ArticleBMC research notes2026
Barriers to cure in advanced non-seminomatous germ cell tumors: a clinical audit from a resource-limited region in India.
Article in BMC research notes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeNon-seminomatous germ cell tumors (NSGCT) are considered highly curable malignancies in developed nations. However, outcomes in low- and middle-income countries remain suboptimal, and literature describing outcomes and barriers to cure in advanced NSGCT from resource-limited settings is scarce.
methodsA retrospective analysis was conducted among patients with advanced NSGCT treated at a tertiary cancer center in central India. Primary endpoint was overall survival (OS), while secondary endpoints included progression-free survival (PFS), and treatment-related toxicity.
resultsAmong 108 evaluated patients with testicular cancer, 60% had NSGCT and 51% had advanced disease. The median age was 28 years, and the median time from symptom onset to presentation was 5.5 weeks. Disease staging revealed 9% stage IIC, 6% stage IIIA, 24% stage IIIB, and 61% stage IIIC disease. Nearly half of the patients (49%) were underweight, and 45% had hypoalbuminemia. Treatment delays and/or dose modifications occurred in 81% of patients, primarily due to treatment-related toxicities. Hematologic toxicities were frequent, including grade 3–4 anemia (23%), neutropenia (19%), and febrile neutropenia (29%). There were two treatment-related deaths. At a median follow-up of 21 months, the median PFS and OS were 8.6 months and 11.9 months, respectively. Normal body mass index (BMI) was significantly associated with improved PFS (p = 0.03) and OS (p = 0.015).
conclusionOutcomes for advanced NSGCT in this resource-limited setting were significantly inferior to those reported from high-income countries. Key contributing factors included delayed presentation, advanced disease at diagnosis, poor chemotherapy tolerance, and frequent treatment delays and dose modifications.
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