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Abstract：
Germ cell tumors (GCTs) are one of the most common tumors in adolescents and young adults. There is paucity of data on GCT from low-middle-income countries (LMIC). The present study was conducted to assess the demographic features, clinical manifestations, pathology, and outcomes of GCT patients treated at our center. Patients with testicular GCT above the age of 18 years, treated at our center from 2001 to 2015 were included in the study. Data were extracted retrospectively from the case records. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan-Meier method and the variables were compared using the log-rank test. The study included 421 patients among whom 128 (30%) had a histological diagnosis of seminoma and 293 (70%) had non-seminomatous germ cell tumor (NSGCT). Metastatic disease at presentation was observed in 83/128 (65%) with seminoma and 254/293 (87%) with NSGCT. According to the International Germ Cell Cancer Collaborative Group (IGCCCG) risk stratification for metastatic disease, good- and intermediate-risk seminoma were observed in 55/83 (66%) and 28/83 (34%) patients, respectively, and good-, intermediate-, and poor-risk NSGCT were observed in 82/254 (32%), 76/254 (30%), and 96/254 (38%) patients, respectively. The median follow-up was 32.3 months (range 0.03-200 months). The 3-year OS for the entire cohort was 80.3%. The 3-year OS for seminoma was 91.4%, and for NSGCT was 75.3%. Factors significantly associated with inferior EFS and OS on multivariate analysis included poor performance status, scrotal orchidectomy, carboplatin-based regimen, NSGCT histology, and treatment default. Patients with testicular GCT in India present in an advanced stage and higher IGCCCG risk compared to Western data. Factors unique to LMIC like treatment default, bulky disease, dose compromise, and scrotal orchidectomy have a negative impact on the outcome.
摘要：
生殖细胞肿瘤（GCTs）是青少年和年轻人中最常见的肿瘤之一。来自中低收入国家（LMIC）的GCT数据很少。本研究是为了评估人口统计学特征，临床表现，病理学,以及在我们中心治疗的GCT患者的结局。18岁以上的睾丸GCT患者，本研究纳入了2001年至2015年在我们中心接受的治疗。从病例记录中回顾性提取数据。使用Kaplan-Meier方法计算无事件生存期（EFS）和总生存期（OS），并使用对数秩检验比较变量。该研究包括421例患者，其中128例（30％）有精原细胞瘤的组织学诊断，293例（70％）有非精原细胞瘤（NSGCT）。在83/128（65％）的精原细胞瘤和254/293（87％）的NSGCT中观察到转移性疾病。根据国际生殖细胞癌症协作组（IGCCCG）转移性疾病的风险分层，在55/83（66％）和28/83（34％）患者中观察到了高危和中危精原细胞瘤，分别,而且很好-，中介-，在82/254（32%）中观察到低风险NSGCT，76/254（30%），96/254（38%）患者，分别。中位随访时间为32.3个月（0.03-200个月）。整个队列的3年OS为80.3%。精原细胞瘤的3年OS为91.4%，NSGCT为75.3%。在多变量分析中，与较差的EFS和OS显著相关的因素包括较差的表现状态，阴囊睾丸切除术,以卡铂为基础的方案，NSGCT组织学，和治疗默认。与西方数据相比，印度睾丸GCT患者处于晚期，IGCCCG风险更高。LMIC特有的因素，如治疗默认，庞大的疾病，剂量折衷，阴囊睾丸切除术对结局有负面影响。
