Impact of time to diagnosis on survival of testicular cancer

摘要

Objectives: Testicular cancer is the leading cancer of young adults and its incidence is increasing in almost all industrialized countries. The survival rate after testicular cancer is 95, all stages combined, but a group of patients with poor prognosis still fails to respond to treatment. The time to diagnosis is defined as the time in months between perception of the first symptoms of testicular cancer by the patient and the diagnosis of the disease by the doctor. The objective of this study is to determine whether the time to diagnosis has a prognostic value, particularly whether it is correlated with the stage of the disease and survival. Material and Methods: The time to diagnosis was studied in 542 patients with a diagnosis of testicular cancer between 1983 and 2002 in the Midi-Pyrenees region. Information concerning the disease and treatments contained in medical files was collected on a summary document. The time to diagnosis was correlated with prognostic parameters, including stage and survival. Results: The mean time to diagnosis was 3.7 +/- 5.1 months and was longer for seminomas (4.9 +/- 6.1 months) than for non-seminomatous germ cell tumours (NSGCT) (2.8 +/- 4.0 months). The time to diagnosis was correlated with the stage of the disease and the 5-year survival on the overall population and in the NSGCT group, but not in the seminoma group. Conclusions: Early diagnosis has a prognostic value (correlation with stage of the disease and 5-year survival rate). Testicular cancer information campaigns should therefore be envisaged.