Department of Urology, First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Street, Nanjing, 210029, Jiangsu Province, China.
BMC Urol. 2023 Sep 2;23(1):144. doi: 10.1186/s12894-023-01309-3.
After the introduction of cisplatin-based chemotherapy, the survival time of testicular cancer (TC) patients has improved dramatically. However, the overall risk of death in patients with TC remains significantly higher than in the general population. The aim of this study was to assess and quantify the causes of death after TC diagnosis.
In total, 44,975 men with TC in the United States diagnosed and registered by the Surveillance, Epidemiology, and End Results (SEER) database during 2000 to 2018 were studied. In this study, standardized mortality rates (SMRs) were calculated for each cause of death in TC individuals and further analyzed in strata according to age and race.
Of the included participants, 3,573 (7.94%) died during the follow-up period. The greatest proportion of deaths (38.20%) occurred within 1 to 5 years after diagnosis. Most deaths occurred from TC itself and other cancers. For non-malignant conditions, the most common causes of death within 1 years after diagnosis were accidents and adverse effects (53, 4.75%) followed by diseases of heart (45, 4.04%). However, > 1 years after diagnosis, the most common noncancer causes of death were heart diseases. Results of stratified analysis show that non-Hispanic White TC participants have a lower SMR (0.68, 95% CI, 33.39-38.67) from Cerebrovascular Diseases than the general U.S.
Although TC remains the most common cause of death after TC diagnosis, other non-TC causes of death represent a significant number of deaths among TC men. These findings help TC survivors understand the various health risks that may occur at different follow-up periods.
顺铂为基础的化疗引入后,睾丸癌(TC)患者的生存时间显著改善。然而,TC 患者的总体死亡风险仍明显高于普通人群。本研究旨在评估和量化 TC 诊断后死亡的原因。
本研究共纳入美国监测、流行病学和最终结果(SEER)数据库 2000 年至 2018 年间诊断和登记的 44975 例 TC 男性患者。在本研究中,计算了 TC 个体每种死因的标准化死亡率(SMR),并进一步根据年龄和种族进行分层分析。
在纳入的参与者中,有 3573 例(7.94%)在随访期间死亡。最大比例的死亡(38.20%)发生在诊断后 1 至 5 年内。大多数死亡归因于 TC 本身和其他癌症。对于非恶性疾病,诊断后 1 年内最常见的死因是意外和不良反应(53 例,4.75%),其次是心脏病(45 例,4.04%)。然而,在诊断 1 年后,最常见的非癌症死因是心脏病。分层分析结果显示,非西班牙裔白人 TC 患者死于脑血管疾病的 SMR 较低(0.68,95%CI,33.39-38.67),低于美国一般人群。
尽管 TC 仍然是 TC 诊断后死亡的最常见原因,但其他非 TC 死因在 TC 男性中也代表了相当数量的死亡。这些发现有助于 TC 幸存者了解在不同随访期间可能发生的各种健康风险。