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. 2022 Apr;40(4):169.e1-169.e12.
doi: 10.1016/j.urolonc.2021.12.012. Epub 2022 Feb 8.

Survival of nonseminomatous germ cell tumors in pediatric patients and young adults - A stage group stratified analysis

Arnav Srivastava  1 , Hiren V Patel  2 , Elizabeth Koehne  3 , Gopal N Gupta  3 , Richard Drachtman  4 , Phillip M Pierorazio  5 , Aditya Bagrodia  6 , Sammy E Elsamra  7 , Isaac Y Kim  8 , Saum Ghodoussipour  8 , Eric A Singer  8 , Thomas L Jang  8 , Hiten D Patel  3 , Joseph G Barone  7
Affiliations

Survival of nonseminomatous germ cell tumors in pediatric patients and young adults - A stage group stratified analysis

Arnav Srivastava et al. Urol Oncol. 2022 Apr.

Abstract

Introduction: Testicular germ cell tumors, particularly nonseminomatous germ cell tumors (NSGCT), comprise the most common solid malignancy in male children and younger adults. While these patients experience excellent survival outcomes, few studies have characterized their survival by age. Thus, we aimed to characterize the relative survival of NSGCT by age, stratifying patients by stage group.

Methods: Using the Surveillance Epidemiology and End Results (SEER) database, we divided patients with NSGCT into pediatric patients and adolescents (<19 years), young adults (19-30 years), and older adults (>30 years). Survival analysis, using Cox proportional hazards models and Kaplan Meier curves, described overall and cancer-specific survival (CSS) of each age category for Stage I-III NSGCT by stage group.

Results: A total of 14,786 patients met inclusion criteria and comprised the age groups <19 years (N=1,287), 19 to 30 years (N=7,729), and >30 years (N=5,770). Stage group distribution at presentation was similar between each group. Survival analysis demonstrated no differences in cancer-specific survival (CSS) among Stage I or II NSGCT. However, among Stage III tumors, multivariable models noted worse CSS in patients >30 years (HR=3.35 (95%CI: 1.45-7.73), P=0.005) and those 19-30 years (HR=2.28 (95%CI: 0.99-5.21), P=0.053) compared to pediatric and adolescent patients.

Conclusions: Younger NSGCT patients experience excellent oncologic outcomes compared to their older counterparts. These survival differences by age group are largely driven by differential survival among Stage III neoplasms. Furthermore, our report lends additional evidence that age is an important prognostic factor in advanced NSGCT, including pediatric and adolescent patients.

Keywords: Nonseminomatous germ cell tumor; Pediatric oncology; Testicular cancer.

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Figures

Figure 1:
Figure 1:
Distribution of Histology and NSGCT by Age
Figure 2A:
Figure 2A:
Cancer-specific Survival of Stage I NSGCT by Age Group
Figure 2B:
Figure 2B:
Overall Survival of Stage I NSGCT by Age Group
Figure 3A:
Figure 3A:
Cancer-specific Survival of Stage II NSGCT by Age Group
Figure 3B:
Figure 3B:
Overall Survival of Stage II NSGCT by Age Group
Figure 4A:
Figure 4A:
Cancer-specific Survival of Stage III NSGCT by Age Group
Figure 4B:
Figure 4B:
Overall Survival of Stage III NSGCT by Age Group
See this image and copyright information in PMC

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