Incesu Reha-Baris, Barletta Francesco, Tappero Stefano, Piccinelli Mattia Luca, Garcia Cristina Cano, Morra Simone, Scheipner Lukas, Tian Zhe, Saad Fred, Shariat Shahrokh F, Ahyai Sascha, Longo Nicola, Chun Felix K H, de Cobelli Ottavio, Terrone Carlo, Briganti Alberto, Tilki Derya, Graefen Markus, Karakiewicz Pierre I
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Cancer Epidemiol. 2024 Apr;89:102538. doi: 10.1016/j.canep.2024.102538. Epub 2024 Feb 20.
BACKGROUND: Historic evidence suggests that non-Caucasian race/ethnicity predisposes to higher testis cancer-specific mortality (CSM) in non-seminoma. However, it is unknown, whether higher CSM in non-Caucasians applies to Hispanics or Asians or African-Americans, or all of the above groups. In contemporary patients, we tested whether CSM is higher in these select non-Caucasian groups than in Caucasians, in overall and in stage-specific comparisons: stage I vs. stage II vs. stage III. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database (2004 -2019) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of race/ethnicity on CSM after stratification for stage (I vs. II vs. III) and adjustment for prognosis groups in stage III. RESULTS: In all 13,515 non-seminoma patients, CSM in non-Caucasians was invariably higher than in Caucasians. In stage-specific analyses, race/ethnicity represented an independent predictor of CSM in Hispanics in stage I (HR 1.8, p = 0.004), stage II (HR 2.2, p = 0.007) and stage III (HR 1.4, p < 0.001); in African-Americans in stage I (HR 3.2; p = 0.007) and stage III (HR 1.5; p = 0.042); and in Asians in only stage III (HR 1.6, p = 0.01). CONCLUSIONS: In general, CSM is higher in non-Caucasian non-seminoma patients. However, the CSM increase differs according to non-Caucasian race/ethnicity groups. Specifically, higher CSM applies to all stages of non-seminoma in Hispanics, to stages I and III in African-Americans and only to stage III in Asians. These differences are important for individual patient management, as well as for design of prospective trials.
背景：历史证据表明，非白种人种族/族裔在非精原细胞瘤中更容易导致更高的睾丸癌特异性死亡率（CSM）。然而，尚不清楚非白种人中较高的CSM是否适用于西班牙裔、亚裔或非裔美国人，或者上述所有群体。在当代患者中，我们测试了在总体以及特定分期（I期与II期与III期）比较中，这些特定的非白种人群体的CSM是否高于白种人。 方法：使用监测、流行病学和最终结果（SEER）数据库（2004 - 2019年）。Kaplan-Meier曲线和多变量Cox回归模型在对分期（I期与II期与III期）进行分层并对III期的预后组进行调整后，测试种族/族裔对CSM的影响。 结果：在所有13515例非精原细胞瘤患者中，非白种人的CSM始终高于白种人。在特定分期分析中，种族/族裔是西班牙裔I期（风险比[HR] 1.8，p = 0.004）、II期（HR 2.2，p = 0.007）和III期（HR 1.4，p < 0.001）CSM的独立预测因素；是非裔美国人I期（HR 3.2；p = 0.007）和III期（HR 1.5；p = 0.042）CSM的独立预测因素；是亚裔仅III期（HR 1.6，p = 0.01）CSM 的独立预测因素。 结论：一般而言，非白种人非精原细胞瘤患者的CSM较高。然而，CSM的增加因非白种人种族/族裔群体而异。具体而言，西班牙裔非精原细胞瘤各期的CSM均较高，非裔美国人I期和III期较高，而亚裔仅III期较高。这些差异对于个体患者管理以及前瞻性试验设计都很重要。
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