Epidemiological pattern and time trends in testicular germ-cell tumors: a single institution 20-year experience

RESUMEN

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ABSTRACT

Introduction. Recent studies have suggested a risein the incidence of testicular germ-cell tumors(TGTs) in the last years, mainly due to an increaseof early stage cases. We analysed the time trendsin biological features of these patients in order toconfirm this tendency in our environment.Materials and methods. The clinical records of136 consecutive patients with TGTs treated at asingle institution over a 20-year period (1984-2003)were retrospectively reviewed. Pathological, clinical,therapeutic and outcome data were collected.Patients were allocated into four consecutive 5-year intervals and their characteristics were comparedby means of the chi-squared test. The survivalanalysis was performed with the method ofKaplan and Meier.Results. A progressive increase in the incidence ofnew cases, and a more frequent diagnosis of stageI versus stage II-IV disease was confirmed withinthis time period. It was also observed a greater useof postorchiectomy chemotherapy, mainly due toan increase in the adjuvant indications. A significantdecrease in the recurrence rate was noted.Ten-year overall survival was 86.5%. There was atrend for improved outcome, but the differencesamong the two decades were not statistically significant.Conclusions. A real increase in the incidence of TGTsand in the proportion of early stages was confirmed.This may be due to an epidemiological change or toan earlier diagnosis. This new pattern is associatedwith a more frequent use of adjuvant chemotherapyand with a reduction in the relapse rate