Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131, Naples, Italy.
Int Urol Nephrol. 2023 Dec;55(12):3119-3128. doi: 10.1007/s11255-023-03763-2. Epub 2023 Aug 28.
It is unknown whether five-year overall survival (OS) differs and to what extent between testicular germ-cell tumor (TGCT) patients and age-matched male population-based controls.
We identified newly diagnosed (2004-2014) TGCT patients within Surveillance Epidemiology and End Results database 2004-2019. We compared OS between non-seminoma (NS-TGCT) and seminoma (S-TGCT) patients relative to age-matched male population-based controls based on Social Security Administration Life-Tables. Smoothed cumulative incidence plots displayed cancer-specific mortality (CSM) vs. other-cause mortality (OCM).
Of all 20,935 TGCT patients, 43% had NS-TGCT and 57% had S-TGCT. Of NS-TGCT patients, 63% were stage I vs. 16% stage II vs. 21% stage III. Of S-TGCT patients, 86% were stage I vs. 8% were stage II vs. 6% stage III. Five-year OS differences between NS-TGCT patients vs age-matched male population-based controls were 97 vs. 99% (Δ = 2%) for stage I, 96 vs. 99% (Δ = 3%) for stage II, 76 vs 98% (Δ = 22%) for stage III. Five-year OS differences between S-TGCT patients vs age-matched male population-based controls were 97 vs. 98% (Δ = 1%) for stage I, 95 vs. 97% (Δ = 2%) for stage II, 87 vs. 98% (Δ = 11%) for stage III. OCM rates ranged from 1 to 3% in NS-TGCT patients and from 2 to 4% in S-TGCT patients.
The OS difference between NS-TGCT patients vs. age-matched male population-based controls was invariably higher across all stages (2-22%) than for S-TGCT patients (1-11%). Reassuringly, OCM rates were marginal in stage I and stage II patients. Conversely, higher OCM rates were recorded in stage III patients.
目前尚不清楚 5 年总生存率（OS）是否在睾丸生殖细胞肿瘤（TGCT）患者和年龄匹配的男性人群对照之间存在差异，以及差异程度如何。
我们在 2004 年至 2019 年的监测、流行病学和最终结果数据库中确定了新诊断的（2004-2014 年）TGCT 患者。我们根据社会保障管理局的生命表，将非精原细胞瘤（NS-TGCT）和精原细胞瘤（S-TGCT）患者的 OS 与年龄匹配的男性人群对照进行比较。平滑累积发病率图显示了癌症特异性死亡率（CSM）与其他原因死亡率（OCM）。
在所有 20935 例 TGCT 患者中，43%为 NS-TGCT，57%为 S-TGCT。NS-TGCT 患者中，63%为 I 期，16%为 II 期，21%为 III 期。S-TGCT 患者中，86%为 I 期，8%为 II 期，6%为 III 期。NS-TGCT 患者与年龄匹配的男性人群对照的 5 年 OS 差异分别为 I 期 97%与 99%（Δ=2%），II 期 96%与 99%（Δ=3%），III 期 76%与 98%（Δ=22%）。S-TGCT 患者与年龄匹配的男性人群对照的 5 年 OS 差异分别为 I 期 97%与 98%（Δ=1%），II 期 95%与 97%（Δ=2%），III 期 87%与 98%（Δ=11%）。NS-TGCT 患者的 OCM 发生率在 1%至 3%之间，S-TGCT 患者的 OCM 发生率在 2%至 4%之间。
NS-TGCT 患者与年龄匹配的男性人群对照之间的 OS 差异在所有阶段（2%-22%）均高于 S-TGCT 患者（1%-11%）。令人安心的是，I 期和 II 期患者的 OCM 发生率较低。相反，III 期患者的 OCM 发生率较高。
