Outcomes of Testicular Germ Cell Tumours: A Single-centre Study from the Sultanate of Oman
Noor Nabi Junejo, Tasnim Musallam Hamed Al-Hinai, Safa Ali Abdullah Al-Mamari, Shahid Aquil, Khurram Mutahir SiddiquiObjectives:
This study aims to evaluate the clinical and oncological outcomes of patients diagnosed with testicular germ cell tumours (TGCTs) at our centre and to identify areas to further improve the quality of care for patients with testicular cancer.
Material and Methods:
This retrospective study included males aged >14 years with TGCTs managed at Sultan Qaboos University Hospital between 1 January 2006 and 31 July 2023. Patient data, including demographics, symptoms, initial diagnostic findings, clinical stage, treatment details, follow-up and outcomes, were collected from the hospital information system (TrackCare ® software system). Data analysis was performed using Microsoft Excel and the Statistical Package for the Social Sciences (IBM SPSS).
Results:
We identified 29 patients who underwent inguinal orchiectomy during the study period; 21 were diagnosed with TGCTs, 3 were Leydig cell tumours, 2 sarcoma, one was lymphoma and two cases were benign adenomatoid tumours. The mean age at diagnosis was 28.7 ± 13.9 years. Ninety-three per cent of patients were of Omani descent. The most common clinical presentation was painless, palpable testicular swelling (17 patients, 81%). All patients underwent radical inguinal orchiectomy. The American Joint Committee on Cancer staging system was applied for only germ cell tumours; stages 1, 2 and 3 patients were 52.4%, 19% and 28.6%, respectively. There was no Stage 4 patient. In stages 2 and 3, 75% and 67 % patients received adjuvant chemotherapy, and a significant number either refused or were lost to follow-up. The mean follow-up was 39.8 ± 18.2 months, and 95% of them were disease-free at the last follow-up.
Conclusion:
This study demonstrates that timely diagnosis and appropriate management result in improved patient outcomes. We identified that a significant number of patients did not comply with our recommendation of adjuvant chemotherapy. Our findings encourage other institutions to evaluate and report their oncological outcomes. Educational interventions regarding chemotherapy are critically needed to ensure the delivery of the highest standard of care for patients in the Sultanate of Oman.