Open AccessTesticular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience
Author(s) -
Claudio Spinelli,
Gianmartin Cito,
Girolamo Morelli,
Marco Ghionzoli,
Alessia Bertocchini,
Beatrice Sanna,
Luca Galli,
Andrea Antonuzzo,
Riccardo Morganti,
Silvia Strambi
Publication year - 2021
Publication title -
archivio italiano di urologia andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.429
H-Index - 23
eISSN - 2282-4197
pISSN - 1124-3562
DOI - 10.4081/aiua.2021.3.301
Subject(s) - medicine , lymphadenectomy , single center , surgery , young adult , stage (stratigraphy) , orchiectomy , testicular cancer , cancer , chemotherapy , paleontology , biology
Objective: To investigate and compare the effectiveness of active surveillance versus post-surgical active treatment, in patients with testicular germ cells tumor (TGCT). Materials and methods: We retrospectively analyzed 52 patients who underwent surgery for TGCT from January 2009 to December 2014. All the patients were divided into two age groups: the Group A included children-adolescents from 18 months to 21 years old, while the Group B comprised young adults from 22 to 39 years old. Clinical, histopathological, therapeutic and follow-up data were collected. Results: Overall, 22 patients (42,3%) were enrolled in the Group A and 30 patients (57.7%) were categorized in the Group B. Inguinal orchiectomy was performed in all patients. Retroperitoneal lymphadenectomy was performed in 4 patients (7.7%). Post-surgical management differed based on clinical stage, resulting in active surveillance or adjuvant therapy. After an average 7 years follow-up period (range: 3.5-9.0 years), the overall survival rate is 100%. The relapse risk is significantly higher for the patients in the Group B, displaying a recurrence free-survival rate of 72% versus 95% (Group A); 11 relapses (21.1%) were recorded 2 years after surgery. Of these, 3 recurrences (12.0%) occurred in patients undergoing an active surveillance approach, while 8 (29.6%) in patients subjected to an active treatment. Conclusions: The excellent prognosis in both age groups confirms the high curability of this neoplasia. The active surveillance could represent an optimal option for low recurrence risk tumors. However, post-surgical treatments should be taken into consideration for TGCT with high risk factors, including tumor size, lymphovascular and rete testis invasion.