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International Journal of Clinical Oncology

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24-01-2024 | Nonseminoma | Original Article

The prognostic impact of treatment centralization in patients with testicular germ cell tumors: analysis of hospital-based cancer registry data in Japan

Authors: Shuhei Suzuki, Yoshiyuki Nagumo, Shuya Kandori, Kousuke Kojo, Satoshi Nitta, Ichiro Chihara, Masanobu Shiga, Atsushi Ikeda, Takashi Kawahara, Akio Hoshi, Hiromitsu Negoro, Mathis J. Bryan, Ayako Okuyama, Takahiro Higashi, Hiroyuki Nishiyama

Published in: International Journal of Clinical Oncology | Issue 3/2024

Abstract

Background

To identify the prognostic impact of treatment centralization in patients with testicular germ cell tumors (TGCT).

Methods

We used a hospital-based cancer registry data in Japan to extract seminoma and non-seminoma cases that were diagnosed in 2013, histologically confirmed, and received the first course of treatment. To compare the 5-years overall survival (OS) rates of patients stratified by institutional care volume, we performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) method to adjust patient backgrounds.

Results

A total of 1767 TGCT patients were identified. The 5-years OS rates for stage II and III TGCT patients treated at low-volume institutions (< 7 cases) were significantly worse than high-volume institutions (≥ 7 cases) (91.2% vs. 83.4%, p = 0.012). Histological stratification revealed that 5-year OS rates for stage II and III seminoma patients in the low-volume group were significantly worse than the high-volume group (93.5% vs. 84.5%, p = 0.041). Multivariate OS analysis using an IPTW-matched cohort showed that institutional care volume was an independent prognostic factor (hazard ratio 2.13 [95% confidence interval: 1.23–3.71], p = 0.0072).

Conclusion

Our results indicate that stage II and III TGCT patients experience lower survival rates at low-volume institutions and would benefit from treatment centralization.

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Title: The prognostic impact of treatment centralization in patients with testicular germ cell tumors: analysis of hospital-based cancer registry data in Japan
Authors: Shuhei Suzuki
Yoshiyuki Nagumo
Shuya Kandori
Kousuke Kojo
Satoshi Nitta
Ichiro Chihara
Masanobu Shiga
Atsushi Ikeda
Takashi Kawahara
Akio Hoshi
Hiromitsu Negoro
Mathis J. Bryan
Ayako Okuyama
Takahiro Higashi
Hiroyuki Nishiyama
Publication date: 24-01-2024
Publisher: Springer Nature Singapore
Keywords: Nonseminoma
Nonseminoma
Seminoma
Seminoma
Testicular Tumor
Testicular Cancer
Published in: International Journal of Clinical Oncology / Issue 3/2024
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-023-02457-0

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Abstract

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Conclusion

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