Evaluation of Relapse Risk Factors and Treatment Outcomes in Stage 1 Germ Cell Testicular Tumors

Abstract

Aim: This study aims to evaluate risk factors for relapse in stage 1 germ cell tumors (GCTs) and compare relapse and survival outcomes between treated and untreated patients.
 Method: The study encompasses patients diagnosed with GCTs aged 18 and above, treated and monitored at our oncology clinic between 2012 and 2022. After excluding cases with secondary malignancies, 54 patients with confirmed histopathological stage 1 testicular tumors were analyzed. Patient data, treatment received, and follow-up information were recorded, and statistical analyses were performed using IBM SPSS Statistics version 22.0.
 Results: In the seminoma subgroup, relapse was observed in 3 out of 24 (12.5%) patients. Although there was no statistically significant difference in terms of relapse between the groups with and without risk factors such as rete testis involvement and tumor diameter, it was observed that relapse occurred at a higher frequency in both risk groups. Among non-seminomatous tumors, 5 out of 30 (16.7%) patients experienced relapse. Although a notable numerical difference in lymphovascular invasion —a defined risk factor—was observed, statistical significance was lacking. A significant difference in relapse was observed between patients receiving adjuvant treatment and those who did not.
 Conclusion: For both seminoma and non-seminomatous tumors at stage 1, surveillance is recommended for patients lacking identified risk factors. Nevertheless, patients with established risk factors warrant personalized consideration, weighing factors such as age, comorbidities, and preferences to guide treatment decisions.