Testicular cancer in Europe and the USA: survival still rising among older patients

Ann Oncol. 2013 Feb;24(2):508-513. doi: 10.1093/annonc/mds460. Epub 2012 Oct 30.

Abstract

Background: Despite high curability, some testicular cancer (TC) patient groups may have increased mortality. We provide a detailed age- and histology-specific comparison of population-based relative survival of TC patients in Europe and the USA. Design Using data from 12 European cancer registries and the USA Surveillance, Epidemiology and End Results 9 database, we report survival trends for patients diagnosed with testicular seminomas and nonseminomas between 1993-1997 and 2003-2007. Additionally, a model-based analysis was used to compare survival trends and relative excess risk (RER) of death between Europe and the USA adjusting for differences in age and histology.

Results: In 2003-2007, the 5-year relative survival of patients with testicular seminoma was at least 98% among those aged <50 years, survival of patients with nonseminoma remained 3%-6% units lower. Despite improvements in the relative survival of nonseminoma patients aged ≥ 50 years by 13%-18% units, survival remained markedly lower than the survival of seminoma patients of the same age. Model-based analyses showed increased RERs for nonseminomas, older, and European patients.

Conclusions: There remains little room for survival improvement among testicular seminoma patients, especially for those aged <50 years. Older TC patients remain at increased risk of death, which seems mainly attributable to the lower survival among the nonseminoma patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Europe / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Risk
  • Seminoma / drug therapy
  • Seminoma / epidemiology
  • Seminoma / mortality*
  • Survival Analysis
  • Survival Rate
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / epidemiology
  • Testicular Neoplasms / mortality*
  • United States / epidemiology
  • Young Adult