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Standardized Treatment Improves Outcomes in Germ Cell Tumors

MONDAY, Aug. 10, 2020 -- Clinical outcomes are similar for patients receiving standardized treatment for germ cell tumors (GCTs) at a public safety net hospital or an academic tertiary care center, according to a study published online Aug. 10 in Cancer.

Nathan Chertack, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues analyzed GCT patients treated at a public safety net hospital and an academic tertiary care center in the same metropolitan area (106 and 95 patients, respectively); the same group of physicians managed both institutions.

The researchers found that patients at the safety net hospital were younger and more likely to be Hispanic, be uninsured, present via the emergency department, and have metastatic disease. For stage I patients, an absence of lymphovascular invasion and an embryonal carcinoma component was associated with reduced adjuvant treatment use (odds ratios, 0.30 [95 percent confidence interval, 0.12 to 0.73; P = 0.008] and 0.36 [95 percent confidence interval, 0.15 to 0.84; P = 0.02] respectively); there was no association observed for hospital setting (odds ratio, 0.67; 95 percent confidence interval, 0.18 to 2.48; P = 0.55). No difference was seen in the performance of postchemotherapy retroperitoneal lymph node dissection between the safety net hospital and the tertiary care center for patients with stage II/III nonseminomatous GCTs (52 versus 64 percent). Recurrence rates did not differ between the cohorts (5 versus 6 percent).

"The integrated care of safety net patients at our high-volume academic center appears to offer equivalent cancer-specific outcomes, regardless of care site," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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Posted: August 2020

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