Patterns of Care and Survival Outcomes for Malignant Sex Cord Stromal Testicular Cancer: Results from The National Cancer Data Base.
J Urol. 2016 Mar 29;
Authors: Banerji JS, Odem-Davis K, Wolff EM, Nichols CR, Porter CR
Abstract
PURPOSE: Sex-cord stromal tumors (SCSTs) of the testis comprise < 5% of testicular neoplasms. Consequently, data regarding patterns of care and survival is sparse. Utilizing a large national database, we sought to provide a more definitive analysis of outcomes and management of these malignancies.
MATERIALS & METHODS: Data were obtained from the National Cancer Data Base. Patients diagnosed from 1998 to 2011 with two of the most frequent SCSTs of the testis, Leydig and Sertoli cell, were selected. Overall survival estimates was assessed by Kaplan-Meier.
RESULTS: Of the 79,120 cases of testicular cancer between 1998 and 2011, 315 (0.39%) were primary malignant Leydig or Sertoli tumors. The median age was 43 years for both. Of the 315 patients, 250 (79%) had malignant Leydig tumors and 65 (21%) had malignant Sertoli tumors; majority were stage I (94% and 78%, respectively). Overall survival at 1 and 5 years for stage I Leydig tumors were 98% (95% CI: 96-100) and 91% (95% CI: 85- 96), respectively, and for stage I Sertoli were 93% (95% CI: 83-100) and 77% (95% CI: 62-95, p=0.015). Most patients with stage I tumors received no further treatment following orchiectomy (94% Leydig, 84% Sertoli).
CONCLUSIONS: Five-year survival estimates of stage I Leydig and Sertoli cell tumors are significantly lower when compared to stage I germ cell tumors, with Sertoli cell tumors being significantly worse than Leydig cell. These differences in survival of SCSTs, indicate the importance of large databases to evaluate efficacy of treatment for rare neoplasms.
PMID: 27036305 [PubMed - as supplied by publisher]
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