%0 Journal Article
%T Survival differences in non-seminoma testis cancer patients according to race/ethnicity.
%A Incesu RB
%A Barletta F
%A Tappero S
%A Piccinelli ML
%A Garcia CC
%A Morra S
%A Scheipner L
%A Tian Z
%A Saad F
%A Shariat SF
%A Ahyai S
%A Longo N
%A Chun FKH
%A de Cobelli O
%A Terrone C
%A Briganti A
%A Tilki D
%A Graefen M
%A Karakiewicz PI
%J Cancer Epidemiol
%V 89
%N 0
%D 2024 Apr 19
%M 38377946
%F 2.89
%R 10.1016/j.canep.2024.102538
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.