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Leendert H. J. Looijenga - One of the best experts on this subject based on the ideXlab platform.

  • predicting gonadal Germ Cell Cancer in people with disorders of sex development insights from developmental biology
    International Journal of Molecular Sciences, 2019
    Co-Authors: Leendert H. J. Looijenga, Chiasui Kao, Muhammad T Idrees
    Abstract:

    The risk of gonadal Germ Cell Cancer (GGCC) is increased in selective subgroups, amongst others, defined patients with disorders of sex development (DSD). The increased risk is due to the presence of part of the Y chromosome, i.e., GonadoBlastoma on Y chromosome GBY region, as well as anatomical localization and degree of testicularization and maturation of the gonad. The latter specifically relates to the Germ Cells present being at risk when blocked in an embryonic stage of development. GGCC originates from either Germ Cell neoplasia in situ (testicular environment) or gonadoblastoma (ovarian-like environment). These precursors are characterized by presence of the markers OCT3/4 (POU5F1), SOX17, NANOG, as well as TSPY, and cKIT and its ligand KITLG. One of the aims is to stratify individuals with an increased risk based on other parameters than histological investigation of a gonadal biopsy. These might include evaluation of defined susceptibility alleles, as identified by Genome Wide Association Studies, and detailed evaluation of the molecular mechanism underlying the DSD in the individual patient, combined with DNA, mRNA, and microRNA profiling of liquid biopsies. This review will discuss the current opportunities as well as limitations of available knowledge in the context of predicting the risk of GGCC in individual patients.

  • molecular heterogeneity and early metastatic clone selection in testicular Germ Cell Cancer development
    British Journal of Cancer, 2019
    Co-Authors: Lambert C J Dorssers, Hans Stoop, Ad J. M. Gillis, Ronald Van Marion, Marleen M Nieboer, Job Van Riet, Harmen J G Van De Werken, Wolter J Oosterhuis, Jeroen De Ridder, Leendert H. J. Looijenga
    Abstract:

    Testicular Germ Cell Cancer (TGCC), being the most frequent malignancy in young Caucasian males, is initiated from an embryonic Germ Cell. This study determines intratumour heterogeneity to unravel tumour progression from initiation until metastasis. In total, 42 purified samples of four treatment-resistant nonseminomatous (NS) TGCC were investigated, including the precursor Germ Cell neoplasia in situ (GCNIS) and metastatic specimens, using whole-genome and targeted sequencing. Their evolution was reconstructed. Intratumour molecular heterogeneity did not correspond to the supposed primary tumour histological evolution. Metastases after systemic treatment could be derived from Cancer stem Cells not identified in the primary Cancer. GCNIS mostly lacked the molecular marks of the primary NS and comprised dominant clones that failed to progress. A BRCA-like mutational signature was observed without evidence for direct involvement of BRCA1 and BRCA2 genes. Our data strongly support the hypothesis that NS is initiated by whole-genome duplication, followed by chromosome copy number alterations in the Cancer stem Cell population, and accumulation of low numbers of somatic mutations, even in therapy-resistant cases. These observations of heterogeneity at all stages of tumourigenesis should be considered when treating patients with GCNIS-only disease, or with clinically overt NS.

  • molecular heterogeneity and early metastatic clone selection in testicular Germ Cell Cancer development
    bioRxiv, 2018
    Co-Authors: Lambert C J Dorssers, Hans Stoop, Ad J. M. Gillis, Marleen M Nieboer, Wolter J Oosterhuis, Jeroen De Ridder, Ronald Van Marion, Job Van Riet, Harmen J G Van De Werken, Leendert H. J. Looijenga
    Abstract:

    Background: Testicular Germ Cell Cancer (TGCC), being the most frequent malignancy in young Caucasian males, is initiated from an embryonic Germ Cell. This study determines intratumor heterogeneity to unravel tumor progression from initiation till metastasis. Methods: In total 42 purified samples of four treatment-resistant nonseminomatous TGCC (NS) were investigated, including the precursor Germ Cell neoplasia in situ (GCNIS) and metastatic specimens, using whole genome- and targeted sequencing. Their evolution was reconstructed. Results: Intratumor molecular heterogeneity did not correspond to the supposed primary tumor histological evolution. Metastases after systemic treatment could be derived from Cancer stem Cells not identified in the primary Cancer. GCNIS mostly lacked the molecular marks of the primary NS and comprised dominant clones that failed to progress. A BRCA-like mutational signature was observed without evidence for direct involvement of BRCA1 and BRCA2 genes. Conclusions: Our data strongly support the hypothesis that NS is initiated by whole genome duplication, followed by chromosome copy number alterations in the Cancer stem Cell population, and accumulation of low numbers of somatic mutations. These observations of heterogeneity at all stages of tumorigenesis should be considered when treating patients with GCNIS-only disease, or with clinically overt NS.

