所有分期原发性肿瘤标本中睾丸纯畸胎瘤与混合性生殖细胞肿瘤患者的生存率比较
Survival of Testicular Pure Teratoma vs. Mixed Germ Cell Tumor Patients in Primary Tumor Specimens across All Stages.
作者信息
Cano Garcia Cristina, Barletta Francesco, Incesu Reha-Baris, Piccinelli Mattia Luca, Tappero Stefano, Panunzio Andrea, Tian Zhe, Saad Fred, Shariat Shahrokh F, Antonelli Alessandro, Terrone Carlo, De Cobelli Ottavio, Graefen Markus, Tilki Derya, Briganti Alberto, Wenzel Mike, Banek Severine, Kluth Luis A, Chun Felix K H, Karakiewicz Pierre I
机构信息
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H3A 2B4, Canada.
Goethe University Frankfurt, Department of Urology, University Hospital Frankfurt, 60590 Frankfurt, Germany.
出版信息
Cancers (Basel). 2023 Jan 23;15(3):694. doi: 10.3390/cancers15030694.
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%, < 0.001; stage II: 100 vs. 95.9%, < 0.001; stage III: 66.8 vs. 77.8%, = 0.021). In stage I, survival differences originated from higher OCM (6.4 vs. 1.2%; < 0.001). Conversely in stage III, survival differences originated from higher CSM (29.4 vs. 19.0%; = 0.03). In multivariable CRR models, pure teratoma was associated with higher OCM in stage I (Hazard Ratio (HR): 4.83; < 0.01). Conversely, in stage III, in multivariable CRR models, pure teratoma was associated with higher CSM (HR: 1.92; = 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.
我们旨在以分期特异性的方式，检测睾丸纯畸胎瘤与混合性生殖细胞肿瘤（GCT）患者之间的生存差异。在监测、流行病学和最终结果数据库（2004 - 2019年）中识别原发性肿瘤标本中的纯畸胎瘤和混合性GCT。Kaplan-Meier曲线描绘了五年总生存率（OS），随后，累积发病率图以分期特异性的方式描绘了癌症特异性死亡率（CSM）和其他原因死亡率（OCM）。使用了多变量竞争风险回归（CRR）模型。在9049例患者中，299例（3%）患有纯畸胎瘤。在I期、II期和III期，纯畸胎瘤和混合性GCT的五年OS率不同（I期：91.6%对97.2%，<0.001；II期：100%对95.9%，<0.001；III期：66.8%对77.8%，=0.021）。在I期，生存差异源于较高的OCM（6.4%对1.2%；<0.001）。相反，在III期，生存差异源于较高的CSM（29.4%对19.0%；=0.03）。在多变量CRR模型中，纯畸胎瘤在I期与较高的OCM相关（风险比（HR）：4.83；<0.01）。相反，在III期，在多变量CRR模型中，纯畸胎瘤与较高的CSM相关（HR：1.92；=0.04）。在纯畸胎瘤中，I期患者的生存劣势与OCM有关。III期纯畸胎瘤的生存劣势源于较高的CSM。
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