Clinicopathologic features, outcomes, and prognostic factors of testicular sarcoma: a population-based study

Int Urol Nephrol. 2021 Feb;53(2):257-267. doi: 10.1007/s11255-020-02634-4. Epub 2020 Sep 7.

Abstract

Purpose: To describe clinical characteristics and identify prognostic factors among men with testicular sarcoma, and to compare survival with other testicular cancers.

Methods: The surveillance, epidemiology, and end results (SEER) database (1975-2016) was queried to identify adults with testicular sarcoma. Multivariable Cox proportional hazards, Fine and Gray competing-risks regression, propensity score matching, and Kaplan-Meier analyses were used.

Results: 230 men were included in this study. Median age at diagnosis was 58 years (range 18-94), and median OS was 10.3 years. Patients with tumors larger than 8 cm in size had worse OS (HR 1.88, p = 0.016) compared to patients with tumors < 8 cm. Disease with distant metastasis was associated with worse OS (HR 4.70, p < 0.0001) and worse CSS (HR 11.41, p < 0.0001) as compared to disease localized to the testis. Men with rhabdomyosarcoma had worse CSS (HR 3.25, p = 0.03) as compared to men with liposarcoma. Testicular sarcoma patients had worse OS than matched patients with either seminomatous germ cell tumors (GCTs, p < 0.0001) or nonseminomatous GCTs (p = 0.0019), and similar survival to matched patients with sex cord stromal tumors, testicular lymphoma, or sarcomas of the lower limb-the most common anatomic site of origin of soft tissue sarcomas.

Conclusions: In the largest cohort of men with testicular sarcoma to date, we identified tumor size, disease extent, and rhabdomyosarcoma histology as independent predictors of worse survival. Stage-adjusted survival was worse as compared to men with GCTs, and similar to men with sex cord stromal tumors, testicular lymphoma, and sarcomas of other primary sites.

Keywords: Intratesticular; Neoplasia; Paratesticular; Sarcomatoid; Spermatic.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • SEER Program
  • Sarcoma / diagnosis*
  • Sarcoma / mortality
  • Survival Rate
  • Testicular Neoplasms / diagnosis*
  • Testicular Neoplasms / mortality
  • Young Adult