Abstract：
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.
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.
摘要：
背景：历史证据表明，非高加索种族/种族倾向于非精原细胞瘤中更高的睾丸癌症特异性死亡率（CSM）。然而,它是未知的，非高加索人的CSM是否适用于西班牙裔或亚洲人或非洲裔美国人，或以上所有组。在当代患者中，我们测试了这些非高加索人群的CSM是否高于高加索人群，在总体和特定阶段的比较中：I阶段与第二阶段vs.第三阶段。
方法：监测，流行病学,并使用最终结果（SEER）数据库（2004-2019年）。Kaplan-Meier图和多变量Cox回归模型测试了阶段分层后种族/种族对CSM的影响（Ivs.IIvs.III）和III期预后组的调整。
结果：在所有13,515例非精原细胞瘤患者中，非白种人的CSM总是高于白种人。在特定阶段的分析中，种族/民族代表了第一阶段西班牙裔CSM的独立预测因子(HR1.8，p=0.004)，II期（HR2.2，p=0.007）和III期（HR1.4，p<0.001）；在I期（HR3.2；p=0.007）和III期（HR1.5；p=0.042）的非洲裔美国人中，仅在III期（HR1.6，p=0.01）。
结论：一般来说，非白种人非精原细胞瘤患者的CSM较高。然而,CSM的增加根据非高加索种族/种族群体而不同.具体来说,较高的CSM适用于西班牙裔非精原细胞瘤的所有阶段，非洲裔美国人的第一阶段和第三阶段，只有亚洲人的第三阶段。这些差异对于个体患者管理很重要，以及前瞻性试验的设计。
方法：监测，流行病学,并使用最终结果（SEER）数据库（2004-2019年）。Kaplan-Meier图和多变量Cox回归模型测试了阶段分层后种族/种族对CSM的影响（Ivs.IIvs.III）和III期预后组的调整。
结果：在所有13,515例非精原细胞瘤患者中，非白种人的CSM总是高于白种人。在特定阶段的分析中，种族/民族代表了第一阶段西班牙裔CSM的独立预测因子(HR1.8，p=0.004)，II期（HR2.2，p=0.007）和III期（HR1.4，p<0.001）；在I期（HR3.2；p=0.007）和III期（HR1.5；p=0.042）的非洲裔美国人中，仅在III期（HR1.6，p=0.01）。
结论：一般来说，非白种人非精原细胞瘤患者的CSM较高。然而,CSM的增加根据非高加索种族/种族群体而不同.具体来说,较高的CSM适用于西班牙裔非精原细胞瘤的所有阶段，非洲裔美国人的第一阶段和第三阶段，只有亚洲人的第三阶段。这些差异对于个体患者管理很重要，以及前瞻性试验的设计。
