Analysis of clinical-pathologic variables, staging and prognostic groups, and therapeutic results of 106 germ-cell testicular tumors.
OBJECTIVE
Retrospective review of 106 germ-cell testicular tumors treated in our center between 1992 and 2009.


METHODS
Description and analysis of several clinical-pathologic and prognostic variables and survival analysis.


RESULTS
68% of our patients were diagnosed in the last 5 years. 54.7% presented seminoma histology. The mean age at diagnosis was 33.47 for the seminoma (S) and 27.63 for non seminoma (NS), p=0,001. The median tumoral size in mm was 45.99mm (globally). 44.3% presented elevation of at least one tumor marker; Alpha-fetoprotein (AFP) or Human chorionic gonadotropin (HCG) .29.3% in the S and 60.4% in NS; p=0.02. The percentage of patients with increased HCG in S was 29.3% and 52.1% in NS; p=0.017 and AFP was elevated in 5.2% of S and 45.8% of NS; P <0.001. Accordingly to the classification of The Royal Marsden Hospital 96.5% of S and 83.2% of NS were diagnosed in stage I-II. Using the classification of the International Germ Cell Cancer Collaborative Group (IGCCG) for patients with advanced disease, 98.2% of S and 83.2% of NS belonged to the good prognostic group. Regarding the risk factors for relapse in stage I S (Rete testis invasion (RTI) and tumoral size (TS)> 4cm) 28% of our patients presented both risk factors. 18% of stage I NS presented vascular (VI) or lymphatic invasion (LI). Following the treatment protocols in consideration with the histology, stage and risk factors, 100% of stage I S with both risk factors and 100% of NS with vascular or lymphatic invasion received adjuvant therapy. Almost all the stage II-IV S and NS received different protocols of chemotherapy. In 2.8% of stage II NS a retroperitoneal lymph node dissection was performed. Residual tumor resection was documented in eight patients with stage II-IV NS. With a median follow-up of 60 months, the event free survival (EFS) was 93.3%.


CONCLUSIONS
Our study has similar characteristics compared to other studies.
Urology Department, Hospital Principe de Asturias, Madrid, Spain.
Angeles Sanchís
AS
Bonet
Eva Golmayo
EG
Muñoz-Delgado
Francisco José Ortiz
FJ
Vico
Juan Carlos Tamayo
JC
Ruiz
Manuel Sánchez
MS
Chapado
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D059186:Chemoradiotherapy, Adjuvant; D016001:Confidence Intervals; D003456:Cryptorchidism / Q000473:pathology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D009919:Orchiectomy; D011379:Prognosis; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
D014408:Biomarkers, Tumor