Patient-Reported Outcomes and Long-Term Toxicity in stage I TGCT: A Retrospective Single-Center Cohort (1994-2023)

Area of Science:

• Oncology
• Survivorship Research
• Quality of Life Studies

Background:

• Clinical stage I testicular germ-cell tumors (TGCT) have near-universal survival post-orchiectomy.
• As oncologic outcomes improve, patient-centered outcomes like late comorbidities and health-related quality of life (HRQoL) are crucial for treatment decisions.

Purpose of the Study:

• To evaluate long-term comorbidities and HRQoL in clinical stage I TGCT survivors based on their initial management strategy.
• To inform treatment choices between surveillance and adjuvant therapy by comparing patient-centered outcomes.

Main Methods:

• Retrospective cohort study of 159 clinical stage I TGCT survivors (1994-2023).
• Collected data on late comorbidities and patient-reported outcomes (PROs) using EORTC QLQ-C30, QLQ-TC26, and RAND SF-36 questionnaires.
• Analyzed comorbidity prevalence and HRQoL differences between surveillance and adjuvant therapy groups.

Main Results:

• Common late complications included dyslipidemia (39.9%), chronic fatigue (16.7%), and hypogonadism (17.5%).
• Surveillance and adjuvant groups exhibited similar comorbidity profiles; no consistent dose-toxicity pattern emerged.
• Global HRQoL was high across all management strategies, with generally clinically insignificant differences between groups.

Conclusions:

• Long-term clinical stage I TGCT survivors demonstrate high HRQoL with no significant differences in late comorbidities based on initial management.
• Findings support minimizing platinum exposure in adjuvant therapy and emphasize structured survivorship care for cardiometabolic, neurosensory, endocrine, and psychological sequelae, including sexual health.