Factors Influencing the Response Rate and Survival of Testicular Germ Cell Tumors: A Single Institution Experience from Egypt

Abstract

Background: Testicular germ cell tumors (TGCTs) are the most common cancer in young adult males, and they represent one of the most curable solid tumors. The treatment modalities of different stages are variable among centers. Aim: To describe the management of TGCTs and its outcome in an Egyptian cancer center. Methods: The medical records of patients with TGCT treated between January 2012 and December 2016 were retrospectively reviewed. Thirty-two patients were included. Demographic, clinical, treatment, and outcome data were analyzed. Results: The median age of the patients was 34.5 years. The most common presentation was unilateral painless testicular mass (87.5%). Seminoma represented 53% of cases and almost half of them had Stage I disease. For all patients, the clinical stage and International Germ Cell Cancer Collaborative Group (IGCCC) risk classification were significantly associated with survival outcomes. Five-year overall survival for stage I patients was 100%, compared to 87.5% for stage II (p<0.0001). Patients with good risk had a 5-year OS of 87.4% while none of the poor risk group survived for 5 years (p =0.002). The 5-year disease-free survival for stage I was 83% for those who remained under active surveillance versus 87.5% for those who received adjuvant carboplatin (p=0.364). Conclusions: Stage I TGCTs has an excellent overall survival regardless of the treatment modality received. In advanced disease, the clinical stage and IGCCC risk stratification remain valid prognostic risk factors.