Epidemiology, treatment patterns, and survival outcomes of spermatocytic seminoma: A National Cancer Database analysis.

5027 Background: Spermatocytic seminoma (SS) is a rare germ cell tumor, representing 2-5% of seminomas. Unlike classical seminomas, SS primarily affects older men (median age: 55 years) and exhibits low metastatic potential, though rare sarcomatoid transformations can lead to aggressive behavior. Treatment typically involves orchiectomy, with adjuvant therapies reserved for advanced cases. Despite its distinct clinical behavior, SS remains understudied, with limited data on its epidemiology, demographic patterns, and socioeconomic influences. Leveraging the National Cancer Database (NCDB) could provide critical insights into its epidemiology and management. Methods: A retrospective cohort study using the 2004–2020 NCDB identified patients with histologically confirmed SS (ICD-O-3 code 9063). Demographic, socioeconomic, and clinical variables were analyzed descriptively, with incidence trends evaluated via regression analysis. Results: A total of 541 patients with histologically confirmed SS were identified in the NCDB from 2004–2020. The incidence rate remained stable (R^2 = 0.012). All patients were male, with a mean age of 58.9 years (SD = 16.6). The cohort was predominantly White (91.5%) and non-Hispanic (89.6%), with 49.2% privately insured and 38.6% covered by Medicare. Most patients (55.1%) resided in metropolitan areas, and treatment was primarily delivered at comprehensive community cancer programs (43.5%) and academic/research programs (26.1%). Most patients (67.8%) were diagnosed at Stage I, with 82.4% having a Charlson-Deyo comorbidity score of 0. Surgery was performed in 98.9% of cases, with 95.2% achieving no residual tumor. Radiation therapy (18.3%) and chemotherapy (5.9%) were rarely used. The 30-day mortality rate was 0.6%, and the 90-day mortality rate was 1.0%. Survival rates were 98.0% (2-year), 96.0% (5-year), and 91.5% (10-year). Conclusions: This represents the first NCDB in-depth demographic analysis of spermatocytic seminoma (SS), addressing a significant gap in the literature on this rare malignancy. The study shows that SS predominantly affects males, with a strong predilection for non-Hispanic White individuals, consistent with prior case reports and small-scale studies. Additionally, this analysis provides novel insights into the socioeconomic profile of SS patients, revealing a tendency toward higher income brackets, residence in urban metropolitan areas, and treatment at community-based cancer programs rather than academic institutions. Future research should explore how demographic and socioeconomic factors influence diagnostic pathways, treatment decisions, and survival outcomes in this patient population.