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Background <p> <!--Query ID="Q1" Text="The Corresponding author’s e-mail address is missing in the manuscript. We followed the information supplied in the submission system. Please check if correct." Resolved="yes"-->Testicular germ cell tumors (TGCTs) are the most common solid malignancies among young men. Although overall survival exceeds 95%, a subset of patients still present with advanced disease or relapse. Identifying clinicopathological and modifiable lifestyle factors associated with advanced-stage presentation may improve risk stratification and guide management.</p> Methods <p> <!--Query ID="Q2" Text="Please check if the article title is presented correctly." Resolved="yes"-->This retrospective study included 96 patients with TGCTs treated at a single tertiary center. Data on smoking status, body mass index (BMI), lymphovascular invasion (LVI), and tumor size were analyzed. Associations between these parameters and stage at diagnosis were assessed using chi-square tests and multivariable logistic regression. Recurrence-free survival (RFS) was evaluated by the Kaplan–Meier method.</p> Results <p> <!--Query ID="Q3" Text="Please confirm if the author names and their affiliations were presented and captured accurately." Resolved="yes"-->Among 96 patients (median age, 31 years), 59.4% had early-stage and 40.6% had advanced-stage disease. Smoking (OR = 8.17; <i>p</i> = 0.014), LVI (OR = 70.23; <i>p</i> &lt; 0.001), and tumor size ≥ 4&#xa0;cm (OR = 12.00; <i>p</i> = 0.009) were independently associated with advanced-stage presentation, whereas BMI showed no significant association. Recurrence occurred in 13.5% of patients, more frequently among smokers and LVI-positive cases, though not statistically significant.</p> Conclusion <p>Smoking, lymphovascular invasion, and tumor size ≥ 4&#xa0;cm were independently associated with advanced-stage presentation in TGCTs, whereas obesity showed no significant association. The combined evaluation of pathological and lifestyle factors may enhance individualized risk stratification and inform future risk-adapted management strategies.</p>

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Independent factors associated with advanced testicular germ cell tumors: the roles of smoking, lymphovascular invasion, and tumor size

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月19日

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  • Selahattin Çelik,
  • Engin Eren Kavak,
  • İsmail Dilli,
  • Esra Zeynelgil,
  • Hatice Ayyıldız Sevim,
  • Samed Rahatlı,
  • Tülay Eren

摘要

Background

Testicular germ cell tumors (TGCTs) are the most common solid malignancies among young men. Although overall survival exceeds 95%, a subset of patients still present with advanced disease or relapse. Identifying clinicopathological and modifiable lifestyle factors associated with advanced-stage presentation may improve risk stratification and guide management.

Methods

This retrospective study included 96 patients with TGCTs treated at a single tertiary center. Data on smoking status, body mass index (BMI), lymphovascular invasion (LVI), and tumor size were analyzed. Associations between these parameters and stage at diagnosis were assessed using chi-square tests and multivariable logistic regression. Recurrence-free survival (RFS) was evaluated by the Kaplan–Meier method.

Results

Among 96 patients (median age, 31 years), 59.4% had early-stage and 40.6% had advanced-stage disease. Smoking (OR = 8.17; p = 0.014), LVI (OR = 70.23; p < 0.001), and tumor size ≥ 4 cm (OR = 12.00; p = 0.009) were independently associated with advanced-stage presentation, whereas BMI showed no significant association. Recurrence occurred in 13.5% of patients, more frequently among smokers and LVI-positive cases, though not statistically significant.

Conclusion

Smoking, lymphovascular invasion, and tumor size ≥ 4 cm were independently associated with advanced-stage presentation in TGCTs, whereas obesity showed no significant association. The combined evaluation of pathological and lifestyle factors may enhance individualized risk stratification and inform future risk-adapted management strategies.