A comparison of pediatric, adolescent, and adult testicular germ cell malignancy

Nicholas G. Cost, Jessica D. Lubahn, Mehrad Adibi, Adam Romman, Jonathan E. Wickiser, Ganesh V. Raj, Arthur I. Sagalowsky, Vitaly Margulis

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background: Testicular germ cell tumors (T-GCTs) occur from infancy to adulthood, and are the most common solid tumor in adolescent and young adult males. Traditionally, pediatric T-GCTs were perceived as more indolent than adult T-GCTs. However, there are few studies comparing these groups and none that specifically evaluate adolescents. Methods: An institutional database of T-GCT patients was reviewed and patients were categorized into Pediatric, aged 0-12 years, Adolescent, aged 13-19 years, and Adult, older than 20 years, cohorts. Demographics, tumor characteristics, disease stage, treatment, event-free survival (EFS), and overall survival (OS) were compared between groups. Results: Overall, 413 patients (20 pediatric, 39 adolescent, 354 adult) met study criteria and were followed for a median of 2.0 years (0.1-23.6). Adolescents presented with more advanced stage than children (P=0.018) or adults (P=0.008). There was a higher rate of events in Adolescents (13, 33.3%) than in Adults (61, 17.2%) or Children (2, 10.0%). Three-year EFS was 87.2% in the Pediatric group, 59.9% in Adolescents and 80.0% in Adults (P=0.011). In a multivariate analysis, controlling for stage, IGCCCG risk, and histology, the hazard ratio (HR) for an event was: 1 (Reference) for Adults, HR=0.82 (95% CI 0.19-3.46; P=0.33) for the Pediatric group, and HR=2.22 (95% CI 1.21-4.07; P=0.01) for Adolescents. Five-year OS was 100% in the Pediatric group, 84.8% in Adolescents, and 92.8% in Adults (P=0.388). Conclusion: Lower EFS in adolescent T-GCT patients was observed than in either children or adults. Elucidating factors associated with inferior outcomes in adolescents is an important focus of future research.

Original languageEnglish (US)
Pages (from-to)446-451
Number of pages6
JournalPediatric Blood and Cancer
Issue number3
StatePublished - Mar 2014


  • Adolescent oncology
  • Germ cell malignancy
  • Pediatric oncology
  • Testicular cancer

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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