AUA 2016: Survival outcomes of adolescent patients with non-seminoma testicular germ cell tumors: A population based study - Session Highlights

San Diego, CA USA ( A very interesting podium presentation was presented in today’s sexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I session at the AUA 2016 that described the SURVIVAL OUTCOMES OF ADOLESCENT PATIENTS WITH NON-SEMINOMA TESTICULAR GERM CELL TUMORS.

Dr. Nicholas Cost Testicular germ cell tumors (TGCT) are the most common solid malignancy in adolescent and young adult men. In adolescents, approximately 90% of TGCTs are non-seminomas (NS). Very few data exists on the impact of age, specifically adolescence, on outcomes of NS TGCTs. The authors were interested in this specific cohort of young patients. They examined The SEER database for individuals ≥13yr diagnosed with NS TGCTs from 1995-2012. Patients were categorized into adolescent (13-19yr) and adult (≥ 20yr) cohorts. A Cox proportional hazards model was used for multivariate analysis (MVA). 13,964 patients (1,496 adolescents, 12,467 adults) were included. Median follow up ranged from 1-215 months. 5yr OS and CSS for adolescent and adult patients was 94% VS 92% and 95% VS 94% respectively. Multivariable analysis revealed improved OS (HR, 0.61; 95% CI, 0.50-0.75; p<0.001) and CSS (HR, 0.65; 95% CI, 0.51-0.82; p<0.001) in the adolescence group. In a logistic regression analysis adjusting for demographics, compared to adults, adolescent patients more commonly presented with regional or distant metastatic disease (OR 1.16; 95% CI, 1.01-1.35), were more likely to undergo an additional tumor excision (OR 2.43; 95% CI, 1.57-3.77) and other adjuvant surgery (OR 5.87; 95% CI 2.25-15.3). Additionally, adolescents were less likely to undergo radiation (OR 0.61; 95% CI, 0.39-0.97). The authors conclude that adolescent patients with NS TGCTs had slightly improved survival compared to adults, despite more advanced disease. This may imply that while adolescent patients present at more advanced stage, they achieve excellent survival outcomes but possibly at the cost of greater therapeutic burden. The main limitation of the study is lack of ability to analyze RFS.


Presented By: Nicholas Cost, MD

Written By: Miki Haifler MD. Fox Chase Cancer Center, Philadelphia, PA. at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA