Archivio Italiano di Urologia e Andrologia (Jun 2021)

Specialist management of testicular cancer: Report of the last 10 years at a Portuguese tertiary referral academic centre

  • André Marques-Pinto,
  • Ana Inês Gomes,
  • Joana Febra,
  • Eugénia Rosendo,
  • Manuel Castanheira de Oliveira,
  • Avelino Fraga,
  • José La Fuente de Carvalho,
  • Nuno Louro

DOI
https://doi.org/10.4081/aiua.2021.2.153
Journal volume & issue
Vol. 93, no. 2

Abstract

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Objectives: To describe our experience on testicular cancer (TC) management, underlining the clinical/pathological scope, administered treatments, outcomes, and challenges. TC incidence is rising globally. The predominant histology is germ cell tumour (GCT). In most patients, orchiectomy is curative. Still, a significant proportion of patients will need further tailored treatment. Specialist Reference Centres have proven themselves successful in this setting. Published data regarding TC in Northern Portugal is lacking. Methods: Retrospective review of consecutive TC patients at a specialist tertiary referral academic centre between January 2010 and December 2020. Statistical analysis was performed using the STATA® version 13.1 software. Multivariate logistic and survival analyses were performed. Results: 125 patients met the inclusion criteria. The median age is 35 (28-40) years; 19% of patients had risk factors for TC – infertility being the most common (11%); 50% of patients wanted sperm cryopreservation prior to treatment; 68% of patients had stage I GCT, 16% stage II, and 17% stage III. Compared to seminoma, non-seminomatous GCT were associated with younger age (p < .001) and higher stages at diagnosis (p = .02); 24% of stage IA/B GCT underwent adjuvant chemotherapy; 47% of patients with metastatic GCT at presentation had refractory disease, requiring tailored treatment. The median follow-up time is 33 (13-65) months. There was no late relapse. The 5-year OS rate is 98.0%. The 5-year survival of metastatic disease is 95.8%. Conclusions: Despite contemporary excellent cure rates, the challenges of testicular cancer management still endure, especially in advanced stages. Therefore, public awareness is recommended, in order to avoid late presentations - special attention should be given to those who have known risk factors. The existence of Reference Centres is of paramount importance in order to achieve the best outcomes possible.

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