Epidemiological and overall survival characteristics of testicular cancers in Ege University Hospital database
Öz
Aim: The purpose of this study was to describe the general characteristics, treatment modalities and overall survival times of testicular cancer patients that diagnosed and treated in the period of 26 years (1992 – June 2018) at Ege University Hospital.
Materials and Methods: Ege University Cancer Control, Research and Application Center registered the collected testicular cancer data in CANREG which is a special computer program for grouping and analyzing the data in WHO and SEER based systems. Fisher’s Exact Test Kaplan Meier survival analyzing technique was used in statistical analysis. Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) and Tarone-Ware statistical techniques were used in survival analysis. p<0,05 was considered significant in statistical analysis.
Results: Pathological data of 864 testicular cancer patients and survival data of 831 patients were obtained. The most common observed patient age range was 26-32 years old. Right testicular involvement was observed in 42%, left testicular involvement in 35,9% and bilateral testicular involvement in 13,4% ratio. 94,6% of the patients were germ cell tumors and 5,3% were non-germ cell tumors.49,2% of the cases with testicular cancer were seminoma and 50,7% were nonseminoma. When subtypes of nonseminoma tumors were examined; Mixt germ cell tumors were in 33,1%, embryonal carcinoma were in 9,5%, yolk sak tumors were in 3,6%, teratoma were in 2,3%, choriocarcinoma were in 1,1% and spermatocytic seminoma were in 1,2% detected. While 54.3% of the patients presented with testicular limited disease, 14% presented with denovo metastatic disease. 94.8% of the patients treated with orchiectomy, 23.2% of them treated with radiotherapy and 42.4% of them treated with chemotherapy. According to histological subtypes, survival was 277 months in seminoma, 211 months in yolk sak, 197 months in mixt germ cell tumor, 176 months in teratoma and 25 months in choriocarcinoma. The 5, 10- and 15-year survival rates of the patients were detected 88.1%, 85.3% and 81.1% respectively.
Conclusion: According to our obtained data, nonseminoma tumors are more common than seminomas. Among these, the most common histologic subtype is mixt germ cell tumors. Most of our patients are nonmetastatic. The best survival was found in seminomas and the worst survival was found in cases with choriocarcinoma.
Anahtar Kelimeler
Kaynakça
- 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. Epub 2019 Jan 8.
- 2. McGlynn KA, Devesa SS, Sigurdson AJ, Brown LM, Tsao L, Tarone RE. Trends in the incidence of testicular germ cell tumors in the United States.Cancer. 2003;97(1):63.
- 3. Williamson SR, Delahunt B, Magi-Galluzzi C, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017 Feb;70(3):335-346. doi: 10.1111/his.13102. Epub 2016 Dec 14.
- 4. SEER Cancer Statistics Factsheets: Testis Cancer.National Cancer İinstitude.Bethesda,MD.2018. October 17, 2018.
- 5. Sarıcı H, Telli O, Eroğlu M. Bilateral testicular germ cell tumors. Turk J Urol. 2013 Dec;39(4):249-52.
- 6. Gajendran VK, Nguyen M, Ellison LM. Testicular cancer patterns in African-American men. Urology. 2005 Sep;66(3):602-5.
- 7. Vasdev N, Moon A, Thorpe AC. Classification, epidemiology and therapies for testicular germ cell tumours. Int J Dev Biol. 2013;57(2-4): 133-9.
- 8. Richie JP, Sheinfeld J. International consultation on urologic diseases: testicular cancer: Societe Internationale d'Urologie/International Consultation on Urologic Diseases Consensus Meeting on Germ Cell Tumors (GCT), Shanghai 2009. Urology. 2011 Oct;78(4 Suppl):S425-6.
- 9. Oliver RT, Mason MD, Mead GM et al. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet. 2005 Jul 23-29;366(9482):293-300.
- 10. 9.Van Dijk MR, Steyerberg EW, Habbema JD . Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer. 2006;42(7):820.
