Age as a Predictor of Treatment Outcome in Metastatic Testicular Germ Cell Tumors

Angelika Terbuch; Florian Posch; Thomas Bauernhofer; Martin Pichler; Heidi Peinsith; Joanna Szkandera; Jakob Riedl; Georg C Hutterer; Karl Pummer; Richard Partl; Karin S Kapp; Herbert Stöger; Michael Stotz; Armin Gerger

doi:10.21873/anticanres.13753

Age as a Predictor of Treatment Outcome in Metastatic Testicular Germ Cell Tumors

Anticancer Res. 2019 Oct;39(10):5589-5596. doi: 10.21873/anticanres.13753.

Authors

Angelika Terbuch^{1

2}, Florian Posch^{1

2}, Thomas Bauernhofer^{1

2}, Martin Pichler^{1

2

3}, Heidi Peinsith^{1

2}, Joanna Szkandera^{1

2}, Jakob Riedl^{1

2}, Georg C Hutterer^{2

4}, Karl Pummer^{2

4}, Richard Partl^{2

5}, Karin S Kapp^{2

5}, Herbert Stöger^{1

2}, Michael Stotz^{6

2}, Armin Gerger^{1

2

7}

Affiliations

¹ Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
² Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria.
³ Department of Experimental Therapeutics, The University of Texas, MD Anderson Cancer Center, Houston, TX, U.S.A.
⁴ Department of Urology, Medical University of Graz, Graz, Austria.
⁵ Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria.
⁶ Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria Michael.stotz@medunigraz.at.
⁷ Research Unit Genetic Epidemiology and Pharmacogenetics, Medical University of Graz, Graz, Austria.

PMID: 31570454
DOI: 10.21873/anticanres.13753

Abstract

Background/aim: To quantify the prognostic impact of age on relapse and mortality in patients with metastatic testicular germ cell tumors (TGCT).

Patients and methods: Electronical medical records of 1,225 TGCT patients who were treated at a single academic center between 1994 and 2015 were reviewed.

Results: Higher age did not predict for worse progression-free survival (PFS) or for higher progression risk. The corresponding 5-year PFS estimates were 85% in patients younger than 40 years and 83% in the elderly population. Although not statistically significant, higher age was numerically associated with worse overall survival (OS) (univariate HR per five years increase in age=1.18, 95%CI=0.99-1.41). This was explained in regression analysis where age predicted for significantly higher risk of treatment-related death (p=0.022).

Conclusion: Elderly patients with metastatic TGCT can achieve high cure rates similar to younger patients if they tolerate risk-adapted chemotherapy.

Keywords: Age; chemotherapy; germ cell tumors; outcome; prognosis; testicular cancer.

MeSH terms

Adult
Age Factors
Disease Progression
Humans
Male
Neoplasms, Germ Cell and Embryonal / drug therapy*
Neoplasms, Germ Cell and Embryonal / pathology*
Prognosis
Progression-Free Survival
Recurrence
Retrospective Studies
Risk Factors
Testicular Neoplasms / drug therapy*
Testicular Neoplasms / pathology*
Treatment Outcome

Supplementary concepts

Testicular Germ Cell Tumor