Testicular germ cell tumours in Iceland: a nationwide clinicopathological study.
The purpose of this study was to examine the pathology of all germ cell tumours of the testis diagnosed in Iceland 1955-2002. A total of 214 patients were included in the study. The current age-standardized incidence was found to be 6.1 per 100,000 and had increased almost fourfold during the study period. Seminoma was diagnosed in 55% of cases. Non-seminomas were diagnosed in 45%, and these were further classified as mixed germ cell tumours (33%), embryonal carcinoma (8%), teratoma (3%), and yolk sac tumour (n=1). The mean age at diagnosis was significantly higher for the seminomas than the non-seminomas (38 years versus 29 years) (p<0.001) and the non-seminomas were diagnosed at a significantly higher stage than the seminomas (p<0.001). Thus, in seminoma patients the tumour was localized to the testis (stage I) in 81% of cases, in 17% of patients the tumour had spread to the lymph nodes (stage II or III), and only 2% had extranodal metastasis at diagnosis (stage IV). In contrast, in the non-seminoma patients, the tumours were found to be stage I in 56%, stage II or III in 24%, and stage IV in 20% of cases. No significant difference in staging was found between non-seminoma subtypes. Identification of necrosis or vascular invasion was significantly associated with metastatic disease at diagnosis (p=0.002). During the study period a significant increase in stage I tumours was found as well as a decrease in the size of the tumours.
Agnarsson
Bjarni A
BA
Department of Pathology, Landspitali-University Hospital, Reykjavik, Iceland. bjarniaa@landspitali.is
Gudbjartsson
Tomas
T
Einarsson
Gudmundur Vikar
GV
Magnusson
Kjartan
K
Thoroddsen
Asgeir
A
Bergthorsson
Jon Thor
JT
Amundadottir
Laufey
L
Barkardottir
Rosa B
RB
Björnsson
Johannes
J
D000328:Adult; D002675:Child, Preschool; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology