{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:23:58Z","timestamp":1791869038173,"version":"4.3.4"},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"34","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Residual lesions after chemotherapy are frequent in metastatic seminoma. Watchful waiting is recommended for lesions &lt; 3 cm as well as for fluorodeoxyglucose (FDG) positron emission tomography (PET)\u2013negative lesions \u2265 3 cm. Information on the optimal management of PET-positive residual lesions \u2265 3 cm is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We retrospectively identified 90 patients with metastatic seminoma with PET-positive residual lesions after chemotherapy. Patients with elevated \u03b1-fetoprotein or nonseminomatous histology were excluded. We analyzed the post-PET management and its impact on relapse and survival and calculated the positive predictive value (PPV) for PET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median follow-up time was 29 months (interquartile range [IQR], 10 to 62 months). Median diameter of the largest residual mass was 4.9 cm (range, 1.1 to 14 cm), with masses located in the retroperitoneum (77%), pelvis (16%), mediastinum (17%), and\/or lung (3%). Median time from the last day of chemotherapy to PET was 6.9 weeks (IQR, 4.4 to 9.9 weeks). Post-PET management included repeated imaging in 51 patients (57%), resection in 26 patients (29%), biopsy in nine patients (10%) and radiotherapy in four patients (4%). Histology of the resected specimen was necrosis in 21 patients (81%) and vital seminoma in five patients (19%). No biopsy revealed vital seminoma. Relapse or progression occurred in 15 patients (17%) after a median of 3.7 months (IQR, 2.5 to 4.9 months) and was found in 11 (22%) of 51 patients on repeated imaging, in two (8%) of 26 patients after resection, and in two (22%) of nine patients after biopsy. All but one patient who experienced relapse were successfully treated with salvage therapy. The PPV for FDG-PET was 23%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FDG-PET has a low PPV for vital tumor in residual lesions after chemotherapy in patients with metastatic seminoma. This cautions against clinical decisions based on PET positivity alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.18.00210","type":"journal-article","created":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T16:00:48Z","timestamp":1538668848000},"page":"3381-3387","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":67,"title":["Questioning the Value of Fluorodeoxyglucose Positron Emission Tomography for Residual Lesions After Chemotherapy for Metastatic Seminoma: Results of an International Global Germ Cell Cancer Group Registry"],"prefix":"10.1200","volume":"36","author":[{"given":"Richard","family":"Cathomas","sequence":"first","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Klingbiel","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Bernard","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Lorch","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Garcia del Muro","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Morelli","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Fedyanin","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Oing","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; Christoph Oing, University Medical..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege Sagstuen","family":"Haugnes","sequence":"additional","affiliation":[{"name":"Richard Cathomas, Kantonsspital Graub\u00fcnden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; J\u00f6rg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Z\u00fcrich, Z\u00fcrich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of D\u00fcsseldorf, D\u00fcsseldorf; 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