Clinicopathological Features and Survival of Young Turkish Patients with Testicular Germ Cell Tumors

  • Ozgun, Alpaslan (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital) ;
  • Karagoz, Bulent (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital) ;
  • Tuncel, Tolga (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital) ;
  • Emirzeoglu, Levent (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital) ;
  • Celik, Serkan (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital) ;
  • Bilgi, Oguz (Department of Medical Oncology, Gulhane Military Medical Academy, Haydarpasa Training Hospital)
  • Published : 2013.11.30


Background: Testicular germ cell tumors (TGCTs) are a relatively common malignancy in young men. The aim of this study was to investigate the clinicopathological features and survival of young Turkish patients with TGCT. Materials and Methods: In this retrospective study, the clinical and pathological characteristics of young Turkish patients with TGCT who were monitored by the Department of Medical Oncology of a military hospital between 2008 and 2013 were investigated. Overall survival data were analyzed. Results: Ninety-six patients were included in the study. The mean age was 26.4 years. Among the patients, 17.7% had seminoma and 43.8% had mixed non-seminomatous germ cell tumors. Some 46.9% were Stage I, 30.2% were Stage II, and 22.9 were Stage III. Of the patients, 83.3% received chemotherapy, 25% underwent retroperitoneal lymph node dissection (RPLND), 3.1% received radiotherapy, and 12.5% were followed-up without treatment. In addition, 18.8% of the patients were administered salvage chemotherapy due to relapse or progression. The 5-year overall survival rate was 90.2% for all patients. The 2-year overall survival rate was 100% for Stage I patients, 94% for Stage II patients, and 70.2% for Stage III patients. The difference between the survival curves of stages was statistically significant (p=0.029). Conclusions: In young Turkish patients with TGCT, good results were obtained with appropriate treatment, most receiving chemotherapy. The prognosis of the disease was good even in the advanced stage.


Testicular germ cell tumor;young Turkish patients;treatment;prognosis


  1. Bajorin DF, Sarosdy MF, Pfister DG, et al (1993). Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multi-institutional study. J Clin Oncol, 11, 598.
  2. Bokemeyer C, Kollmannsberger C, Stenning S, et al (2004). Metastatic seminoma treated with either single agent carboplatin or cisplatin-based combination chemotherapy: a pooled analysis of two randomised trials. Br J Cancer, 91, 683.
  3. Bosl GJ, Motzer RJ (1997). Testicular germ-cell cancer. N Engl J Med, 337, 242-53.
  4. Bray F, Ferlay J, Devesa SS, et al (2006). Interpreting the international trends in testicular seminoma and nonseminoma incidence. Nat Clin Pract Urol, 3, 532.
  5. Chia VM, Quraishi SM, Devessa SS, et al (2010). International trends in the incidence of testicular cancer. Cancer Epidemiol Biomarkers Prev, 19, 1151-59.
  6. Culine S, Kerbrat P, Kramar A, et al (2007). Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: a randomized trial of the Genito-Urinary Group of the French Federation of Cancer Centers (GETUG T93BP). Ann Oncol, 18, 917.
  7. Daugaard G, Skoneczna IA, Aass N, et al (2010). A randomized phase III study comparing standard dose BEP with sequential high-dose cisplatin, etoposide, ifosfamide (VIP) plus stem cell support in males with poor prognosis germ cell cancer (GCC): An intergroup study of EORTC, GTCSG, and Grupo Germinal. J Clin Oncol, 28, 15.
  8. de Wit R, Roberts JT, Wilkinson PM, et al (2001). Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the European organization for research and treatment of cancer genitourinary tract cancer cooperative group and the medical research council. J Clin Oncol, 19, 1629.
  9. Devesa S, Blot W, Stone B, et al (1995). Recent cancer trends in the United States. J Natl Cancer Inst, 87, 175.
  10. Dieckmann KP, Pichlmeier U (2004). Clinical epidemiology of testicular germ cell tumors. World J Urol, 22, 2.
  11. Eble J, Sauter G, Epstein J, et al (2004). Pathology and genetics of tumours of the urinary system and male genital organs. Lyon, France: IARC Press.
  12. Einhorn LH, Williams SD, Loehrer PJ, et al (1989). Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a South Eastern cancer study group protocol. J Clin Oncol, 7, 387.
  13. Grimison PS, Stockler MR, Thomson DB, et al (2010). Comparison of two standard chemotherapy regimens for good-prognosis germ cell tumors: updated analysis of a randomized trial. J Natl Cancer Inst, 102, 1253.
  14. Hinton S, Catalano PJ, Einhorn LH, et al (2003). Cisplatin, etoposide and either bleomycin or ifosfamide in the treatment of disseminated germ cell tumors: final analysis of an intergroup trial. Cancer, 97, 1.
  15. Horwich A, Sleijfer D, Fossa S, et al (1997). Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic nonseminomatous germ cell cancer: a multi-institutional medical research council/European Organization for Research and Treatment of Cancer trial. J Clin Oncol, 15, 1844.
  16. Jemal A, Siegel R, Xu J, et al (2010). Cancer Statistics 2010. CA Cancer J Clin, 60, 277.
  17. Kondagunta GV, Bacik J, Bajorin D, et al (2005). Etoposide and cisplatin chemotherapy for metastatic good-risk germ cell tumors. J Clin Oncol, 23, 9290.
  18. Motzer RJ, Nichols CJ, Margolin KA, et al (2007). Phase III randomized trial of conventional-dose chemotherapy with or without high-dose chemotherapy and autologous hematopoietic stem-cell rescue as first-line treatment for patients with poor-prognosis metastatic germ cell tumors. J Clin Oncol, 25, 247.
  19. Park DS, Chung MK, Chung JI, et al (2008). Histologic type, staging, and distrubition of germ cell tumors in Korean adults. Urol Oncol, 26, 590-94.
  20. Purdue MP, Devessa SS, Sigurdson AJ, et al (2005). International patterns and trends in testis cancer incidence. Int J Cancer, 115, 822-27.
  21. Sant M, Aareleid T, Berrino F, et al (2004). Survival of cancer patients diagnosed 1990-94, results and commentary. Ann Oncol, 14, 61-118.
  22. Saxman SB, Finch D, Gonin R, et al (1998). Long-term follow-up of a phase III study of three versus four cycles of bleomycin, etoposide, and cisplatin in favorable-prognosis germ-cell tumors: the Indiana University experience. J Clin Oncol, 16, 702.
  23. Tan GH, Azrif M, Shamsul AS, et al (2011). Clinicopathological features and survival of testicular tumours in a Southeast Asian University Hospital: A Ten-year Review. Asian Pac J Cancer Prev, 12, 2727-30.

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