A North-West London Experience of the Impact of Treatment Related Toxicity on Clinical Outcomes of Elderly Patients with Germ Cell Tumors

SIMPLE SUMMARY: Germ cell testicular cancer is seen in men aged 15–35. Incidence of this cancer in the elderly aged > 45 is less than 10%. The aim of our retrospective study is to understand the treatment-related toxicity in the elderly population, the chemotherapy regimens used, and its tolerability in this age group. Incidence of non-seminomatous germ cell cancer was 42% and incidence of seminoma was 58% in this cohort of patients. We used chemotherapy regimens, similar to those used in the younger population; platinum-based regimens were the backbone of the treatment algorithm. Outcomes were similar to the population group aged 15–35, and around 96% of the population were alive 5 years after and beyond. Toxicity was more common in this age group, and careful consideration should be made for dose modification and appropriate use of supportive therapies. ABSTRACT: Background/Aim: The occurrence of germ cell tumour (GCT) in the elderly is rare, with scarce data available. The aim of this study was to understand the clinical outcomes of patients with GCT in patients aged > 45 years. Materials and Methods: A retrospective study was conducted in a large tertiary cancer centre in north-west London. Between 1 January 2003 and 31 March 2022, 108 cases of GCT in men aged > 45 years were identified and treated at the Mount Vernon Cancer Centre. The median age at diagnosis was 54 years (range = 45–70 years). Results: The 5-year survival rate of all patients was 96%, and the toxicity profile was similar to the younger age group. Conclusion: Older patients with GCT are able to tolerate chemotherapy; however, care must be taken to prevent life-threatening complications using appropriate dose modification.