  • accurate primary Germ Cell Cancer diagnosis using serum based microrna detection amptsmir test
    Oncotarget, 2017
    Co-Authors: Ton Van Agthoven, Leendert H. J. Looijenga
    Abstract:

    // Ton van Agthoven 1 and Leendert H.J. Looijenga 1 1 Department of Pathology, Josephine Nefkens Building, Erasmus MC Cancer Institute, Rotterdam, The Netherlands Correspondence to: Leendert H.J. Looijenga, email: l.looijenga@erasmusmc.nl Keywords: testicular Germ Cell Cancer, microRNA, serum biomarker, RT-qPCR, miR-371a-3p/373-3p/367-3p Received: March 02, 2016      Accepted: June 30, 2016      Published: July 27, 2016 ABSTRACT Multiple studies, including various methods and overall limited numbers of mostly heterogeneous cases, indicate that the level of embryonic stem Cell microRNAs (miRs) (e.g. 371a-3p, 372-3p, 373-3p, and 367-3p) are increased in serum at primary diagnosis of almost all testicular Germ Cell Cancer (TGCC). Here we determine the status of three of these miRs in serum samples of 250 TGCC patients, collected at time of primary diagnosis, compared with 60 non-TGCC patients and 104 male healthy donors. The levels of miRs were measured by the robust ampTSmiR test, including magnetic bead-based miR isolation and target specific pre-amplification followed by real-time quantitative PCR (RT-qPCR) detection. Calibration is performed based on the non-human spike-in ath-miR-159a, and normalization on the endogenous control miR-30b-5p. The serum levels of miR-371a-3p, 373-3p, and 367-3p are informative to accurately detect TGCC patients, both seminomas and non-seminomas, at the time of primary diagnosis ( p < 0.000). Receiver Operating Characteristic (ROC) analysis demonstrate that the Area Under the Curve (AUC) for miR-371a-3p is 0.951 (being 0.888 for miR-373-3p and 0.861 for miR-367-3p), with a sensitivity of 90%, and a specificity of 86% (positive predictive value of 94% and negative predictive value of 79%). Inclusion of miR-373-3p and 367-3p resulted in a AUC of 0.962, with a 90% sensitivity and 91% specificity. Similar results were obtained using the raw Ct data. Importantly, the results demonstrate that ampTSmiR is not suitable to detect pure teratoma as well as the precursor of TGCC, i.e., Germ Cell Neoplasia In Situ (GCNIS). The largest series evaluated so far, demonstrate that detection of the embryonic stem Cell miR-371a-3p, 373-3p and 367-3p is highly informative to diagnose patients with a primary TGCC.

  • cripto expression epigenetic regulation and potential diagnostic use in testicular Germ Cell tumors
    Molecular Oncology, 2016
    Co-Authors: Cassy M Spiller, Josephine Bowles, Guillaume Burnet, Hans Stoop, Peter Koopman, Ad J. M. Gillis, Leendert H. J. Looijenga
    Abstract:

    Type II Germ Cell tumors arise after puberty from a Germ Cell that was incorrectly programmed during fetal life. Failure of testicular Germ Cells to properly differentiate can lead to the formation of Germ Cell neoplasia in situ of the testis; this precursor Cell invariably gives rise to Germ Cell Cancer after puberty. The Nodal co-receptor Cripto is expressed transiently during normal Germ Cell development and is ectopically expressed in non-seminomas that arise from Germ Cell neoplasia in situ, suggesting that its aberrant expression may underlie Germ Cell dysregulation and hence Germ Cell Cancer. Here we investigated methylation of the Cripto promoter in mouse Germ Cells and human Germ Cell Cancer and correlated this with the level of CRIPTO protein expression. We found hypomethylation of the CRIPTO promoter in undifferentiated fetal Germ Cells, embryonal carcinoma and seminomas, but hypermethylation in differentiated fetal Germ Cells and the differentiated types of non-seminomas. CRIPTO protein was strongly expressed in Germ Cell neoplasia in situ along with embryonal carcinoma, yolk sac tumor and seminomas. Further, cleaved CRIPTO was detected in media from seminoma and embryonal carcinoma Cell lines, suggesting that cleaved CRIPTO may provide diagnostic indication of Germ Cell Cancer. Accordingly, CRIPTO was detectable in serum from 6/15 patients with embryonal carcinoma, 5/15 patients with seminoma, 4/5 patients with Germ Cell neoplasia in situ Cells only and in 1/15 control patients. These findings suggest that CRIPTO expression may be a useful serological marker for diagnostic and/or prognostic purposes during Germ Cell Cancer management.

