B115
The incidence of extragonadal germ cell tumours in England, 1979 to 2003
Ramandeep Arora1, Robert Alston1, Tim Eden2, Anthony Moran2, Marco Geraci1, Jillian Birch1
1University of Manchester, UK, 2Christie Hospital NHS Foundation Trust, Manchester, UK
Background
Whereas the epidemiology of testicular germ cell tumours(GCT) has been the subject of extensive research, there has been no population based analysis of extragonadal GCT. We aim to analyse and characterise the incidence of these tumours.
Method
All malignant GCT and benign and uncertain behaviour CNS GCT newly diagnosed between 1979 and 2003 in the age group 0 to 89 years were included. Age-standardised incidence rates were expressed per million person years.
Results
Overall 1213 of the 33464 GCTs (3.6%) were extragonadal in location but 44% of all GCTs in children aged 0-14 years were extragonadal. The overall incidence rate was 1.17. CNS was the most common extragonadal site for GCT followed by mediastinum in males and pelvis/sacrococcyx in females. Among CNS GCT, a large distinct peak of pineal germinomas was seen at 10-14 years of age in males and a much smaller peak in females. In contrast, teratomas and non-pineal CNS GCT peaked at 0-4 years age with the incidence higher in females. GCT of the mediastinum (germinoma and teratoma) and retroperitoneum (teratoma) had a strong male preponderance and peaked in incidence at 30-34 years and 25-29 years age respectively. Pelvic/Sacrococcygeal tumours (yolk sac tumours and teratomas) had a female preponderance and peaked at age 0-4 years and then sharply declined in incidence.
Conclusion
While, there is considerable similarity between the age-incidence patterns of gonadal and extragonadal GCTs, some important differences are highlighted. Future genetic and epidemiological studies need to consider GCTs from all sites to enable a better understanding of the biology and etiology of these tumours.
