In previous reports on scrotal carcinomas, overall 5-year survival rates have varied from 18% to 70% without explanation. In this study, survival was determined through the active follow-up of the Connecticut Tumor Registry for 65 cases of scrotal carcinoma diagnosed in the state from 1935 to 1980. The overall actuarial probability of surviving 5 years was 0.57. Stage and age at diagnosis were statistically significant predictors of survival (P < 0.001 and P = 0.016, respectively). Survival varied progressively with combinations of these two variables with subjects younger than age 65 years and localized at diagnosis having 5-year survival of 0.75, compared to 0.17 for subjects age 65 years and older with regional or distant spread; these survival outcomes encompassed those of previous reports. With the passage of more than four decades, no improvement in survival was detectable. Initial radiotherapy, given to nine cases, also bore no detectable relationship to survival after adjustment for other variables. The 30 men in metalworking occupations previously shown to be associated with this cancer were not more frequently diagnosed with the cancer in localized stage, and showed a survival similar to that for the 29 men in other occupations.
Cancer 55666-671, 1985.
ONNECTICUT METALWORKERS have had more than C a 1 0-fold risk for scrotal carcinoma, and this occupational group alone appears to have accounted for more than 50% of the cases diagnosed in the state.l For the past four decades, the risk for this cancer in Connecticut has not declined significantly among metalworkers' or in the general population.2 Cutting oils constitute an important potential group of carcinogens among metalworkers, various subgroups of whom appear to be at increased risk for cancers of the internal nose and paranasal sin use^,^ lung ~a n c e r , ~, ~ and cancer of the gastrointestinal t r a ~t . ~, ~* ~ This article examines survival experience of patients with scrotal carcinoma because of apparent inconsistencies when previous literature is considered, because survival might have improved since publication of earlier reports, and because few published data (if any) compare survival in metalworkers with survival in non-metalworkers.