Incidence and long-term effects of treatment of malignant germ cell neoplasms in Ukraine

To describe incidence of malignant germ cell neoplasms (GCNs) in Ukraine and assess the medical care to patients with GCNs and its efficacy.

Records on 6495 males and 1038 females with malignant GCNs diagnosed in 2000-2013 extracted from the database of National Cancer Registry of Ukraine have been analyzed using methods of descriptive epidemiology and survival evaluation.

In Ukraine, GCNs covered 79.1% of testicular cancers and 48.9% of ovarian cancers in patients aged 0-19 years, while their proportions in total cancer incidence did not exceed 0.7% in males and 0.1% in females. Most of GCNs in males (75.9%) were diagnosed at the reproductive age (20-49) and in females 72.2% of GCNs were diagnosed at the age of 0-44 years. Female gonadal GCNs were divided by germinomatous and nongerminomatous as 49.3% vs 50.7% while in males this proportion was 65.3% vs 34.7%. Age-specific incidence of genital GCNs in Ukraine reached peak values in males aged 25-39 years and in females aged 10-24 years. Nonseminomatous testicular GCN cases were more common than seminomatous cases in males until the age of 30 years with an incidence of seminomas peaked 10 years later than non-seminomas. Ovarian germinomas were more common than non-germinomas in females aged 15-29. Total GCN incidence rate in 2013 was 1.99 ± 0.09⁰/₀₀₀₀ in males and 0.32 ± 0.04⁰/₀₀₀₀ in females, being closer to that in the countries of Eastern Europe and Asia. In Ukraine, 5-year survival of patients with testicular GCN of stage I who received surgery combined with chemotherapy or radiotherapy was lower than that reported for Europe and USA, and substantially lower in patients with stages II-IV. Five-year survival of patients with ovarian GCN treated with surgery plus chemotherapy was close to that reported in a study for populations of European countries.

The trends and patterns of GCN incidence in Ukraine are similar to those in other European countries, while patterns of treatment and survival in Ukraine are closer to that in countries in transition. Further research and analysis are impossible without due registration of both the diagnosis and the treatment undertaken as well as close follow-up of patients' life status.