Aim: Testicular cancer is a rare tumour in Australia with an incidence rate of 6.6/100,000. There is no published literature regarding clinical characteristics of testicular germ cell tumours from Northern Territory. We conducted a retrospective study to assess the pathological pattern, treatments, and outcomes of testicular cancer amongst indigenous patients in Darwin between 2000-2014.
Methods: Cases of testicular germ cell tumour diagnosed and treated during the above period were identified retrospectively through the medical oncology clinics and chemotherapy protocols and from hospital record numbers received from Northern Territory population Cancer Registry. Patient characteristics including cancer markers, histopathology, stage, treatment and follow-ups were recorded in a structured data sheet in deidentified fashion. This audit was approved by the local human research committee prior to commencement.
Results: Case notes of 54 testicular germ cell tumour cases were reviewed. The median age at diagnosis was 36 years. Only five patients (9%) were indigenous Australians One out of 5 indigenous Australians had seminoma with the remaining diagnosed as non- seminoma (80%) histologically. In non-indigenous group Nonseminoma/ mixed germ cell tumours were diagnosed 21 / 49 (43%) patients. All indigenous patients presented with advanced disease. Patients were followed up for a median of 36 months with significant loss of follow-ups. Follow up was shorter with Indigenous patients with the average being 6months. Adjuvant chemotherapy was administered in 18 out of 29 seminomas, 8 underwent adjuvant radiotherapy. Four patients out of 54 died due to cancer treatment / progression with 3 of them from neutropenic sepsis. Detailed statistical analysis of various disease characteristics will be presented at the meeting.
Conclusion: To best of our understanding this is the first study to ascertain the clinical characteristics of testicular cancer from Top End. Indigenous Australians with testicular cancer had high proportion of non-seminomatous histology and advanced disease at presentation with poorly defined natural history. Prospective study is warranted to analyse the factors for improving service delivery and cancer outcome.