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- Title
Clinicopathological characteristics and outcomes in men with mesothelioma of the tunica vaginalis testis: analysis of published case-series data.
- Authors
Grogg, Josias Bastian; Fronzaroli, Jordi Nicola; Oliveira, Pedro; Bode, Peter-Karl; Lorch, Anja; Issa, Allaudin; Beyer, Joerg; Eberli, Daniel; Sangar, Vijay; Hermanns, Thomas; Clarke, Noel William; Fankhauser, Christian Daniel
- Abstract
Purpose: Mesothelioma of the tunica vaginalis testis (MTVT) is a rare tumor, and currently, there are no published treatment recommendations. Methods: We performed a systematic literature review and synthesized clinical presentation, clinicopathological factors associated with metastatic disease, treatment options, and outcomes in men with MTVT. Results: We included 170 publications providing data on 275 patients. Metastatic disease occurred in 84/275 (31%) men with malignant MTVT: Most common sites included retroperitoneal lymph nodes (LNs) (40/84, 48%), lungs (30/84, 36%), and inguinal LNs (23/84, 27%). Invasion of the spermatic cord or scrotum was the only risk factor for local recurrence [odds ratio (OR) 3.21, 95% confidence interval (CI) 1.36–7.57]. Metastatic disease was associated with age ≥ 42 years (OR 3.02, 95% CI 1.33–6.86), tumor size ≥ 49 mm (OR 6.17, 95% CI 1.84–20.74), presence of necrosis (OR 8.31, 95% CI 1.58–43.62), high mitotic index (OR 13.36, 95% CI 1.53–116.51) or angiolymphatic invasion (OR 3.75, 95% CI 1.02–13.80), and local recurrence (OR 4.35, 95% CI 2.00–9.44). Complete remission in the metastatic setting was observed in five patients, most of whom were treated with multimodal therapy. Median survival in patients with metastatic disease was 18 months (IQR 7–43). Conclusion: Malignant MTVT is a rare but aggressive disease. Since local recurrence is a risk factor for metastatic progression, we recommend aggressive local treatment. Survival and response to any treatment in the metastatic setting are limited.
- Subjects
TESTIS; SURVIVAL rate; MESOTHELIOMA; COMBINED modality therapy; LYMPHATIC metastasis; ODDS ratio; NECROSIS
- Publication
Journal of Cancer Research & Clinical Oncology, 2021, Vol 147, Issue 9, p2671
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-021-03533-6