Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis

The International Germ Cell Consensus (IGCC) Classification distinguishes patients with non-seminomatous germ cell tumours (NSGCT) with a good, intermediate or poor prognosis, with a reported 5-year overall survival of 92%, 80% and 48%, respectively. Since the IGCC classification was based on patients treated between 1975 and 1990, we aimed to investigate whether survival has improved for more recently treated patients. We did a systematic search of the literature and included studies on survival of patients with NSGCT, treated after 1989 and classified according to the IGCC classification. Survival estimates of selected studies were pooled using meta-analytic techniques. We included 10 papers, describing 1775 patients with NSGCT with good (n = 1087), intermediate (n = 232), or poor (n = 456) prognosis. Pooled 5-year survival estimates were 94%, 83% and 71%, respectively. Since the publication of the IGCC classification, there was a small increase in survival for good and intermediate prognosis patients, and a large increase in survival for patients with a poor prognosis. This increase is most likely due to both more effective treatment strategies and more experience in treating NSGCT patients.