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Sprakel, A.
Eine deskriptive Analyse der klinischen Charakteristika testikulärer Keimzelltumoren zum Diagnosezeitpunkt im Verlauf der letzten zwei Jahrzehnte
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 68 [OPEN ACCESS]


Authors Med Uni Graz:
Barth Dominik Andreas
Pichler Martin

Introduction: Testicular germ cell tumors (GCT) are the most common malignant solid tumors in young men. Due to the high incidence, previous studies have identified many genetic and exogenous factors in patients affected by the disease. Over the past 25 years the Medical University of Graz, Austria has collected data including but not limited to the patient age at presentation, size, and staging of testicular tumors. The aim of this study is to analyze any changes in clinical manifestations and disease characteristics over a 25-year period. Materials and Methods: A total of 1300 patients with GCTs were treated at the University Hospital of Graz during the years 1995-2020. For each individual, the following parameters were documented and evaluated: patient age, tumor histology, clinical stage (CS) and time of death to calculate 5- and 10- year overall survival. To analyze possible changes and trends in clinical characteristic at the time of diagnosis, we divided our cohort into five groups at five yearly intervals (group 1: 1994-1999; group 2: 2000-2004; group 3: 2005-2009; group 4: 2010-2014; group 5: 2015-2020). In addition to a descriptive presentation of the results, a comparison with the current international literature was made. Results: For the patient collective the following values were obtained: median age 35 years; seminoma proportion 55.8%; non-seminoma proportion 43.1%; median size of primary tumor 4.1cm; proportion in CS I 71.1%; proportion CS>I 26.8%. Comparing the five groups after 25 years, there was a statistically significant increase in patient age at the time of diagnosis (p<0.001, ANOVA), a decrease in the mean size of primary tumor from 4,5 ± 2,77cm in group 1 to 3,7 ± 2,45cm in group 5 (p=0.03, Kruskal-Wallis test) and lastly a tumor stage migration was found toward organ-confined tumor stages (p<0.022 chi-square test). Conclusion: The results provide a detailed description of clinical characteristics of testicular GCT at the time of diagnosis in a representative Austrian patient population. In accordance with the international literature, there is at least a tendency towards an increase in age and a higher proportion of low tumor stages, as well as a decrease in tumor size at the time of diagnosis. The multifaceted appearance profile and the ethnic-geographical differences are remarkable and the causes are still partly unclear. Further evaluation is therefore required to further clarify biological background.

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