Germ Cell Tumors of Undescended vs. Descended Testes: Population-Based Clinical and Outcomes Data

Abstract

Objective: Testicular cancer has been associated with undescended testes (UDT) for decades, with a relative risk of testicular cancer in cryptorchidism at 2.75–8. Tumors of UDT are infrequently encountered in clinical practice and no population-based prior analysis has described clinical patterns of care in their case. Methods: Information on malignant testicular lesions was retrieved from the population-based Surveillance Epidemiology and End Results (SEER) data for the period 1983–2005. Site codes C62.0 (UDT) were compared with C62.1 (descended testis; DT), using appropriate surgical codes for the era reported. Analysis was made of the seminomatous histology codes (ICD-03 9061–9063) vs. the nonseminomatous germ cell tumor codes (ICD-03 9065–9085). Further analysis was stratified by presenting extent of disease (local, regional, or distant). Results: 462 cases of tumors of UDT were documented; 416 (90%) were germ cell tumors (GCT). In this timeframe, 7414 cases of DT GCT were described. UDT lesions were more frequently seminoma (74.7% vs. 60.8%; p< 0.0001), and diagnosed at a more advanced stage than DT lesions ( x2 = 18, p = 0.0001). Similar frequency of RT was noted for localized seminoma, whether UDT or DT, after RadOrch ( p = 0.13), and was rarely delivered for NSGCT. 5-yr observed (5YOS) and relative survival (5YRS) of seminomas did not differ between the DT and UDT cohorts, or between the DT and UDT NSGCT cohorts. Conclusions: Our results support recent literature revealing seminomas are more frequent in cryptorchid testes. RT was equally used between localized UDT and DT seminomas. Penetrance of RadOrch is similar in local and regional disease by histology. Survival is equivalent for UDT compared to DT lesions in both seminomatous and NSGCT histologies.