{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:47:11Z","timestamp":1773798431342,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T00:00:00Z","timestamp":1372118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2013,7]]},"abstract":"\n Objective<\/jats:title>\n \n \n \n To determine the characteristics of patients with germ cell cancer and bone metastases.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n \n \n \n The case records of patients with known germ cell tumours (\n GCTs<\/jats:styled-content>\n ) within the\n A<\/jats:styled-content>\n nglian\n G<\/jats:styled-content>\n erm\n C<\/jats:styled-content>\n ell\n C<\/jats:styled-content>\n ancer\n G<\/jats:styled-content>\n roup database between\n J<\/jats:styled-content>\n anuary 2005 and\n M<\/jats:styled-content>\n arch 2011 were reviewed retrospectively.\n <\/jats:p>\n <\/jats:list-item>\n \n Data were collected for histopathology, presence of bone metastases at diagnosis or relapse, site of bone metastases and imaging method used to confirm bone metastases, treatment received, response to treatment and overall survival.<\/jats:p>\n <\/jats:list-item>\n \n \n We present here the largest unselected cohort of bone metastases in patients with\n GCTs<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n \n In all, 2550 cases of\n GCTs<\/jats:styled-content>\n were reviewed and there was bone involvement in 19 cases.\n <\/jats:p>\n <\/jats:list-item>\n \n \n The primary site was either testicular (13\/19), mediastinal (1\/19) or unknown (5\/19). Most cases were non\u2010seminomatous\n GCTs<\/jats:styled-content>\n (11\/19, 58%) and only three cases of seminomatous\n GCTs<\/jats:styled-content>\n (3\/19, 16%) with five cases in which diagnosis was based on clinical history and significantly raised\n GCT<\/jats:styled-content>\n markers (5\/19, 26%). In all of these five cases \u03b2\u2010human chorionic gonadotrophin was raised and in three \u03b1\u2010fetoprotein was raised, consistent with non\u2010seminomatous\n GCT<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n \n There were bone metastases at diagnosis (0.51%, 13\/2550) or at relapse (0.24%, 6\/2550). The sites of bone metastases were the vertebrae (15\/19, 79%), pelvis (3\/19, 16%), ribs (3\/19, 16%) and femur (2\/19, 11%). Ten patients (53%) had solitary, and nine patients (47%) had multiple, sites of bone metastases. In patients presenting with bone metastases at diagnosis compared with relapse, the mortality rate was 23% (3\/13) and 50% (3\/6), respectively.<\/jats:p>\n <\/jats:list-item>\n \n After receiving one line of chemotherapy, nine patients (47%) remained in remission not requiring further treatment, six (32%) required further chemotherapy due to subsequent relapse, three (16%) died after first\u2010line chemotherapy and one was lost to follow\u2010up.<\/jats:p>\n <\/jats:list-item>\n \n \n At the time of data collection and based on the last clinic follow\u2010up, six patients (32%) had died with a median (interquartile range,\n IQR<\/jats:styled-content>\n ) follow\u2010up of 11.5 (4.3, 24.8) months and 10 (53%) remained alive with a median (\n IQR<\/jats:styled-content>\n ) follow\u2010up of 26 (13.5, 48) months Three patients were lost to follow\u2010up. Of the known patients alive, eight (42%) remained in remission and two (11%) had recurrent disease requiring further treatment.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n \n \n Although bone disease in germ cell cancer is rare, awareness of this condition is important and there is a need for prospective evaluation of patient characteristics, treatment approaches and survival outcome in this group of patients.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12218","type":"journal-article","created":{"date-parts":[[2013,5,9]],"date-time":"2013-05-09T06:36:00Z","timestamp":1368081360000},"page":"176-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Bone metastases in germ cell tumours: lessons learnt from a large retrospective 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