Öz
Amaç: Ege Üniversitesi Hastanesinde 1992-Haziran 2018 arası kanser tanısı konan ve tedavi edilen 26 yıllık testis kanseri hastalarının genel özellikleri, tedavi modaliteleri ve sağ kalım sürelerinin tanımlanması amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan testis kanseri verileri CANREG özel bilgisayar programına kaydedilmiş, DSÖ ve SEER sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Fisher’s Exact Test, Kaplan-Meier sağ kalım analizleri uygulanmıştır. Sağ kalım analizinde Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p<0,05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Toplam 864 testis kanser (TK) hastanın patolojik verisine ve 831 hastanın sağ kalım verisine ulaşılmıştır. En sık görüldüğü yaş 26-32 olarak saptanmıştır. Sağ testis tutulumu %42, sol testis tutulumu %35,9 ve bilateral testis tutulumu %13,4 olarak gözlenmiştir. Hastaların %94,6’sını germ hücreli tümörler ve %5,3’ünü non-germ hücreli tümörler oluşturmaktadır. Germ hücreli tümörlerin ise seminomlar %49,2’sini, nonseminom tümörler ise %50,7’sini oluşturmaktadır. Nonseminomatöz tümörlerin %33,1’ini miks germ hücreli; %9,5’ini embriyonel karsinom; %3,6’sını yolk sak tümör; %2,3’ünü teratom, %0,85’ini koriyokarsinom ve %1,2’sini spermatositik seminom oluşturmaktadır. Hastaların %54,3‘ü testise sınırlı hastalık ile başvururken %14 hasta ise metastatik hastalık ile başvurmuştur. Hastaların %94,8’i orşiektomi,%23,2’si radyoterapi ve %42,4’ü ise kemoterapi tedavisi almıştır. Sağ kalım analizinde seminom tanısı alanlarda 277 ay, yolk sak 211 ay, miks germ hücreli tümör 197 ay, teratom 176 ay ve koriokarsinom 25 ay saptanmıştır. Hastaların 5, 10 ve 15 yıllık sağ kalımları sırayla %88,1, %85,3 ve %81,1 bulunmuştur.
Sonuç: Verilerimize göre non-seminomatöz tümörler seminomlara göre daha sık gözlenmektedir. En sık görülen histolojik alt tip miks germ hücreli tümördür. Hastalarımızın büyük kısmı nonmetastatik olarak başvurmaktadır. En iyi sağ kalım seminomlarda, en kötü sağ kalım koriyokarsinomlarda izlenmektedir.
Anahtar Kelimeler
Kaynakça
- 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. Epub 2019 Jan 8.
- 2. McGlynn KA, Devesa SS, Sigurdson AJ, Brown LM, Tsao L, Tarone RE. Trends in the incidence of testicular germ cell tumors in the United States.Cancer. 2003;97(1):63.
- 3. Williamson SR, Delahunt B, Magi-Galluzzi C, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017 Feb;70(3):335-346. doi: 10.1111/his.13102. Epub 2016 Dec 14.
- 4. SEER Cancer Statistics Factsheets: Testis Cancer.National Cancer İinstitude.Bethesda,MD.2018. October 17, 2018.
- 5. Sarıcı H, Telli O, Eroğlu M. Bilateral testicular germ cell tumors. Turk J Urol. 2013 Dec;39(4):249-52.
- 6. Gajendran VK, Nguyen M, Ellison LM. Testicular cancer patterns in African-American men. Urology. 2005 Sep;66(3):602-5.
- 7. Vasdev N, Moon A, Thorpe AC. Classification, epidemiology and therapies for testicular germ cell tumours. Int J Dev Biol. 2013;57(2-4): 133-9.
- 8. Richie JP, Sheinfeld J. International consultation on urologic diseases: testicular cancer: Societe Internationale d'Urologie/International Consultation on Urologic Diseases Consensus Meeting on Germ Cell Tumors (GCT), Shanghai 2009. Urology. 2011 Oct;78(4 Suppl):S425-6.
- 9. Oliver RT, Mason MD, Mead GM et al. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet. 2005 Jul 23-29;366(9482):293-300.
- 10. 9.Van Dijk MR, Steyerberg EW, Habbema JD . Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer. 2006;42(7):820.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 15 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 |