Clinical Characteristics and Prognostic Factors of Testicular Sarcoma: A Population-Based Study

Xingyuan Wang; Zeyu Chen; Shi Qiu; Dehong Cao; Kun Jin; Jin Li; Bo Chen; Haoran Lei; Yin Huang; Yige Bao; Lu Yang; Liangren Liu; Qiang Wei

doi:10.3389/fonc.2021.614093

Clinical Characteristics and Prognostic Factors of Testicular Sarcoma: A Population-Based Study

Front Oncol. 2021 Feb 25:11:614093. doi: 10.3389/fonc.2021.614093. eCollection 2021.

Authors

Xingyuan Wang^{1

2}, Zeyu Chen^{1

2}, Shi Qiu^{1

3}, Dehong Cao¹, Kun Jin^{1

2}, Jin Li^{1

2}, Bo Chen^{1

2}, Haoran Lei^{1

2}, Yin Huang^{1

2}, Yige Bao¹, Lu Yang¹, Liangren Liu¹, Qiang Wei¹

Affiliations

¹ Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
² West China School of Medicine, Sichuan University, Chengdu, China.
³ Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, China.

Abstract

Objectives: To study clinical characteristics and factors that may affect the prognosis of testicular sarcoma patients.

Patients and methods: In the Surveillance Epidemiology and End Results database (2006-2016), people with testicular sarcoma were enrolled in our research. Multivariable Cox proportional hazard model and Multivariable Logistic regression model were used to compare the impact of different factors on cancer-specific survival, localized metastasis, and distant metastasis.

Results: This research was based on the registry information of 158 testicular sarcoma patients. All patients with a median age of 17.00 (1.00-93.00) years were pathologically diagnosed with orchiectomy or needle biopsy specimens. Patients with Grade I, II, III, and IV testicular sarcoma accounted for 34.29% (n = 24), 10.10% (n = 7), 22.86% (n = 16), and 32.86% (n = 23) of all patients, respectively. There were 42 (30.43%), 53 (38.41%), 15 (10.87%), 20 (14.49%), 5 (3.62%), 3 (2.17%) patients with Tis, T1, T2, T3, T4, and >T4 (the invasion degree exceeded the staging system of testicular cancer) disease respectively. Among all included patients, localized metastasis occurred in 31 (20.13%) patients, distant metastasis was found in 28 (18.18%) patients during observation, and 61.69% (n = 95) had no metastasis. Thirty-two (20.25%) patients died of this cancer. According to our study, patients with distant metastasis [OR = 17.86, 95% CI (4.63-68.84), p < 0.0001] and T3 disease [OR = 4.13, 95% CI (1.10-15.53), p = 0.0359] were more likely to die of this cancer. Patients with advanced T stage were more likely to occur distant metastasis, [OR = 13.91, 95% CI (1.80-107.54), p = 0.0116] for T3 and [OR = 16.36, 95% CI (1.36-196.21), p = 0.0275] for T4.

Conclusions: According to our research, factors including metastasis and higher T stage were significantly related with poorer prognosis of testicular sarcoma. Higher T stage was also found to be a risk factor of distant metastasis. The recognization of these poor prognostic factors may allow physicians to make comprehensive and appropriate management decision for testicular sarcoma patients.

Keywords: cancer-specific survival; differentiation grade; metastasis; prognosis; testicular sarcoma.