Jorg Beyer - One of the best experts on this subject based on the ideXlab platform.

  • esmo consensus conference on testicular Germ Cell Cancer diagnosis treatment and follow up
    Annals of Oncology, 2018
    Co-Authors: Friedemann Honecker, Gedske Daugaard, Carsten Bokemeyer, Jorg Beyer, Richard Cathomas, Noel W Clarke, Daniel M Berney, Jorge Aparicio, Gabriella Cohncedermark, Kp Dieckmann
    Abstract:

    The European Society for Medical Oncology (ESMO) consensus conference on testicular Cancer was held on 3-5 November 2016 in Paris, France. The conference included a multidisciplinary panel of 36 leading experts in the diagnosis and treatment of testicular Cancer (34 panel members attended the conference; an additional two panel members [CB and K-PD] participated in all preparatory work and subsequent manuscript development). The aim of the conference was to develop detailed recommendations on topics relating to testicular Cancer that are not covered in detail in the current ESMO Clinical Practice Guidelines (CPGs) and where the available level of evidence is insufficient. The main topics identified for discussion related to: (1) diagnostic work-up and patient assessment; (2) stage I disease; (3) stage II-III disease; (4) post-chemotherapy surgery, salvage chemotherapy, salvage and desperation surgery and special topics; and (5) survivorship and follow-up schemes. The experts addressed questions relating to one of the five topics within five working groups. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel. A consensus vote was obtained following whole-panel discussions, and the consensus recommendations were then further developed in post-meeting discussions in written form. This manuscript presents the results of the expert panel discussions, including the consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.

  • maintaining success reducing treatment burden focusing on survivorship highlights from the third european consensus conference on diagnosis and treatment of Germ Cell Cancer
    Annals of Oncology, 2013
    Co-Authors: Jorg Beyer, C Bokemeyer, J Aparicio, P Albers, Renske Altena, Jonas Busch, Richard Cathomas, Eva Cavallinstahl, Noel W Clarke, J Clasen
    Abstract:

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of Germ-Cell Cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, similar to 50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

  • review testis Cancereuropean consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    OBJECTIVES: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. METHODS: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. RESULTS: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. CONCLUSIONS: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. Methods: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. Results: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Richard S Foster - One of the best experts on this subject based on the ideXlab platform.

  • survival of good risk Germ Cell tumor patients following post chemotherapy retroperitoneal lymph node dissection the effect of bleomycin during induction chemotherapy
    Journal of Clinical Oncology, 2014
    Co-Authors: Clint K Cary, Lawrence H. Einhorn, Jose A Pedrosa, Hristos Z Kaimakliotis, Timothy A Masterson, Richard S Foster
    Abstract:

    4565 Background: Patients presenting with metastatic International Germ Cell Cancer Collaborative Group (IGCCCG) good risk testicular Cancer may receive either 4 cycles of etoposide and cisplatin (EP) or 3 cycles of bleomycin, etoposide, and cisplatin (BEP). Those with residual retroperitoneal masses following either of these induction chemotherapy regimens will require a post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND). We sought to examine differences in survival following PC-RPLND between patients receiving EPx4 compared to BEPx3. Methods: The Indiana University Testis Cancer database was queried to identify IGCCCG good risk PC-RPLND patients who received either EPx4 or BEPx3 induction chemotherapy. The primary outcome was overall survival (OS). Kaplan-Meier plots were generated for the EPx4 and BEPx3 groups and compared using the log-rank test. Survival time was calculated from the date of surgery until date of death or the last date the social security death index was accessed. Resu...

