{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:11:09Z","timestamp":1760145069939,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Harendra Mankodi"},{"name":"Jim B. Norton, M.D."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Germ cell tumor of the testis (GCT) is a curable cancer even when it is widely metastatic; however, outcomes can differ based on tumor histology. Chemo-resistance in certain phenotypes, such as teratoma and yolk sac tumor, contributes to poor clinical outcomes in some patients with GCT. Despite this resistance to S-YSTemic therapy, many of these tumor subtypes remain amenable to surgical resection and possible cure. In this study, we report on a series of seven patients highlighting two chemo-resistant subtypes of nonseminomatous germ cell tumor (NSGCT), sarcomatoid yolk sac tumor (S-YST), and epithelioid trophoblastic tumor (ETT) for which early resection rather than additional salvage chemotherapy or high-dose intense chemotherapy might provide a superior clinical outcome and enhance cure rate.<\/jats:p>","DOI":"10.3390\/jcm13123436","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T08:45:50Z","timestamp":1718181950000},"page":"3436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Germ Cell Tumor of the Testis: Lethal Subtypes of a Curable Cancer"],"prefix":"10.3390","volume":"13","author":[{"given":"Jamaal C.","family":"Jackson","sequence":"first","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8463-7644","authenticated-orcid":false,"given":"Darren","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Johns","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1915-4491","authenticated-orcid":false,"given":"Matthew T.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6047-8431","authenticated-orcid":false,"given":"Ahmet M.","family":"Aydin","sequence":"additional","affiliation":[{"name":"Division of Urology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neriman","family":"Gokden","sequence":"additional","affiliation":[{"name":"Division of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Maraboyina","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason L.","family":"Muesse","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6027-8774","authenticated-orcid":false,"given":"John F.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis L.","family":"Pisters","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niki M.","family":"Zacharias","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles C.","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Ming","family":"Tu","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1002\/cncr.29996","article-title":"Intratumoral heterogeneity: Role of differentiation in a potentially lethal phenotype of testicular cancer","volume":"122","author":"Tu","year":"2016","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1200\/JCO.18.01608","article-title":"Impact of Teratoma on the Cumulative Incidence of Disease-Related Death in Patients with Advanced Germ Cell Tumors","volume":"37","author":"Funt","year":"2019","journal-title":"J. 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