SUN-280 - Insights from the SEER Database into Demographic and Treatment Factors in Survival of Sertoli Cell and Sertoli-Leydig Tumors

Introduction/

Background: Sertoli and Sertoli-Leydig cell tumors (SLCTs) are rare neoplasms with generally indolent behavior. Prior epidemiological studies are limited, and a gap exists in comprehensively evaluating the impact of demographic and socioeconomic factors on patient survival.

Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2022) for patients with ovarian SLCTs using ICD-O-3 codes 8631/3, 8634/3, and 8640/3. Overall survival was analyzed using Kaplan-Meier curves and log-rank tests in GraphPad Prism. Associations were evaluated for age, race, marital status, household income, and primary treatment modality (surgery, chemotherapy, radiation).

Results: The study included 352 patients. Over a median follow-up of 61 months, 107 deaths occurred. Increasing age was the single most significant prognostic factor. Pediatric patients (n=72, 7 deaths) had significantly better survival than adults < 65 (Hazard Ratio [HR] 0.43, 95% Confidence Interval [CI] 0.26-0.72, p=0.0046) and adults ≥65 (HR 0.15, CI 0.07-0.29, p< 0.0001). Adults < 65 (n=230, 70 deaths) also had better survival than those ≥65 (n=50, 30 deaths; HR 0.37, CI 0.22-0.63, p=0.02). Regarding treatment, surgery was associated with the best outcomes (n=342, 102 deaths). Compared to surgery, chemotherapy (n=156, 59 deaths) was associated with worse survival (HR 1.42, CI 1.01-2.00, p=0.044). Radiation (n=8, 8 deaths) performed worst versus surgery (HR 10.67, CI 2.98-38.29, p=0.0003) and chemotherapy (HR 3.99, CI 1.35-11.84, p=0.0126). Non-significant trends pointed toward poorer survival in Caucasian, unmarried, and lower-income patients.

Conclusions: SLCTs are indolent with good overall survival, but age is a powerful prognostic factor. The superior outcomes with surgery likely reflect more aggressive or systemic disease in chemotherapy and or palliative use of radiation. The high mortality in elderly and untreated patients suggests consideration for more aggressive intervention in operable cases. Observed demographic disparities require validation in larger cohorts due to the limited sample size.

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