  • predicting retroperitoneal histology in postchemotherapy testicular Germ Cell Cancer a model update and multicentre validation with more than 1000 patients
    European Urology, 2007
    Co-Authors: Yvonne Vergouwe, Dirk Sleijfer, Richard S Foster, Ronald De Wit, Ewout W Steyerberg, Sophie D Fossa, A Gerl, Trevor J Roberts, Dik J F Habbema
    Abstract:

    Abstract Objectives Surgical resection of postchemotherapy retroperitoneal lymph nodes is often performed in patients with advanced nonseminomatous testicular Germ Cell Cancer. We previously developed a model to predict the probability that the lymph nodes contain only necrotic or fibrotic (benign) tissue versus mature teratoma and viable Cancer (tumour) to identify patients who actually need resection. The present study used an updated model with new patient data and studied the validity of the updated model across various settings. Methods We combined data of 544 patients from the original model with data of 550 new patients and performed a new logistic regression analysis, which included the same six predictors: histology of the primary tumour, prechemotherapy serum levels of α-fetoprotein, human chorionic gonadotropin, lactate dehydrogenase, residual mass size measured on computed tomography, and change in mass size. The validity of the updated model was studied in individual centres. Calibration of the predicted probabilities was assessed graphically and with the Hosmer-Lemeshow test. Discrimination was studied with the concordance ( c )-statistic. Results The updated model had slightly different, although more precise, regression coefficients. Statistically nonsignificant Hosmer-Lemeshow tests confirmed good calibration in most centres. The c -statistic for all centres except one exceeded 0.80. The updated model was valid over the complete range of predicted probabilities across a broad spectrum of centres. Conclusions This finding gives confidence in the applicability of the model to select patients for resection, particularly patients with small residual masses and low predicted probabilities of benign tissue (i.e., substantial predicted risks of residual tumour).

  • outcome analysis for patients with elevated serum tumor markers at postchemotherapy retroperitoneal lymph node dissection
    Journal of Clinical Oncology, 2005
    Co-Authors: Stephen D W Beck, Lawrence H. Einhorn, Richard S Foster, Richard Bihrle, John P Donohue
    Abstract:

    Purpose To evaluate the therapeutic benefit of postchemotherapy retroperitoneal lymph node dissection (PCRPLND) in patients with persistently elevated serum tumor markers. Patients and Methods One hundred fourteen patients with metastatic Germ Cell Cancer with elevated serum tumor markers after first-line (50 patients) or second-line chemotherapy (64 patients) who underwent PCRPLND between 1977 and 2000 with a minimum follow-up of 2-years were included in this retrospective study. Results The 5-year overall survival was 53.9%. Sixty-one patients (53.5%) are alive with a medium follow-up of 72 months. Fifty-three patients died of disease, with a medium time to death of 8.0 months. Mean preoperative serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (βHCG) levels were 483 ng/mL and 555 mU/mL, respectively, with no difference in 5-year survival (P = .2). Retroperitoneal pathology revealed Germ Cell Cancer in 53.5% of patients, teratoma in 34.2% of patients, and fibrosis in 12.2% of patients,...

  • a benign para aortic lymph node of histologically proved follicular hyperplasia mimicking metastatic Germ Cell Cancer
    The Journal of Urology, 2000
    Co-Authors: Stephen D W Beck, Thomas M Ulbright, Richard S Foster
    Abstract:

    Follicular hyperplasia of the Germinal centers of lymph nodes is a well-known response to infection, inflammation and immunodeficiency. We report on a man with testicular Cancer that was radiographically staged B2 because of a 3 cm. left para-aortic lymph node that histologically proved to be follicular hyperplasia. Over staging of Germ Cell tumors persists despite newer generation computerized tomography (CT) scanners.

  • delayed orchiectomy after chemotherapy for metastatic nonseminomatous Germ Cell tumors
    The Journal of Urology, 1996
    Co-Authors: Ilan Leibovitch, Richard S Foster, Samuel J Little, Randall G Rowland, Richard Bihrle, John P Donohue
    Abstract:

    AbstractPurpose: We reviewed current experience at our university with delayed orchiectomy after chemotherapy in patients with metastatic nonseminomatous Germ Cell tumors.Materials and Methods: We retrospectively analyzed the records of 160 patients with metastatic Germ Cell Cancer who were given systemic chemotherapy, and subsequently underwent orchiectomy and retroperitoneal lymph node dissection.Results: Analysis of 160 testicular specimens revealed necrosis or scar in 70 (43.7 percent), pure teratoma in 50 (31.2 percent) and persistent Germ Cell Cancer in 40 (25 percent). Corresponding incidences of histopathological findings in the post-chemotherapy retroperitoneal lymph node dissection specimens were significantly different, correlating with less than half of the cases (chi-square, p = 0.002).Conclusions: Our study confirms the need for delayed orchiectomy after systemic chemotherapy even when there seems to be a partial or complete clinical response at other sites.

