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Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study

World Journal of Urology volume 39, pages 1211–1217 (2021)Cite this article

Abstract

Introduction

Yolk sac tumor (YST) is a rare malignant germ cell tumor, which usually affects young males. Because of the low incidence, few studies on YST have been published. In our study, we aim to investigate the clinical characteristics, survival and risk factors of male YST patients based on the Surveillance, Epidemiology, and End Results (SEER) program.

Methods

We identified 569 male YST patients from the SEER-18 database with additional treatment fields. Clinical characteristics, survival and prognostic factors were described in the study. Chi-square tests were applied to analyze categorical and continuous variables between different groups. Univariate and multivariate Cox proportional hazard model were performed to assess the relative impacts of risk factors on cancer-specific survival (CSS) in YST patients. Kaplan–Meier method and the log-rank test were used to analyze differences in survival that were significant.

Results

The major primary sites of YST were testis (74.69%), mediastinum (15.47%), retroperitoneum (2.64%) and central nervous system (1.24%). The 3-year and 5-year CSS was 70.0%, 56.5% vs. 97.2%, 96.0% for the mediastinal and testicular YST patients, respectively (p < 0.001). Primary site of mediastinum, distant SEER Summary stage were independent factors of poor prognosis (hazard ratio (HR) = 2.010 (1.094–3.695), p = 0.025; HR = 6.501 (2.294–18.424), p < 0.001, respectively). Receiving surgery was a good prognosis factor for all patients (HR = 0.495 (0.260–0.940), p = 0.032) and for the mediastinal group (p = 0.0019). Being treated with chemotherapy indicated poor outcome in all patients (HR = 3.624 (1.050–12.507), p = 0.042) and in the localized testicular YST patients (p = 0.0077).

Conclusion

For the first time, our study revealed the primary site distribution of male YST, and summarized the clinical characteristics, survival and prognostic factors based on the SEER database, which provided important epidemiological evidence for clinical practice.

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Author notes

  1. Ruixuan Geng and Zhibo Zheng contributed to the work equally and should be regarded as co-first authors.

Affiliations

  1. Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China

    Ruixuan Geng, Zhibo Zheng, Yaguang Li, Guannan Ge, Xiaoyan Dai, Qiuyue Ye, Junfeng Zhen, Ying Zhang, Chenwei Fu & Yongning Li

  2. Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Yaguang Li & Guannan Ge

  3. Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Yuxiao Lin & Jieshi Zhang

  4. Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Chenyu Wang

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  1. Ruixuan Geng
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Contributions

Ruixuan Geng and Zhibo Zheng: protocol/project development, data collection or management, data analysis, manuscript writing/editing. Yuxiao Lin: manuscript writing/editing, Yaguang Li, Guannan Ge, Xiaoyan Dai, Qiuyue Ye, Junfeng Zhen: data collection or management. Jieshi Zhang: protocol/project development. Chenyu Wang: data analysis. Ying Zhang: data analysis. Chenwei Fu, Yongning Li: manuscript writing/editing.

Corresponding authors

Correspondence to Chenwei Fu or Yongning Li.

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1. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in this manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. 2. Since all information from the SEER database has been deidentified and no personal identifying information was used in our analysis, informed consent was not required in our study.

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Geng, R., Zheng, Z., Lin, Y. et al. Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study. World J Urol 39, 1211–1217 (2021). https://doi.org/10.1007/s00345-020-03311-y

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Keywords

  • Yolk sac tumor
  • Testis
  • Mediastinum
  • Prognosis
  • SEER