Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration
(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressi...
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MDPI AG
2024-11-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/31/12/551 |
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| author | Gianluca Scalia Gianluca Ferini Zubayer Shams Francesca Graziano Giancarlo Ponzo Eliana Giurato Maria Grazia Galasso Vitalinda Pumo Martina Caruso Gianluca Galvano Salvatore Marrone Jessica Naimo Giovanni Federico Nicoletti Giuseppe Emmanuele Umana |
| author_facet | Gianluca Scalia Gianluca Ferini Zubayer Shams Francesca Graziano Giancarlo Ponzo Eliana Giurato Maria Grazia Galasso Vitalinda Pumo Martina Caruso Gianluca Galvano Salvatore Marrone Jessica Naimo Giovanni Federico Nicoletti Giuseppe Emmanuele Umana |
| author_sort | Gianluca Scalia |
| collection | DOAJ |
| description | (1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course. Spinal metastases, while rare, pose significant challenges due to their potential to cause spinal cord compression, neurological deficits, and severe pain. This systematic review aims to evaluate prognosis and treatment approaches for spinal metastases in NSGCT, with a focus on multidisciplinary care and treatment outcomes. (2) Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, and Embase were searched on 18 September 2024, using the Boolean search strategy [(Nonseminomatous germ cell tumor (NSGCT) AND (spinal OR vertebral metastases)]. Case reports, case series, and cohort studies providing detailed patient data were included. Data on patient demographics, tumor histology, metastatic site, treatments, and outcomes were extracted for analysis. (3) Results: A total of 164 cases of NSGCT with spinal metastases were analyzed, with patients aged 23 to 40 years (median: 31.5 years). The lumbar spine was involved in all cases, and spinal cord compression occurred in 59.8% of patients, often causing severe neurological symptoms such as cauda equina syndrome. Chemotherapy, primarily cisplatin-based, was administered in all cases, while surgical interventions, including laminectomy and vertebrectomy, were performed in cases of spinal compression and instability. Complete remission occurred in only 2.4% of patients. Progressive improvement was observed in 56.7% of cases, while 20.1% of patients died. Outcomes varied, highlighting the importance of individualized, multidisciplinary care to manage both systemic and localized disease. (4) Conclusions: Spinal metastases in NSGCT represent a complex clinical scenario, requiring a combination of chemotherapy, surgery, and in some cases, radiotherapy. Chemotherapy remains essential, but surgery is critical for addressing spinal compression and instability. A multidisciplinary approach is vital for optimizing outcomes, as prognosis is variable, with some patients achieving improvement while others face progressive disease or death. Further research is needed to refine the role of radiotherapy and improve long-term treatment strategies for this rare complication. |
| format | Article |
| id | doaj-art-d3f86d9a3d254d50a6470c4211317b9c |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-d3f86d9a3d254d50a6470c4211317b9c2024-12-27T14:19:57ZengMDPI AGCurrent Oncology1198-00521718-77292024-11-0131127459747510.3390/curroncol31120551Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case IllustrationGianluca Scalia0Gianluca Ferini1Zubayer Shams2Francesca Graziano3Giancarlo Ponzo4Eliana Giurato5Maria Grazia Galasso6Vitalinda Pumo7Martina Caruso8Gianluca Galvano9Salvatore Marrone10Jessica Naimo11Giovanni Federico Nicoletti12Giuseppe Emmanuele Umana13Neurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, 95124 Catania, ItalyDepartment of Medicine and Surgery, Kore University of Enna, 94100 Enna, ItalyBrunel Medical School, Brunel University London, Uxbridge, London UB8 3PH, UKNeurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, 95124 Catania, ItalyNeurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, 95124 Catania, ItalyAnatomic Pathology Unit, Garibaldi Hospital, 95124 Catania, ItalyAnatomic Pathology Unit, Garibaldi Hospital, 95124 Catania, ItalyOncology Unit, Garibaldi Hospital, 95124 Catania, ItalyOncology Unit, Garibaldi Hospital, 95124 Catania, ItalyDepartment of Diagnostic Imaging, Interventional Radiology and Neuroradiology, Garibaldi Hospital, 95124 Catania, ItalyDepartment of Neurosurgery, Sant’ Elia Hospital, 93100 Caltanissetta, ItalyPain Therapy and Palliative Care Unit, ASP 7 Ragusa, 97100 Ragusa, ItalyNeurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, 95124 Catania, ItalyDepartment of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course. Spinal metastases, while rare, pose significant challenges due to their potential to cause spinal cord compression, neurological deficits, and severe pain. This systematic review aims to evaluate prognosis and treatment approaches for spinal metastases in NSGCT, with a focus on multidisciplinary care and treatment outcomes. (2) Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, and Embase were searched on 18 September 2024, using the Boolean search strategy [(Nonseminomatous germ cell tumor (NSGCT) AND (spinal OR vertebral metastases)]. Case reports, case series, and cohort studies providing detailed patient data were included. Data on patient demographics, tumor histology, metastatic site, treatments, and outcomes were extracted for analysis. (3) Results: A total of 164 cases of NSGCT with spinal metastases were analyzed, with patients aged 23 to 40 years (median: 31.5 years). The lumbar spine was involved in all cases, and spinal cord compression occurred in 59.8% of patients, often causing severe neurological symptoms such as cauda equina syndrome. Chemotherapy, primarily cisplatin-based, was administered in all cases, while surgical interventions, including laminectomy and vertebrectomy, were performed in cases of spinal compression and instability. Complete remission occurred in only 2.4% of patients. Progressive improvement was observed in 56.7% of cases, while 20.1% of patients died. Outcomes varied, highlighting the importance of individualized, multidisciplinary care to manage both systemic and localized disease. (4) Conclusions: Spinal metastases in NSGCT represent a complex clinical scenario, requiring a combination of chemotherapy, surgery, and in some cases, radiotherapy. Chemotherapy remains essential, but surgery is critical for addressing spinal compression and instability. A multidisciplinary approach is vital for optimizing outcomes, as prognosis is variable, with some patients achieving improvement while others face progressive disease or death. Further research is needed to refine the role of radiotherapy and improve long-term treatment strategies for this rare complication.https://www.mdpi.com/1718-7729/31/12/551non-seminomatousgerm cell tumorstesticularmetastasesspinechemotherapy |
| spellingShingle | Gianluca Scalia Gianluca Ferini Zubayer Shams Francesca Graziano Giancarlo Ponzo Eliana Giurato Maria Grazia Galasso Vitalinda Pumo Martina Caruso Gianluca Galvano Salvatore Marrone Jessica Naimo Giovanni Federico Nicoletti Giuseppe Emmanuele Umana Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration Current Oncology non-seminomatous germ cell tumors testicular metastases spine chemotherapy |
| title | Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration |
| title_full | Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration |
| title_fullStr | Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration |
| title_full_unstemmed | Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration |
| title_short | Spinal Metastases in Non-Seminomatous Germ Cell Testicular Tumors: Prognosis and Integrated Therapeutic Approaches—A Systematic Review with an Institutional Case Illustration |
| title_sort | spinal metastases in non seminomatous germ cell testicular tumors prognosis and integrated therapeutic approaches a systematic review with an institutional case illustration |
| topic | non-seminomatous germ cell tumors testicular metastases spine chemotherapy |
| url | https://www.mdpi.com/1718-7729/31/12/551 |
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