Outcomes of patients with testicular germ cell tumors in Latin-America

BackgroundTesticular germ cell tumors (GCT) are a common malignancy in adolescents and young adults. Outcomes in developed nations report excellent survival rates and several actions have been implemented to mitigate acute and chronic toxicity. Reports on outcomes and toxicity in Latin-American patients are limited, usually reflecting poorer overall survival. Understanding patterns of care, recurrence risk and survival are needed to guide access to care.MethodsThis was a multicenter, retrospective study, involving 16 institutions across Latin-America. Data was collected from 2007 to 2019. The primary endpoint was to evaluate recurrence free (RFS) and overall survival (OS) rates at 5 years. Measures of central tendency and dispersion were obtained for continuous-scale variables, while absolute and relative frequencies were calculated for categorical variables. The Kaplan-Meier actuarial method was used for survival analysis.ResultsA total of 1,262 patients (pts) were analyzed. Median age at diagnosis was 27 y/o (range 15-77). Histology showed 40% were seminoma (SGCT) and 60% were non-seminoma (NSGCT). Overall, 515 pts were stage I, 223 pts were stage II and 496 pts were stage III. For SGCT 81% and 19% were good and intermediate-risk; while in NSGCT 50%, 23% and 27% were good, intermediate, and poor-risk. At the time of data cut-off, 951 pts (75%) were recurrence-free while 315 pts (25%) had developed recurrence, of those 94 (30%) were SGCT and 221 (70%) were NSGCT. The 5-year RFS rate for the overall population was 72%, and 78% and 67% for SGCT and NSGCT, respectively; NSGCT were more likely to recur than seminomas (HR=1.61). The 5-year OS rate was 91% for both histologies, 94% for SGCT and 89% for NSGCT. In 63/73 pts the cause of death was recorded, 55 pts died due to disease progression and 8 died due to treatment-related toxicity.ConclusionsHere, we present outcomes from the largest database of Latin-American patients who presented with testicular germ cell tumors. The proportion of patients with poor risk NSGCT is higher than the reported in US and European Populations. Five-year RFS and OS were worse compared to developed countries. Treatment toxicity was an important cause of death. Additional analysis from this cohort can help to implement strategies to improve outcomes.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureS. Campos Gomez: Financial Interests, Personal, Advisory Board: Merck, AZ, Janssen, Takeda; Financial Interests, Personal, Invited Speaker: Asofarma. F.E. Vera-Badillo: Financial Interests, Personal, Advisory Board: Merck, Janssen, Pfizer, AZ; Financial Interests, Personal, Invited Speaker: Medicamenta, Bayer; Financial Interests, Institutional, Local PI: Janssen, AZ. All other authors have declared no conflicts of interest.