Survival of stage III non-seminoma testis cancer patients versus simulated controls, according to race/ethnicity

Int J Urol. 2024 Oct;31(10):1137-1143. doi: 10.1111/iju.15532. Epub 2024 Jul 5.

Abstract

Background: It is unknown whether 5-year overall survival (OS) differs and to what extent between the American Joint Committee on Cancer stage III non-seminoma testicular germ cell tumor (NS-TGCT) patients and simulated age-matched male population-based controls, according to race/ethnicity groups.

Methods: We identified newly diagnosed (2004-2014) stage III NS-TGCT patients within the Surveillance Epidemiology and End Results database 2004-2019. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration (SSA) Life Tables with 5 years of follow-up. We compared OS rates between stage III NS-TGCT patients and simulated age-matched male population-based controls, according to race/ethnicity groups (Caucasian, Hispanic, Asian/Pacific Islander and African American). Both, cancer-specific mortality (CSM) and other-cause mortality (OCM) were computed.

Results: Of 2054 stage III NS-TGCT patients, 60% were Caucasians versus 33% Hispanics versus 4% Asians/Pacific Islanders versus 3% African Americans. The 5-year OS difference between stage III NS-TGCT patients versus simulated age-matched male population-based controls was highest in Asians/Pacific Islanders (64 vs. 99%, Δ = 35%), followed by African Americans (66 vs. 97%, Δ = 31%), Hispanics (72 vs. 99%, Δ = 27%), and Caucasians (76 vs. 98%, Δ = 22%). The 5-year CSM rate was highest in Asians/Pacific Islanders (32%), followed by African Americans (26%), Hispanics (25%), and Caucasians (20%). The 5-year OCM rate was highest in African Americans (8%), followed by Caucasians (4%), Asians/Pacific Islanders (4%), and Hispanics (2%).

Conclusion: Relative to SSA Life Tables, the highest 5-year OS disadvantage applied to stage III NS-TGCT Asian/Pacific Islander race/ethnicity group, followed by African American, Hispanic and Caucasian, in that order.

Keywords: SEER program; future life expectancy; non‐seminoma testis cancer; racial disparities.

MeSH terms

  • Adult
  • Case-Control Studies
  • Ethnicity
  • Humans
  • Male
  • Neoplasm Staging*
  • Neoplasms, Germ Cell and Embryonal* / ethnology
  • Neoplasms, Germ Cell and Embryonal* / mortality
  • Neoplasms, Germ Cell and Embryonal* / pathology
  • Racial Groups
  • SEER Program / statistics & numerical data
  • Survival Rate
  • Testicular Neoplasms* / ethnology
  • Testicular Neoplasms* / mortality
  • Testicular Neoplasms* / pathology
  • United States / epidemiology

Supplementary concepts

  • Nonseminomatous germ cell tumor