Abstract
Abstract only 401 Background: Pure choriocarcinoma (PC) is a very rare entity and the most aggressive subtype of nonseminomatous germ cell tumor. There is limited published data regarding treatment outcomes in this group of patients. In this series, we report our experience of sixteen patients treated at a single cancer center. Methods: The hospital tumor registry was utilized to retrospectively identify patients with the diagnosis of testicular cancer between 1997-2011. Clinical pathological, radiographic, treatment, and outcome data were retrospectively reviewed and descriptive statistical analysis was performed. Results: Sixteen patients were identified containing choriocarcinoma as component in 120 testicular cancer patients. Four patients (3.3%) had PC and twelve (10%) had mixed choriocarcinoma (MC). The median age of entire cohort was 25 years (range 21–41). Patients with PC was younger (p < 0.001); more advanced stage (IIIC stage 100% vs. 41.7%; p < 0.001), higher rate of lung metastasis (100% vs. 12%; p < 0.001), higher rate of brain metastasis (70% vs. 16.7%; p < 0.001), received more aggressive therapies: RPLND (50% vs. 33.3%; p < 0.001); >2 lines chemotherapy (75% vs. 16.7%; p < 0.001); high dose chemotherapy with stem cell transplant (HDCT) (50% vs. 8.3%; p < 0.001); in comparison with patients with MC. All four PC patients (100%) were classified as poor risk group at diagnosis according to the IGCCCG prognostic classification system. One PC patient died before receiving any therapy, three had standard first and second line chemotherapies (BEP and viep). Two PC patients underwent HDCT (one as third and another as fourth line). One PC patient had pulmonary resection of chemo-resistant disease after HDCT with long term survival. At a median follow-up of 40 months (range 0.2 - 189), three PC (75%) and two MC (16.7%) patients have died in last follow-up. Three-year survival was 25% and 80% in PC and MC, respectively. Conclusions: PC is associated with advanced disease and high rate of pulmonary and brain metastases. The prognoses of these patients remain poor despite of receiving more aggressive therapy, in comparison with patients with MC. Novel therapeutic strategies are urgently needed for patients with this rare cancer.