A review of clinical stage 1 testicular cancer mortality in a high-volume center.

Abstract

390 Background: Clinical stage 1 (CS1) testicular germ-cell tumors (GCT) have an overall survival of nearly 99% regardless of histology. We seek to describe the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) features of the clinical stage 1 testicular cancer patients who died of testis cancer. Methods: Analyses included 1,095 males treated at DF/BWCC between 1997-2012 with data entered into an IRB-approved database developed from electronic medical record abstraction. Patient, tumor, and treatment characteristics were summarized. Analyses focused on testicular-cancer death among the CS1 participants. Results: 616 CS1 testicular patients (291 seminoma-SEM and 324 non-seminoma- NS) were identified and 4 died from their disease (cause-specific survival of 99.3%). Average age at diagnosis amongst the latter patients was 26.7 years. All 4 patients had NS and 2 were embryonal predominant. Average tumor size was 6.3 cm, 2 patients did not have lymphovascular invasion, and 2 were unknown. Following treatment with orchiectomy, 2 patients received 2 cycles of adjuvant bleomycin, etoposide, cisplatin (BEP) chemotherapy. See table 1 for details. Conclusions: Four of 616 (0.6%) patients died after initial presentation with CS1 NSGCT, having relapsed at 1.25, 5.4, 6.25, and 20.7 years after orchiectomy. All patients had non-seminoma histology, 3 of these patients were late relapses (> 2 years), and 2 cases relapsed despite adjuvant BEP. [Table: see text]