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Abstract
Introduction. Testicular germ cell tumors (TGCTs) are a group of malignant neoplasms that originate from germ cells. Despite the rarity of this pathology, TGCTs are the most common type of tumor in the young male population.
Aim. To evaluate unfavorable prognostic factors in men with TGCT.
Materials and Methods. The study included 273 patients with TGCT who were treated or repeated consultations at the N.N. Petrov NMRC of Oncology between 2011 and 2021. Survival was analysed using the Kaplan-Meier method and regression analysis using the Cox method.
Results. Factors significantly associated with inferior overall survival (OS) in non-seminomatous germ cell tumors (NSGCT) included presence of pulmonary metastases (HR 3.927, 95 % CI 1.051-11.111; p = 0.010), presence of non-pulmonary visceral metastases (HR 4.636, 95 % CI 1.710-12.570; p = 0.003), elevated lactate dehydrogenase (LDH) level ≥ 2.5 upper limit of normal (ULN) (HR 4.107, 95 % CI 1.614-10.451; p = 0.003), treatment in general hospitals (HR 2.37, 95 % CI 1.924-4.994; p = 0.003), and deviation from the standards of medical care (HR 3.731, 95 % CI 1.456-9.564; p = 0.006) were analyzed. The statistically significant factors associated with inferior OS for metastatic seminoma were the presence of pulmonary metastases (HR 2.15, 95 % CI 1.024-6.877; p = 0.035) and elevated LDH levels ≥ 2.5 × ULN (HR 2.419, 95 % CI 2.015-8.775; p = 0.027). In multivariate analysis performed for all patients, the absence of pulmonary metastases was associated with improved OS (HR 0.301, 95 % CI 0.100-0.910; p = 0.033).
Conclusion. Factors unfavourably affecting the prognosis with non-seminomatous and seminomatous germ cell tumors were identified. Comparable 3-year and 5-year OS data were obtained for patients treated at the N.N. Petrov NMRC of Oncology in comparison with international data.
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