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Oncological outcomes of testicular cancer patients: 10 years of experiences resulting from a single university-based hospital

Tanan Bejrananda
Tanan Bejrananda
, 
Komsan Leetanaporn
Komsan Leetanaporn
, 
Nannapat Pruphetkaew
Nannapat Pruphetkaew
 und 
Monthira Tanthanuch
Monthira Tanthanuch
   | 03. Mai 2022
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Article Category: Research Article
Online veröffentlicht: 03. Mai 2022
Seitenbereich: 77 - 85
Eingereicht: 15. Nov. 2021
Akzeptiert: 30. Dez. 2021
DOI: https://doi.org/10.2478/fco-2021-0011
Schlüsselwörter
© 2021 Tanan Bejrananda et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Kaplan-Meier survival curve of: (1A) all 45 patients in our cohort; (1B) patients stratified by seminoma of non-seminoma, stratified by stratum; (1C) AJCC staging; (1D) stage Ib–IIIa; (1E) stage IIIb; and (1F) stage IIIc.
Kaplan-Meier survival curve of: (1A) all 45 patients in our cohort; (1B) patients stratified by seminoma of non-seminoma, stratified by stratum; (1C) AJCC staging; (1D) stage Ib–IIIa; (1E) stage IIIb; and (1F) stage IIIc.

Figure 2

Kaplan-Meier survival curve of IGCCC classification.
Kaplan-Meier survival curve of IGCCC classification.

Figure 3

Tumour response after treatment at a response rate cut-off of 75%.
Tumour response after treatment at a response rate cut-off of 75%.

Figure 4

Kaplan-Meier survival curve of tumour response at a cut-off of 75%.
Kaplan-Meier survival curve of tumour response at a cut-off of 75%.

Staging of testicular cancer patients and IGCCC risks classification stratified by seminoma and non-seminoma.

Factors Seminoma, n (%) (n = 23) Non-seminoma, n (%)(n = 22) Total, n (%) (n = 45) p-value
Staging 0.081
  Ib 4 (17.4) 1 (4.5) 5 (11.1)
  IIb 0 (0) 1 (4.5) 1 (2.2)
  IIc 7 (30.4) 2 (9.1) 9 (20)
  IIIa 3 (13) 3 (13.6) 6 (13.3)
  IIIb 7 (30.4) 6 (27.3) 13 (28.9)
  IIIc 1 (4.3) 7 (31.8) 8 (17.8)
  Is 1 (4.3) 2 (9.1) 3 (6.7)
IGCCC
  Good 20 (87) 9 (40.9) 29 (64.4) 0.003
  Intermediate 2 (8.7) 5 (22.7) 7 (15.6)
  Poor 1 (4.3) 8 (36.4) 9 (20)

Treatment of all testicular cancer stratified by seminoma and non-seminoma.

Treatment Seminoma, n (%) Non-seminoma, n (%) Total, n (%) p-value
Surveillance 3 (13) 2 (9.1) 5 (11.1) 0.451
  CMT 17 (73.9) 20 (90.9) 37 (82.2)
  RT 2 (8.7) 0 (0) 2 (4.4)
  RPLND 1 (4.3) 0 (0) 1 (2.2)
Chemotherapy 0.152
  No 6 (26.1) 2 (9.1) 8 (17.8)
  EP 16 (69.6) 16 (72.7) 32 (71.1)
  BEP 1 (4.3) 4 (18.2) 5 (11.1)
Cycle 0.234
  median(IQR) 3 (1,4) 4 (3,4) 3 (2,4)

Univariable and multivariable Cox regression analyses predicting overall survival (OS) in 45 patients with diagnosed testicular cancer between 2007 and 2016.

