{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:26:58Z","timestamp":1769725618309,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate disease presentation, treatment practices, and outcomes of patients with germ cell tumor (GCT) treated in a high\u2010volume cancer center in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis of 609 patients diagnosed with GCT in the Sydney West Cancer Network between 1990 and 2013. Cause and date of death, and second malignancy information was sourced from The Centre for Health Record Linkage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 33 years (range, 14\u201085). Primary site was testis in 590 (96.9%), mediastinum in nine (1.5%), and retroperitoneum in nine (1.5%). History of undescended testis was present in 48 (7.9%). Pure seminoma was seen in 334 (54.8%), with 274 (82.0%) being stage I. There was a decline in use of adjuvant radiotherapy from 83% in 1990\u20101997 to 29% in 2006\u20102013. Nonseminoma GCT (NSGCT) was diagnosed in 275 (45.2%), with 162 (58.9%) being stage 1. Active surveillance has increased as the initial treatment, from 58% between 1990 and 1997 to 89% between 2006 and 2013. Metastatic disease at presentation was seen in 162 (26.6%): 55 (34.0%) seminoma and 107 (66.0%) NSGCT. With median of 15\u2010year follow\u2010up, 18 (3.0%) have died from GCT and 70 (11.5%) from all causes. Ten\u2010year overall survival was 93% and GCT\u2010specific survival was 97%. Forty patients developed a secondary malignancy, with 38 receiving chemotherapy, radiotherapy, or both.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This large Australian series illustrates a changing pattern of care and outcomes and compares them favorably with other series. This serves as a basis for future comparison of outcomes for this malignancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajco.13548","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T10:41:09Z","timestamp":1624272069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns of care and outcomes of men with germ cell tumors in a high\u2010volume Australian center"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1243-639X","authenticated-orcid":false,"given":"Malmaruha","family":"Arasaratnam","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Gosford Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bavanthi","family":"Balakrishnar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7213-900X","authenticated-orcid":false,"given":"Megan","family":"Crumbaker","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Kinghorn Cancer Centre  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Crown Princess Mary Cancer Centre Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy J","family":"Hayden","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Crown Princess Mary Cancer Centre Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Urology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Discipline of Surgery Sydney Medical School  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish I","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Urology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Discipline of Surgery Sydney Medical School  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Urology Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Woo","sequence":"additional","affiliation":[{"name":"Discipline of Surgery Sydney Medical School  Sydney New South Wales Australia"},{"name":"Chris O'Brien Lifehouse  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Bariol","sequence":"additional","affiliation":[{"name":"Department of Urology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Discipline of Surgery Sydney Medical School  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Gurney","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Crown Princess Mary Cancer Centre Westmead Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-008-9168-z"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30903-3"},{"key":"e_1_2_7_4_1","unstructured":"2018 Australian Institute of Health and Welfare Canberra Australia Australian Institute of Health and Welfare (AIHW) Cancer in Adolescents and Young Adults in Australia"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq216"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.1310"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2017.08.024"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.2.594"},{"key":"e_1_2_7_9_1","unstructured":"National ComprehensiveCancer Network (NCCN).NCCN Guidelines: Testicular Cancer.Plymouth Meeting PA:National Comprehensive Cancer Network;2018."},{"key":"e_1_2_7_10_1","unstructured":"ANZUP.ANZUP Stage I Testicular Cancer Surveillance Recommendations.Camperdown Australia:ANZUP Cancer Trials Group Limited;2016.https:\/\/www.anzup.org.au\/docview.aspx?id=492. 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