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A comparison of pediatric, adolescent, and adult testicular germ cell malignancy
Author(s) -
Cost Nicholas G.,
Lubahn Jessica D.,
Adibi Mehrad,
Romman Adam,
Wickiser Jonathan E.,
Raj Ganesh V.,
Sagalowsky Arthur I.,
Margulis Vitaly
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24773
Subject(s) - medicine , young adult , germ cell tumors , malignancy , demographics , pediatrics , multivariate analysis , hazard ratio , pediatric oncology , testicular germ cell tumor , stage (stratigraphy) , seminoma , confidence interval , cancer , demography , chemotherapy , sociology , paleontology , biology
Background Testicular germ cell tumors (T‐GCTs) occur from infancy to adulthood, and are the most common solid tumor in adolescent and young adult males. Traditionally, pediatric T‐GCTs were perceived as more indolent than adult T‐GCTs. However, there are few studies comparing these groups and none that specifically evaluate adolescents. Methods An institutional database of T‐GCT patients was reviewed and patients were categorized into Pediatric, aged 0–12 years, Adolescent, aged 13–19 years, and Adult, older than 20 years, cohorts. Demographics, tumor characteristics, disease stage, treatment, event‐free survival (EFS), and overall survival (OS) were compared between groups. Results Overall, 413 patients (20 pediatric, 39 adolescent, 354 adult) met study criteria and were followed for a median of 2.0 years (0.1–23.6). Adolescents presented with more advanced stage than children ( P = 0.018) or adults ( P = 0.008). There was a higher rate of events in Adolescents (13, 33.3%) than in Adults (61, 17.2%) or Children (2, 10.0%). Three‐year EFS was 87.2% in the Pediatric group, 59.9% in Adolescents and 80.0% in Adults ( P = 0.011). In a multivariate analysis, controlling for stage, IGCCCG risk, and histology, the hazard ratio (HR) for an event was: 1 (Reference) for Adults, HR = 0.82 (95% CI 0.19–3.46; P = 0.33) for the Pediatric group, and HR = 2.22 (95% CI 1.21–4.07; P = 0.01) for Adolescents. Five‐year OS was 100% in the Pediatric group, 84.8% in Adolescents, and 92.8% in Adults ( P = 0.388). Conclusion Lower EFS in adolescent T‐GCT patients was observed than in either children or adults. Elucidating factors associated with inferior outcomes in adolescents is an important focus of future research. Pediatr Blood Cancer 2014;61:446–451. © 2013 Wiley Periodicals, Inc.