Survival of Testicular Pure Teratoma vs. Mixed Germ Cell Tumor Patients in Primary Tumor Specimens across All Stages.

We aimed to test for survival differences between testicular pure teratoma vs. mixed germ cell tumor (GCT) patients in a stage-specific fashion. Pure teratoma and mixed GCT in primary tumor specimens were identified within the Surveillance, Epidemiology, and End Results database (2004-2019). Kaplan-Meier curves depicted five-year overall survival (OS) and subsequently, cumulative incidence plots depicted cancer-specific mortality (CSM) and other-cause mortality (OCM) in a stage-specific fashion. Multivariable competing risks regression (CRR) models were used. Of 9049 patients, 299 (3%) had pure teratoma. In stage I, II and III, five-year OS rates differed between pure teratoma and mixed GCT (stage I: 91.6 vs. 97.2%, p < 0.001; stage II: 100 vs. 95.9%, p < 0.001; stage III: 66.8 vs. 77.8%, p = 0.021). In stage I, survival differences originated from higher OCM (6.4 vs. 1.2%; p < 0.001). Conversely in stage III, survival differences originated from higher CSM (29.4 vs. 19.0%; p = 0.03). In multivariable CRR models, pure teratoma was associated with higher OCM in stage I (Hazard Ratio (HR): 4.83; p < 0.01). Conversely, in stage III, in multivariable CRR models, pure teratoma was associated with higher CSM (HR: 1.92; p = 0.04). In pure teratoma, survival disadvantage in stage I patients relates to OCM. Survival disadvantage in stage III pure teratoma originates from higher CSM.

Cancers. 2023 Jan 23*** epublish ***

Cristina Cano Garcia, Francesco Barletta, Reha-Baris Incesu, Mattia Luca Piccinelli, Stefano Tappero, Andrea Panunzio, Zhe Tian, Fred Saad, Shahrokh F Shariat, Alessandro Antonelli, Carlo Terrone, Ottavio De Cobelli, Markus Graefen, Derya Tilki, Alberto Briganti, Mike Wenzel, Severine Banek, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H3A 2B4, Canada., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria., Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, 37126 Verona, Italy., Department of Urology, IRCCS Policlinico San Martino, 16132 Genova, Italy., Department of Urology, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy., Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany., Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy., Goethe University Frankfurt, Department of Urology, University Hospital Frankfurt, 60590 Frankfurt, Germany.