587 BILATERAL TESTIS GERM CELL TUMORS: OBSERVATIONS FROM THE SEER DATABASE

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011587 BILATERAL TESTIS GERM CELL TUMORS: OBSERVATIONS FROM THE SEER DATABASE A. Ari Hakimi, Steve K. Williams, Reza Ghavamian, and Farhang Rabbani A. Ari HakimiA. Ari Hakimi Bronx, NY More articles by this author , Steve K. WilliamsSteve K. Williams Bronx, NY More articles by this author , Reza GhavamianReza Ghavamian Bronx, NY More articles by this author , and Farhang RabbaniFarhang Rabbani Bronx, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1419AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bilateral testis tumors are rare. We sought to use the population-based Surveillance, Epidemiology, and End Results (SEER) database to evaluate if there are differences between unilateral and bilateral tumors. METHODS From 1973–2006, 30330 men were identified in the SEER database as having a primary germ cell tumor of the testis, of which 29890 were unilateral, 163 bilateral synchronous and 277 bilateral metachronous. Median patient age was 33. Patient demographics and tumor characteristics were compared using the chi-squared test. RESULTS Patients with metachronous bilateral tumors were younger at the time of diagnosis of the first tumor (median age 28) vs. those with unilateral or bilateral synchronous tumors (median age 33 for each group). There was no statistically significant difference in laterality, histology, T stage, N stage, or incidence of AFP or LDH elevation at presentation. Patients with unilateral tumors had a higher incidence of metastases at presentation: 2897/26778 (10.8%) for unilateral, 11/229 (4.8%) for metachronous and 9/141 (6.4%) for synchronous tumors (p=0.0034). Patients with metachronous tumors had a higher incidence of BHCG elevation at diagnosis: 14/21 (67%) for metachronous, 3520/8523 (41%) for unilateral and 16/47 (34%) for synchronous tumors (p=0.037). The distribution of histology was similar in the three groups of patients with unilateral, synchronous and metachronous tumors: the histology was seminoma was in 17382, 94 and 163 cases, respectively; embryonal carcinoma/yolk sac tumor in 4271, 30 and 42 cases, respectively, teratoma/teratocarcinoma/mixed GCT in 7194, 35 and 66 cases, respectively; and choriocarcinoma in 1043, 4 and 6 cases, respectively (p=0.62). The correlation between the histology of the first and second tumor for those with metachronous tumors is shown in the table (p=0.030). Histology of Primary and Secondary Tumors Histology of Primary Tumor Histology of Secondary Tumor Histology of Secondary Tumor Histology of Secondary Tumor Histology of Secondary Tumor Histology of Secondary Tumor Choriocarcinoma Embryonal/Yolk Sac Tumor Seminoma Teratoma/Teratocarcinoma/Mixed Total Choriocarcinoma 1 0 5 0 6 Embryonal/Yolk Sac Tumor 1 7 23 11 42 Seminoma 2 14 119 28 163 Teratoma/Teratocarcinoma/Mixed 5 10 38 13 66 Total 9 31 185 52 277 CONCLUSIONS Patients with metachronous tumors present at a younger age with a higher incidence of BHCG elevation. The lower incidence of metastases in these patients may be due to selection bias as these patients live to develop a second primary tumor. There is weak correlation between the histology of the first and second tumors in those with metachronous tumors. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e236-e237 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information A. Ari Hakimi Bronx, NY More articles by this author Steve K. Williams Bronx, NY More articles by this author Reza Ghavamian Bronx, NY More articles by this author Farhang Rabbani Bronx, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...