Cancers · 2025
Diagnostic and Therapeutic Management of Mesothelioma of the Tunica Vaginalis Testis: A Population-Based Study in Italy.
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Ceresoli Giovanni Luca, Stella Simona, Dallari Barbara, Perduri Riccardo, Storchi Cinzia, Vimercati Luigi, Piro Sara, Giovannetti Lucia, Fedeli Ugo, Casotto Veronica, Migliore Enrica, Stura Antonella, Genova Carlo, Benfatto Lucia, Larese Filon Francesca, D'Agostin Flavia, Cozzi Ilaria, Angelillo Italo Francesco, Spata Eugenia, Murano Stefano, Grappasonni Iolanda, Pascucci Cristiana, Melis Massimo, Stracci Fabrizio, Marinaccio Alessandro, Binazzi Alessandra, Consonni Dario, Mensi Carolina
Аннотация
BACKGROUND: Mesothelioma of the tunica vaginalis testis (MTVT) is an exceedingly rare tumor. We performed a registry-based study on MTVT patient management and survival in Italy.
METHODS: Cases were extracted from the dataset of the Italian National Mesothelioma Registry. A descriptive analysis of patient characteristics, including asbestos exposure, clinical presentation, diagnostic work-up and therapeutic management, was performed. Overall survival was evaluated. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for selected variables by fitting univariate and multivariable Cox models.
RESULTS: Overall, 104 patients with MTVT were included. Median age was 72 years (range 17-92). Epithelioid histotype was the most frequent. Previous asbestos exposure was identified in two thirds of cases. Data on diagnostic and therapeutic management were available for 74 patients (71%). The most frequent presentations were scrotal swelling/mass, hydrocele and inguinal pain. All patients underwent surgery, mostly with orchi-funicolectomy. Adjuvant therapy was administered to 15 patients (20%). Overall median survival was 26.2 months (95% CI 22.1-52.1); 3-, 5- and 10-year survival was 49%, 30% and 18%. Older age at diagnosis and presence of distant metastasis (HR 1.91, CI: 0.85-4.26) were negative prognostic factors. Adjuvant therapy was associated with higher mortality (HR 2.54, CI: 1.25-5.15), indicating a more advanced stage at diagnosis.
CONCLUSIONS: Surgery remains the mainstay of treatment for MTVT; adjuvant therapy in our study did not improve outcome. Data from cancer registries are essential for rare cancers, but they should be integrated routinely with additional diagnostic and therapeutic information.
METHODS: Cases were extracted from the dataset of the Italian National Mesothelioma Registry. A descriptive analysis of patient characteristics, including asbestos exposure, clinical presentation, diagnostic work-up and therapeutic management, was performed. Overall survival was evaluated. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for selected variables by fitting univariate and multivariable Cox models.
RESULTS: Overall, 104 patients with MTVT were included. Median age was 72 years (range 17-92). Epithelioid histotype was the most frequent. Previous asbestos exposure was identified in two thirds of cases. Data on diagnostic and therapeutic management were available for 74 patients (71%). The most frequent presentations were scrotal swelling/mass, hydrocele and inguinal pain. All patients underwent surgery, mostly with orchi-funicolectomy. Adjuvant therapy was administered to 15 patients (20%). Overall median survival was 26.2 months (95% CI 22.1-52.1); 3-, 5- and 10-year survival was 49%, 30% and 18%. Older age at diagnosis and presence of distant metastasis (HR 1.91, CI: 0.85-4.26) were negative prognostic factors. Adjuvant therapy was associated with higher mortality (HR 2.54, CI: 1.25-5.15), indicating a more advanced stage at diagnosis.
CONCLUSIONS: Surgery remains the mainstay of treatment for MTVT; adjuvant therapy in our study did not improve outcome. Data from cancer registries are essential for rare cancers, but they should be integrated routinely with additional diagnostic and therapeutic information.