Presentation Authors: Shengming Jin*, Beihe Wang, Weijie Gu, Dingwei Ye, Shanghai, China, People's Republic of
Introduction: Primary tumor surgery is recommended for patients with seminoma regardless of staging. Our study aims to validate the prognostic value of primary tumor surgery for seminoma patients with distant metastasis at diagnosis.
Methods: 546 seminoma patients with distant metastasis at diagnosis between 2004 and 2014 were identified from The Surveillance, Epidemiology, and End Results (SEER) database. The prognostic value of primary tumor surgery was assessed by Kaplan-Meier methods, log-rank analyses, and multivariate Cox proportional hazards model. Survival curves and a forest graph were also plotted.
Results: In our study, 455 patients (83.3%) had received a surgery while 91 patients (16.7%) did not. Survival analysis indicated that patients who underwent a surgery had a better 5-year overall survival (OS, 67.0%vs86.6%, P < 0.001) and cancer-specific survival (CSS, 72.5%vs89.9%, P < 0.001) than those who did not. Multivariate analyses demonstrated that Primary tumor surgery was an independent prognostic factor for OS (HR:0.369, 95%CI: 0.149-0.909, P=0.030) and CSS (HR: 0.287, 95%CI: 0.100-0.822, P=0.020), along with age at diagnosis, M stage and marital status. Besides, Primary tumor surgery still had considerable prognostic value for OS (N1:P < 0.001, N2-3:P=0.006, Nx:P=0.136) and CSS (N1:P < 0.001, N2-3:P=0.019, Nx:P=0.074) in subgroup analysis of patients with lymph node metastasis.
Conclusions: Our study validated that Primary tumor surgery was correlated with improved survival in seminoma patients with distant metastasis. Furthermore, primary tumor surgery is an independent prognostic indicator for seminoma patients with distant metastasis.