Characteristics and prognosis of testicular mixed teratoma and seminoma

Background: To evaluate the association of demographic and clinicopathological characteristics with the survival of patients with testicular mixed teratoma and seminoma (TMTS).

Methods: The data of 3296 eligible patients with TMTS who underwent surgery between 2010 and 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier survival curves. The association of demographic and clinicopathological characteristics with the OS and CSS of patients with TMTS was assessed using the Cox proportional hazard regression model.

Results: The number of patients with TMTS increased annually. In Kaplan-Meier analyses, TMTS patients with advanced T stage (P < 0.001 for OS and P < 0.001 for CSS), lymph node metastasis (P < 0.001 for OS and P < 0.001 for CSS), distant metastasis (P < 0.001 for OS and P < 0.001 for CSS), no regional lymph node resection (P = 0.003 for OS and P = 0.002 for CSS), large tumor size (P = 0.001 for OS and P = 0.001 for CSS), and LVI (P < 0.001 for OS and P < 0.001 for CSS) exhibited inferior OS and CSS. Moreover, distant metastasis (HR 11.224, P < 0.001; HR 15.817, P < 0.001) and regional lymph node resection (HR 0.425, P = 0.003; HR 0.366, P = 0.004) were identified as independent prognostic factors for OS and CSS in patients with TMTS through multivariable analyses.

Conclusions: Distant metastasis and lymph node metastasis were deemed important prognostic factors for OS and CSS in patients with TMTS. Therefore, a comprehensive understanding and clinical assessments of these prognostic factors are necessary before tailoring clinical management and treatment plan specified for patients with TMTS.