Bhatt Rohit, Davaro Facundo, Wong Ryan, Siddiqui Sameer, Hinyard Leslie, Hamilton Zachary
Saint Louis University School of Medicine, St. Louis, MO, United States.
Division of Urology, Department of Surgery, Saint Louis University, St. Louis, MO, United States.
Cent European J Urol. 2021;74(1):39-43. doi: 10.5173/ceju.2021.0249.R1. Epub 2021 Feb 19.
Epididymal tumors are rare malignancies with sparse research available to guide recommendations. We sought to characterize malignant epididymal tumors in the United States using population level data.
The Surveillance, Epidemiology, and End-Results database was queried for patients diagnosed with malignant epididymal tumors between 1975-2016. International classification of disease for oncology code C63.0 was used to identify population with disease of interest. Primary objective was to characterize patient demographics, disease characteristics, and management. Secondary objectives included overall and cancer-specific survival (CSS) utilizing Kaplan-Meier (KM) analysis.
A total of 66 cases of malignant epididymal tumors were identified during the study period. The cohort was largely white (84.8%), with a mean age of diagnosis of 46.9 years old. The predominant histology consisted of rhabdomyosarcoma 26%, leiomyosarcoma 23%, liposarcoma 17%, adenocarcinoma 9%, and malignant fibrous histiocytoma 5%. During histopathological assessment, 21.1% of tumors were classified as high-grade while 71.2% exhibited sarcomatoid elements. Majority of patients presented with localized disease (68.2%), whereas regional (18.2%) and distant (13.2%) disease was less frequently discovered. All patients were diagnosed by surgical therapy consisting of radical epididymectomy (39.4%), partial epididymectomy (27.3%) or 'unknown surgery' (33.3%). Meanwhile, 15.2% and 34.8% received radiation and chemotherapy, respectively. KM analysis revealed an 84.9% CSS at 5-years. Over 60% of documented cases have arisen since 2000, with 3.0% of the cohort diagnosed in 2016, increased from 1.5% of the diagnoses in 1975.
Malignant epididymal tumors are exceedingly rare and typically present with localized disease. Surgical excision is associated with an estimated 85% CSS at 5-years.
附睾肿瘤是罕见的恶性肿瘤，可供指导建议的研究稀少。我们试图利用人群水平数据来描述美国恶性附睾肿瘤的特征。
查询监测、流行病学和最终结果数据库，以获取1975年至2016年间被诊断为恶性附睾肿瘤的患者信息。使用国际肿瘤疾病分类代码C63.0来识别感兴趣疾病的人群。主要目标是描述患者人口统计学、疾病特征和治疗情况。次要目标包括利用Kaplan-Meier（KM）分析评估总生存率和癌症特异性生存率（CSS）。
在研究期间共识别出66例恶性附睾肿瘤病例。该队列主要为白人（84.8%），平均诊断年龄为46.9岁。主要组织学类型包括横纹肌肉瘤26%、平滑肌肉瘤23%、脂肪肉瘤17%、腺癌9%和恶性纤维组织细胞瘤5%。在组织病理学评估中，21.1%的肿瘤被分类为高级别，而71.2%表现出肉瘤样成分。大多数患者表现为局限性疾病（68.2%），而区域（18.2%）和远处（13.2%）疾病较少见。所有患者均通过手术治疗确诊，包括根治性附睾切除术（39.4%）、部分附睾切除术（27.3%）或“未知手术”（33.3%）。同时，分别有15.2%和34.8%的患者接受了放疗和化疗。KM分析显示5年CSS为84.9%。超过60%的记录病例自2000年以来出现，2016年诊断的病例占队列的3.0%，高于1975年诊断病例的1.5%。
恶性附睾肿瘤极为罕见，通常表现为局限性疾病。手术切除与5年约85%的CSS相关。
