%0 Journal Article
%T The prognostic impact of treatment centralization in patients with testicular germ cell tumors: analysis of hospital-based cancer registry data in Japan.
%A Suzuki S
%A Nagumo Y
%A Kandori S
%A Kojo K
%A Nitta S
%A Chihara I
%A Shiga M
%A Ikeda A
%A Kawahara T
%A Hoshi A
%A Negoro H
%A Bryan MJ
%A Okuyama A
%A Higashi T
%A Nishiyama H
%J Int J Clin Oncol
%V 29
%N 3
%D 2024 Mar 24
%M 38265529
%F 3.85
%R 10.1007/s10147-023-02457-0
%X <B>BACKGROUND: </B>To identify the prognostic impact of treatment centralization in patients with testicular germ cell tumors (TGCT).<BR><B>METHODS: </B>We used a hospital-based cancer registry data in Japan to extract seminoma and non-seminoma cases that were diagnosed in 2013, histologically confirmed, and received the first course of treatment. To compare the 5-years overall survival (OS) rates of patients stratified by institutional care volume, we performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) method to adjust patient backgrounds.<BR><B>RESULTS: </B>A total of 1767 TGCT patients were identified. The 5-years OS rates for stage II and III TGCT patients treated at low-volume institutions (< 7 cases) were significantly worse than high-volume institutions (≥ 7 cases) (91.2% vs. 83.4%, p = 0.012). Histological stratification revealed that 5-year OS rates for stage II and III seminoma patients in the low-volume group were significantly worse than the high-volume group (93.5% vs. 84.5%, p = 0.041). Multivariate OS analysis using an IPTW-matched cohort showed that institutional care volume was an independent prognostic factor (hazard ratio 2.13 [95% confidence interval: 1.23-3.71], p = 0.0072).<BR><B>CONCLUSIONS: </B>Our results indicate that stage II and III TGCT patients experience lower survival rates at low-volume institutions and would benefit from treatment centralization.