Variables Univariable analysis Multivariable analysis
HR(95%CI) P value HR(95%CI) P value
Classification:
  seminoma ref
  non-seminoma 10.4 (1.32–82.21) 0.003 10.2 (1.34–80.12) 0.002
T stage:
  T3–T4 vs T1–T2 0.67 (0.14–3.14) 0.607
N stage :
  N=0 ref
  N1–N2 0.77 (0.05–12.31) 0.113
  N3 3.76 (0.47–30.1)
Serum marker
1 1.27 (0.11–14.02)
2 2.15 (0.22–20.72) 0.141
3 7.23 (0.8–64.88)
Metastasis
no ref
Retroperitoneal LN 1.82 (0.21–15.63)
Lung 0 (0- inf) 0.625
Bone 0 (0- inf)
Retroperitoneal LN and lung 3.33 (0.35–32-03)
Multiple 2.45(0.15–39.18)
Staging
Ib–IIIa ref ref
IIIb 2.06 (0.42–10.23) 0.006 2.05 (0.40–10.20) 0.005
IIIc 6.45 (1.43–29.13) 6.43 (1.41–29.11)
IGCCC risk classification
good ref ref
Intermediate 7.48 (1.25–44.87) 0.003 7.42 (1.21–44.82) 0.002
Poor 12.05 (2.33–62.45) 12.01 (2.31–62.41)

Tumour staging stratified by seminoma and non-seminoma.

Variable Seminoma, n (%) (n = 23) Non-seminoma, n (%) (n = 22) Total, n (%) (n-45) p-value
T stage 0.484
  1 1 (4.3) 0 (0) 1 (2.2)
  2 15 (65.2) 18 (81.8) 33 (73.3)
  3 6 (26.1) 4 (18.2) 10 (22.2)
  4 1 (4.3) 0 (0) 1 (2.2)
N stage 0.117
  0 7 (30.4) 3 (13.6) 10 (22.2)
  1 3 (13) 4 (18.2) 7 (15.6)
  2 0 (0) 4 (18.2) 4 (8.9)
  3 13 (56.5) 11 (50) 24 (53.3)
M stage 0.024
  0 18 (78.3) 9 (40.9) 27 (60)
  1 5 (21.7) 13 (59.1) 18 (40)
Serum marker 0.009
  0 9 (39.1) 1 (4.5) 10 (22.2)
  1 6 (26.1) 8 (36.4) 14 (31.1)
  2 7 (30.4) 6 (27.3) 13 (28.9)
  3 1 (4.3) 7 (31.8) 8 (17.8)
Lymph node status 0.284
  No 7 (30.4) 3 (13.6) 10 (22.2)
  Metastasis 16 (69.6) 19 (86.4) 35 (77.8)
Pulmonary metastasis 0.014
  No 21 (91.3) 12 (54.5) 33 (73.3)
  Metastasis 2 (8.7) 10 (45.5) 12 (26.7)
Metastatic site 0.293
  No 4 (17.4) 3 (13.6) 7 (15.6)
  Retroperitoneal LN 14 (60.9) 9 (40.9) 23 (51.1)
  Lung 0 (0) 3 (13.6) 3 (6.7)
  Bone 1 (4.3) 0 (0) 1 (2.2)
  Retroperitoneal with pulmonary 2 (8.7) 5 (22.7) 7 (15.6)
  Multiple site 2 (8.7) 2 (9.1) 4 (8.9)

Clinical characteristics of testicular cancer testicular cancer patients.

Variables Seminoma (n = 23) Non-seminoma (n = 22) p-value
Mean age ± SD (year) 38.1 (± 7.8) 28.5 (± −6.9) < 0.001
Laterality of testicular mass (n (%))
Right 10 (43.5) 9 (40.9)
Left 12 (52.2) 12 (54.5)
Both 1 (4.3) 1 (4.5)
Pre-op tumour markers (median, ng/mL)
AFP (IQR) 2.4 (2–3.8) 944 (116.2–1,992.2) < 0.001
bHCG (IQR) 12 (3.5–34.3) 120.3 (11.2–3,588.5) 0.005
LDH (IQR) 545 (333–1,137.5) 500 (349.5–946.5) 0.716
Post orchiectomy (median, ng/mL)
AFP (IQR) 2.7 (2–3.6) 70 (3–1,609.8) 0.012
BHCG (IQR) 2.2 (1–9.2) 10.9 (1.1–323.6) 0.099
LDH (IQR) 373 (323.5–734) 438 (327.5–650.5) 0.892
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