MP10-15 PATTERNS OF CARE AND SURVIVAL OUTCOMES FOR MALIGNANT SEX CORD STROMAL TESTICULAR CANCER: RESULTS FROM THE NATIONAL CANCER DATA BASE

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You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Penis/Testis/Urethra: Malignant Disease1 Apr 2015MP10-15 PATTERNS OF CARE AND SURVIVAL OUTCOMES FOR MALIGNANT SEX CORD STROMAL TESTICULAR CANCER: RESULTS FROM THE NATIONAL CANCER DATA BASE John S. Banerji, Katherine Odem-Davis, Erika M. Wolff, Khanh N. Pham, Craig R. Nichols, and Christopher R. Porter John S. BanerjiJohn S. Banerji More articles by this author , Katherine Odem-DavisKatherine Odem-Davis More articles by this author , Erika M. WolffErika M. Wolff More articles by this author , Khanh N. PhamKhanh N. Pham More articles by this author , Craig R. NicholsCraig R. Nichols More articles by this author , and Christopher R. PorterChristopher R. Porter More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.416AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sex-cord stromal tumors (SCSTs) of the testis comprise less than 5% of testicular neoplasms. Consequently, data regarding patterns of care and survival is sparse. Therefore, we sought to provide a more definitive analysis of the outcomes and management of this rare testicular cancer subtype. METHODS Data were obtained from the National Cancer Data Base, which captures over 70% of all newly diagnosed malignancies in the US. We selected patients diagnosed from 1998 to 2011 with ICD-O codes for the two most frequent SCST's of the testis, Leydig cell (8650) and Sertoli cell (8640). Stage was based on pathology or clinical stage if pathology was not reported. Stages 2 and 3 were combined due to low counts. Overall survival was by Kaplan-Meier using data through 2006. RESULTS Of 79,120 cases of testicular cancer, 315 (0.39%)were a primary malignant Leydig or Sertoli cell tumor. The median age at diagnosis was 43 years for both (interquartile range 34–55 Leydig; 34–57 Sertoli). Most were Non-Hispanic white (63% Leydig; 58% Sertoli) with a Charlson Comorbidity of 0 (94% Leydig; 84% Sertoli). The majority were treated at a Comprehensive Community Cancer or Academic Research program (87% Leydig; 83% Sertoli). Of 315 patients, 250 (79%) had malignant Leydig cell tumors and 65 (21%) had Sertoli tumors; most were stage 1 (94% and 78%, respectively). Survival estimates at 1 and 5 years for stage 1 Leydig cell tumors were 98 % (95%CI 96–100) and 91% (95% CI 85–96), respectively, and for stage I Sertoli cell tumors were 93% (95% CI 83–100) and 77% (95% CI 62–95), respectively. The majority of patients with stage 1 tumors received no further treatment following orchiectomy (94% Leydig; 84% Sertoli). Only 18 (7%) patients, with stage 1 tumors underwent RPLND. Few patients with stage 2 or 3 Leydig or Sertoli cell tumors were diagnosed through 2006 (18 total), precluding survival analysis in these groups. The most common treatment modality for these patients following orchiectomy was active surveillance (43%, 13/30), followed by RPLND alone and chemotherapy alone. CONCLUSIONS Stage 1 malignant Leydig cell tumors were the most common SCST's in our series. 5-year survival estimates of stage 1 Leydig and Sertoli cell tumors are reduced when compared to germ cell tumors (approximately 99% for both seminomas and non-seminomas). The majority of stage 1 SCST's are managed with radical orchiectomy alone, with RPLND and adjuvant chemotherapy being reserved for higher stages. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e116-e117 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information John S. Banerji More articles by this author Katherine Odem-Davis More articles by this author Erika M. Wolff More articles by this author Khanh N. Pham More articles by this author Craig R. Nichols More articles by this author Christopher R. Porter More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...