Prognostic Factors for Relapse and Mortality Risk in Chilean Patients With Testicular Cancer: A Retrospective Cohort Study
Valentina Ríos-Correa, José Bennett-Laso, Daniela Guerra-Pérez, Macarena Jiménez-Galindo, Francisco Avendaño-Arriagada, Magdalena Correa-Duque, Alejandra Villarroel, Carolina Miranda, Carolina Ibañez, Alejandro Majerson, Juan Briones-CarvajalPURPOSE
Germ cell tumors (GCTs) are the most common malignancies among young men. In Latin America and the Caribbean, including Chile, population-based data remain limited; however, mortality is consistently reported to be higher than that in other regions. This study aimed to describe the clinical characteristics and survival outcomes of a cohort of Chilean patients with GCT and to assess the performance of established prognostic factors.
METHODS
A retrospective cohort analysis was conducted among patients with GCT treated at two Chilean institutions. Clinical characteristics, recurrence, and survival outcomes were analyzed according to the stage and histological subtype. Established prognostic factors for stage I disease were evaluated for their association with recurrence-free survival.
RESULTS
In total, 628 patients were included in this study. The 5-year overall survival (OS) rate was 98.8% (95% CI, 91.8 to 99.8) for stage I seminoma and 98.0% (95% CI, 92.0 to 99.5) for stage I nonseminomatous disease. Patients with advanced-stage disease had inferior outcomes compared with the International Germ Cell Cancer Collaborative Group reference cohorts. In stage I seminoma, lymphovascular invasion (LVI) and preorchiectomy β-human chorionic gonadotropin levels are associated with relapse. The Harrell C-index was 0.76 (95% CI, 0.6 to 0.9). No evidence of an association was found between internationally recognized risk factors and relapse in the stage I nonseminomatous cohort.
CONCLUSION
The outcomes for stage I GCT in Chile are consistent with the global experience; however, survival in advanced-stage disease remains suboptimal. These findings highlight structural challenges, including a lack of centralized care. Strengthening referral pathways, consolidating specialized management, and expanding national registries are critical steps for improving outcomes.