\u2009&lt;\u200950 versus 236 (5.6%) at age\u2009\u2265\u200950. Compared with patients diagnosed before age 50, older men more frequently had seminoma (62.7% versus 36.7%) and less frequently, nonseminoma (34.7% versus 63.2%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Predominant histology switched from nonseminoma to seminoma around age 35. Distribution of primary sites also differed for older versus younger men (testis: 89.4% versus 92.9%; retroperitoneal: 3.8% versus 0.7%; CNS 0% versus 1.7%) except for mediastinal primary tumors, which remained constant across age groups. Fifty patients age\u2009\u2265\u200950 received first\u2010line platinum\u2010based chemotherapy; 30 experienced complications leading to treatment discontinuation, delay\u2009\u2265\u20097 days, or regimen change. Twenty\u2010two (44%) patients experienced neutropenic fever, 6 despite prophylactic growth factor support. Estimated 5\u2010year survival for chemotherapy\u2010treated patients was 84.9%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      Men aged\u2009\u2265\u200950 years comprise less than 10% of GCT diagnoses and have distinct clinical and histological characteristics as compared with younger patients. Although complications from chemotherapy occur frequently in older men, prognosis remains excellent when risk\u2010directed treatment is administered with curative intent.\n                      <jats:bold>\n                        <jats:italic>Cancer<\/jats:italic>\n                        2013;119:2574\u20132581\n                      <\/jats:bold>\n                      . \u00a9\n                      <jats:italic>2013 American Cancer Society<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.28025","type":"journal-article","created":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T16:19:03Z","timestamp":1366388343000},"page":"2574-2581","source":"Crossref","is-referenced-by-count":35,"title":["Clinical features, presentation, and tolerance of platinum\u2010based chemotherapy in germ cell tumor patients 50 years of age and older"],"prefix":"10.1002","volume":"119","author":[{"given":"Darren R.","family":"Feldman","sequence":"first","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Voss","sequence":"additional","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin P.","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Andres","family":"Suarez","sequence":"additional","affiliation":[{"name":"Department of Medicine St. Luke's Roosevelt Hospital Center, Continuum Cancer Centers New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Turkula","sequence":"additional","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Sheinfeld","sequence":"additional","affiliation":[{"name":"Urology Service, Department of Surgery Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George J.","family":"Bosl","sequence":"additional","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Motzer","sequence":"additional","affiliation":[{"name":"Genitourinary Oncology Service, Department of Medicine Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Memorial Sloan\u2010Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,19]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs","author":"Eble JN","year":"2004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.024"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-10-0031"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1557988309356101"},{"key":"e_1_2_7_6_1","volume-title":"Testis","author":"American Joint Committee on Cancer","year":"2010"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.2.594"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21979"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.4.598"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)01886-1"},{"key":"e_1_2_7_11_1","first-page":"165","volume-title":"Cancer of the Testis","author":"Biggs ML","year":"2007"},{"key":"e_1_2_7_12_1","unstructured":"National Cancer Institute.Cancer of the testis (invasive) Table 25.5. 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