ArticleCancer2016
Intratumoral heterogeneity: Role of differentiation in a potentially lethal phenotype of testicular cancer.
Article in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 44 citations in OpenAlex.
- Preoperative contrast-enhanced computed tomography-based radiomics model for overall survival prediction in hepatocellular carcinoma.World journal of gastroenterology · 2022Trial
- Yolk Sac Elements in Tumors Derived from Pluripotent Stem Cells: Borrowing Knowledge from Human Germ Cell Tumors.International journal of molecular sciences · 2025Review
- Cancer immune evasion, immunoediting and intratumour heterogeneity.Nature reviews. Immunology · 2025Review
- Article
- Germ Cell Tumor of the Testis: Lethal Subtypes of a Curable Cancer.Journal of clinical medicine · 2024Article
- Intratumoral Heterogeneity, Chemoresistance and Lymph Node Landing Zone Prognosis in Testicular Tumors Based on Histopathological Characteristics.Annals of surgical oncology · 2024Article
- Administration of a glypican-3 peptide increases the infiltration and cytotoxicity of CD8Cancer medicine · 2023Article
- Stem Cell Theory of Cancer: Clinical Implications of Epigenomic versus Genomic Biomarkers in Cancer Care.Cancers · 2023Article
- Stem Cell Origin of Cancer: Clinical Implications for Cancer Immunity and Immunotherapy.Cancers · 2023Article
- Artificial Intelligence and Precision Medicine: A New Frontier for the Treatment of Brain Tumors.Life (Basel, Switzerland) · 2022Review
- Stem Cell Theory of Cancer: Implications for Translational Research from Bedside to Bench.Cancers · 2022Article
- Article
- Article
- Integrated Molecular Analysis Reveals 2 Distinct Subtypes of Pure Seminoma of the Testis.Cancer informatics · 2022Article
- Article
- Curing Cancer: Lessons from a Prototype.Cancers · 2021Article
- Application of a Successful Germ Cell Tumor Paradigm to the Challenges of Common Adult Solid Cancers.Journal of cell science & therapy · 2021Article
- Origin of Subsequent Malignant Neoplasms in Patients with History of Testicular Germ Cell Tumor.Cancers · 2020Article
- Establishment and characterisation of testicular cancer patient-derived xenograft models for preclinical evaluation of novel therapeutic strategies.Scientific reports · 2020Article
- Paraneoplastic Limbic Encephalitis in a Patient with Primary Well-differentiated Teratoma and Metastatic Poorly Differentiated Embryonal Carcinoma.The Yale journal of biology and medicine · 2020Article
Corrections and comments
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Authors and funding
19 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIntratumoral heterogeneity presents a major obstacle to the widespread implementation of precision medicine. The authors assessed the origin of intratumoral heterogeneity in nonseminomatous germ cell tumor of the testis (NSGCT) and identified distinct tumor subtypes and a potentially lethal phenotype.
methodsIn this retrospective study, all consecutive patients who had been diagnosed with an NSGCT between January 2000 and December 2010 were evaluated. The histologic makeup of primary tumors and the clinical course of disease were determined for each patient. A Fine and Gray proportional hazards regression analysis was used to determine the prognostic risk factors, and the Gray test was used to detect differences in the cumulative incidence of cancer death. In a separate prospective study, next-generation sequencing was performed on tumor samples from 9 patients to identify any actionable mutations.
resultsSix hundred fifteen patients were included in this study. Multivariate analysis revealed that the presence of yolk sac tumor in the primary tumor (P = .0003) was associated with an unfavorable prognosis. NSGCT could be divided into 5 subgroups. Patients in the yolk sac-seminoma subgroup had the poorest clinical outcome (P = .0015). These tumors tended to undergo somatic transformation (P < .0001). Among the 9 NSGCTs that had a yolk sac tumor phenotype, no consistent gene mutation was detected.
conclusionsThe current data suggest that intratumoral heterogeneity is caused in part by differentiation of pluripotent progenitor cells. Integrated or multimodal therapy may be effective at addressing intratumoral heterogeneity and treating distinct subtypes as well as a potentially lethal phenotype of NSGCT. Cancer 2016;122:1836-43. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.