Trends in Testicular Cancer Survival: A Large Population-based Analysis

• Published in: Urology (Ridgewood, N.J.) Vol. 85; no. 6; pp. 1394 - 1398
• Main Authors: Sui, Wilson, Morrow, David C, Bermejo, Carlos E, Hellenthal, Nicholas J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2015
• Subjects: Adult; European Continental Ancestry Group; Humans; Male; Middle Aged; Survival Rate - trends; Testicular Neoplasms - mortality; Urology; Young Adult
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2015.03.022

Objective To determine whether discrepancies in testicular cancer outcomes between Caucasians and non-Caucasians are changing over time. Although testicular cancer is more common in Caucasians, studies have shown that other races have worse outcomes. Materials and Methods Using the Surveillance, Epidemiology, and End Results registry, we identified 29,803 patients diagnosed with histologically confirmed testicular cancer between 1983 and 2011. Of these, 12,650 patients (42%) had 10-year follow-up data. We stratified the patients by age group, stage, race, and year of diagnosis and assessed 10-year overall and cancer-specific survival in each cohort. Cox proportional hazard models were used to determine the relative contributions of each stratum to cancer-specific survival. Results Predicted overall 10-year survival of Caucasian patients with testicular cancer increased slightly from 88% to 89% over the period studied, whereas predicted cancer-specific 10-year survival dropped slightly from 94% to 93%. In contrast, non-Caucasian men demonstrated larger changes in 10-year overall (84%-86%) and cancer-specific (88%-91%) survival. On univariate analysis, race was significantly associated with testicular cancer death, with non-Caucasian men being 1.69 times more likely to die of testicular cancer than Caucasians (hazard ratio, 1.33-2.16; 95% confidence interval, <.001). Conclusion Historically, non-Caucasian race has been associated with poorer outcomes from testicular cancer. These data show a convergence in cancer-specific survival between racial groups over time, suggesting that diagnostic and treatment discrepancies may be improving for non-Caucasians.