Woldu Solomon L, Aydin Ahmet M, Rao Ashwin V, Hutchinson Ryan C, Singla Nirmish, Clinton Timothy N, Krabbe Laura-Maria, Passoni Niccolo M, Raj Ganesh V, Miller David S, Amatruda James F, Sagalowsky Arthur I, Lotan Yair, Arriaga Yull, Margulis Vitaly, Bagrodia Aditya
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Deparment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
Urology. 2018 Feb;112:103-111. doi: 10.1016/j.urology.2017.08.059. Epub 2017 Dec 6.
To describe epidemiologic patterns, stage at presentation, histology, and treatment differences associated with Hispanic men diagnosed with testicular germ cell tumor (TGCT). Hispanics are the fastest growing demographic in the United States and reports suggest that the incidence of TGCT is rising most rapidly in this demographic, yet little is known about TGCTs in Hispanic patients.
We compared patient factors, tumor characteristics, treatment patterns, and outcomes of non-Hispanic white (NHW) vs Hispanic patients at our own institution in North Texas from 2010 to 2016. The findings were corroborated by analyzing the National Cancer Database testicular cancer registry from 2004 to 2014.
We identified 154 patients with TGCT at our institution, of which 89 were NHW (56.0%) and 65 were Hispanic (40.9%). A review of the National Cancer Database identified 49,607 NHW patients (81.5%) and 6724 Hispanic patients (11.0%) diagnosed with TGCT. At presentation, Hispanic patients were approximately 5 years younger than NHW patients, delay seeking care for testicular cancer, were more likely to have nonseminomatous histology, had a larger tumor size, and had a higher disease burden at presentation. Additionally, we identified differences in treatment patterns at the national level.
Differences in outcomes and treatment patterns of Hispanic and NHW patients with TGCT may represent underlying socioeconomic issues and access to care; however, discrepancies in age of onset and histology of TGCT between Hispanic and NHW patients may signify differences in tumor biology or risk factors. We suggest that this possibility be explored further as we embark upon the genomic classification of TGCT.
描述被诊断为睾丸生殖细胞肿瘤（TGCT）的西班牙裔男性的流行病学模式、就诊时的分期、组织学以及治疗差异。西班牙裔是美国增长最快的人口群体，报告显示TGCT的发病率在该群体中上升最为迅速，但对于西班牙裔患者的TGCT却知之甚少。
我们比较了2010年至2016年在北德克萨斯我们自己机构中，非西班牙裔白人（NHW）与西班牙裔患者的患者因素、肿瘤特征、治疗模式及预后。通过分析2004年至2014年国家癌症数据库的睾丸癌登记数据，对研究结果进行了验证。
我们在本机构中确定了154例TGCT患者，其中89例为NHW（56.0%），65例为西班牙裔（40.9%）。对国家癌症数据库的回顾确定了49,607例被诊断为TGCT的NHW患者（81.5%）和6724例西班牙裔患者（11.0%）。就诊时，西班牙裔患者比NHW患者年轻约5岁，在寻求睾丸癌治疗方面存在延迟，更有可能具有非精原细胞瘤组织学类型，肿瘤尺寸更大，且就诊时疾病负担更高。此外，我们还发现了国家层面治疗模式的差异。
西班牙裔和NHW TGCT患者在预后和治疗模式上的差异可能代表潜在的社会经济问题及医疗可及性；然而，西班牙裔和NHW患者在TGCT发病年龄和组织学上的差异可能意味着肿瘤生物学或危险因素的不同。我们建议在着手进行TGCT的基因组分类时，进一步探讨这种可能性。