Eva Cavallinstahl - One of the best experts on this subject based on the ideXlab platform.

  • maintaining success reducing treatment burden focusing on survivorship highlights from the third european consensus conference on diagnosis and treatment of Germ Cell Cancer
    Annals of Oncology, 2013
    Co-Authors: Jorg Beyer, C Bokemeyer, J Aparicio, P Albers, Renske Altena, Jonas Busch, Richard Cathomas, Eva Cavallinstahl, Noel W Clarke, J Clasen
    Abstract:

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of Germ-Cell Cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, similar to 50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

  • review testis Cancereuropean consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    OBJECTIVES: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. METHODS: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. RESULTS: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. CONCLUSIONS: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. Methods: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. Results: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  • linkage between androgen receptor gene cag trinucleotide repeat length and testicular Germ Cell Cancer histological type and clinical stage
    European Journal of Cancer, 2004
    Co-Authors: Aleksander Giwercman, Eva Cavallinstahl, Kristina Lundin, Jakob Eberhard, Olof Stahl, Magdalena Cwikiel, Yvonne Lundberg Giwercman
    Abstract:

    Sex hormones and/or gonadotropins may play a crucial role in the development of testicular Germ Cell Cancer (TGCC). A direct link between this malignancy and endocrine factors has not been confirmed. We tested whether CAG and GGN repeats of the androgen receptor gene (AR) play a role in the aetiology or pathogenesis of TGCC. Eighty-three TGCC patients and 220 controls were included. Mean CAG or GGN lengths did not differ between the TGCC cases and controls. The proportion of males with CAG lengths above 25, indicative of reduced androgen sensitivity, was significantly lower among patients with pure seminomas and in the combined group of seminomas and mixed tumours compared with non-seminomas and controls. The median CAG length was higher if the tumour was metastasing at diagnosis. This is the first study showing an association between the AR polymorphism and histological type as well as the progression rate of TGCC.

P Albers - One of the best experts on this subject based on the ideXlab platform.

  • maintaining success reducing treatment burden focusing on survivorship highlights from the third european consensus conference on diagnosis and treatment of Germ Cell Cancer
    Annals of Oncology, 2013
    Co-Authors: Jorg Beyer, C Bokemeyer, J Aparicio, P Albers, Renske Altena, Jonas Busch, Richard Cathomas, Eva Cavallinstahl, Noel W Clarke, J Clasen
    Abstract:

    In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of Germ-Cell Cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of Germ-Cell Cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues. The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, similar to 50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.

  • randomized phase iii study comparing paclitaxel bleomycin etoposide and cisplatin bep to standard bep in intermediate prognosis Germ Cell Cancer intergroup study eortc 30983
    Journal of Clinical Oncology, 2012
    Co-Authors: Ronald De Wit, Gedske Daugaard, P Albers, Iwona Skoneczna, Maria De Santis, August Garin, Nina Aass, Alfred J Witjes, Jeffery D White, Jose Ramon Germalluch
    Abstract:

    Purpose To compare the efficacy of four cycles of paclitaxel‐bleomycin, etoposide, and cisplatin (T-BEP) to four cycles of bleomycin, etoposide, and cisplatin (BEP) in previously untreated patients with intermediateprognosis Germ-Cell Cancer (GCC). Patients and Methods Patients were randomly assigned to receive either T-BEP or standard BEP. Patients assigned to the T-BEP group received paclitaxel 175 mg/m 2 in a 3-hour infusion. Patients who were administered T-BEP received primary granulocyte colony-stimulating factor (G-CSF) prophylaxis. The study was designed as a randomized open-label phase II/III study. To show a 10% improvement in 3-year progression-free survival (PFS), the study aimed to recruit 498 patients but closed with 337 patients as a result of slow accrual.

  • review testis Cancereuropean consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    OBJECTIVES: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. METHODS: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. RESULTS: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. CONCLUSIONS: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged.

  • european consensus conference on diagnosis and treatment of Germ Cell Cancer a report of the second meeting of the european Germ Cell Cancer consensus group egcccg part i
    European Urology, 2008
    Co-Authors: Susanne Krege, Carsten Bokemeyer, Jorg Beyer, P Albers, Rainer Souchon, Walter Albrecht, Ferran Algaba, M Bamberg, Istvan Bodrogi, Eva Cavallinstahl
    Abstract:

    Objectives: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. Methods: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. Results: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular Cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with Germ Cell Cancer. In addition, the particular needs of testicular Cancer survivors have been acknowledged. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.