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Pediatr Blood Cancer. 2014 Mar;61(3):446-51. doi: 10.1002/pbc.24773. Epub 2013 Sep 17.

A comparison of pediatric, adolescent, and adult testicular germ cell malignancy.

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  • 1Division of Urologic Oncology, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Urology, University of Colorado School of Medicine, Aurora, Colorado.

Abstract

BACKGROUND:

Testicular germ cell tumors (T-GCTs) occur from infancy to adulthood, and are the most common solid tumor in adolescent and young adult males. Traditionally, pediatric T-GCTs were perceived as more indolent than adult T-GCTs. However, there are few studies comparing these groups and none that specifically evaluate adolescents.

METHODS:

An institutional database of T-GCT patients was reviewed and patients were categorized into Pediatric, aged 0-12 years, Adolescent, aged 13-19 years, and Adult, older than 20 years, cohorts. Demographics, tumor characteristics, disease stage, treatment, event-free survival (EFS), and overall survival (OS) were compared between groups.

RESULTS:

Overall, 413 patients (20 pediatric, 39 adolescent, 354 adult) met study criteria and were followed for a median of 2.0 years (0.1-23.6). Adolescents presented with more advanced stage than children (P = 0.018) or adults (P = 0.008). There was a higher rate of events in Adolescents (13, 33.3%) than in Adults (61, 17.2%) or Children (2, 10.0%). Three-year EFS was 87.2% in the Pediatric group, 59.9% in Adolescents and 80.0% in Adults (P = 0.011). In a multivariate analysis, controlling for stage, IGCCCG risk, and histology, the hazard ratio (HR) for an event was: 1 (Reference) for Adults, HR = 0.82 (95% CI 0.19-3.46; P = 0.33) for the Pediatric group, and HR = 2.22 (95% CI 1.21-4.07; P = 0.01) for Adolescents. Five-year OS was 100% in the Pediatric group, 84.8% in Adolescents, and 92.8% in Adults (P = 0.388).

CONCLUSION:

Lower EFS in adolescent T-GCT patients was observed than in either children or adults. Elucidating factors associated with inferior outcomes in adolescents is an important focus of future research.

© 2013 Wiley Periodicals, Inc.

KEYWORDS:

adolescent oncology; germ cell malignancy; pediatric oncology; testicular cancer

PMID:
24106160
[PubMed - indexed for MEDLINE]
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