Testis cancer: A 20-year epidemiological review of the experience at a regional military medical facility
Testis cancer: A 20-year epidemiological review of the experience at a regional military medical facility
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DOI：
10.1016/j.juro.2008.04.032
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发表时间：
2008-08-01
影响因子：
6.6
通讯作者：
Auge, Brian K.
中科院分区：
文献类型：
--
作者：
Cooper, Daniel E.;L'Esperance, James O.;Auge, Brian K.
目的：睾丸癌是青壮年人群中最常见的实体恶性肿瘤，其发病率呈上升趋势。材料与方法：回顾1988年1月至2007年6月间收治的睾丸癌病例。介绍了患者的人口统计学、癌症组织学和分期、辅助治疗、时间趋势和生存数据。将我们的经验与SEER(监测、流行病学和最终结果)数据库和国家癌症数据库中公布的趋势进行比较。结果：在研究期间，总共诊断出338例睾丸癌(330例生殖细胞肿瘤)。诊断时患者的中位年龄为26.6岁，而SEER数据库为34岁。在研究期间，我们观察到I期肿瘤的暂时性增加(57%至75%)，而精原细胞瘤的比例下降(52%至43%)。在I期精原细胞瘤的辅助治疗方面，放射治疗的使用率下降(91%至75%)，而化疗的使用率增加(1.5%至7.5%)。对于I期非精原细胞瘤，辅助化疗的使用率增加(12%至20%)，而分期腹膜后淋巴清扫的使用率下降(88%至63%)。癌症的5年生存率为97.7%。结论：我们看到确诊时的局部疾病增加，I期疾病的监测增加，5年生存率超过95%，这与SEER和国家癌症数据库中的数据相似。然而，与SEER和国家癌症数据库不同的是，我们的患者更年轻，精原细胞瘤更少，我们进行的腹膜后淋巴结清扫术的分期明显更多。
Purpose: Testis cancer is the most common solid malignancy in the young adult population and the incidence in this population is increasing. We present a 20-year epidemiological review of testis cancers treated at our institution.Materials and Methods: The records of testis cancer cases diagnosed between January 1988 and June 2007 were reviewed. Patient demographics, cancer histology and stage, adjuvant therapy, temporal trends and survival data are presented. Our experience was compared to trends published in the SEER (Surveillance, Epidemiology and End Results) database and the National Cancer Database.Results: A total of 338 testis cancers (330 germ cell tumors) were diagnosed during the study period. Median patient age at diagnosis was 26.6 years vs 34 in the SEER database. We observed a temporal increase in stage I tumors (57% to 75%) and a decrease in the proportion of seminomas (52% to 43%) during the study period. In terms of adjuvant therapy for stage I seminoma the use of radiotherapy decreased (91% to 75%), while the use of chemotherapy increased (1.5% to 7.5%). For stage I nonseminomatous germ cell tumors the use of adjuvant chemotherapy increased (12% to 20%), while the use of staging retroperitoneal lymph node dissection decreased (88% to 63%). Five-year cancer specific survival was 97.7%.Conclusions: We are seeing an increase in localized disease at diagnosis, an increase in surveillance for stage I disease and 5-year survival in excess of 95%, similar to data in SEER and the National Cancer Database. However, unlike in SEER and the National Cancer Database, our patients are younger, we are seeing less seminoma and we are performing significantly more staging retroperitoneal lymph node dissection.