TY - JOUR
T1 - Clinical Disparities for Minorities and Foreign-Born Men with Undescended Versus Descended Testicular Germ Cell Tumors
AU - Klaassen, Zachary
AU - Reinstatler, Lael
AU - Wilson, Shenelle N.
AU - Ellington, Chris
AU - Li, Qiang
AU - Terris, Martha K.
AU - Moses, Kelvin A.
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Few reports have been published regarding the outcomes of patients who develop an undescended testicular malignancy (UTM). Our objective was to analyze the sociodemographic and survival outcomes of patients with UTM and those of with descended testicular malignancy (DTM). Patients and Methods All 17 registries constituting the Surveillance, Epidemiology, and End Results (SEER) database were analyzed from 1988 to 2008. Patients with a descended or undescended testis and a diagnosis of nonseminomatous or seminomatous testicular cancer were identified. Descriptive statistical data and multivariate analysis were used to identify the predictors of a UTM diagnosis. The primary outcomes were overall and disease-specific survival. Results The study cohort included 10,159 men (95.3%) with DTM and 496 (4.7%) with UTM. Patients with UTM were more likely to be older, married, and a minority or foreign born and to have seminoma, a higher rate of node positivity, and a higher SEER stage compared with patients with DTM. The median survival time for patients with UTM was longer than that for patients with to DTM (83.1 vs. 72.5 months; P =.0001), although no difference was found in cancer-specific mortality (P =.34). Conclusion Patients with UTM are more likely to be a minority or foreign born, highlighting a previously unrecognized healthcare disparity that might represent a lack of diagnosis and access to care.
AB - Background Few reports have been published regarding the outcomes of patients who develop an undescended testicular malignancy (UTM). Our objective was to analyze the sociodemographic and survival outcomes of patients with UTM and those of with descended testicular malignancy (DTM). Patients and Methods All 17 registries constituting the Surveillance, Epidemiology, and End Results (SEER) database were analyzed from 1988 to 2008. Patients with a descended or undescended testis and a diagnosis of nonseminomatous or seminomatous testicular cancer were identified. Descriptive statistical data and multivariate analysis were used to identify the predictors of a UTM diagnosis. The primary outcomes were overall and disease-specific survival. Results The study cohort included 10,159 men (95.3%) with DTM and 496 (4.7%) with UTM. Patients with UTM were more likely to be older, married, and a minority or foreign born and to have seminoma, a higher rate of node positivity, and a higher SEER stage compared with patients with DTM. The median survival time for patients with UTM was longer than that for patients with to DTM (83.1 vs. 72.5 months; P =.0001), although no difference was found in cancer-specific mortality (P =.34). Conclusion Patients with UTM are more likely to be a minority or foreign born, highlighting a previously unrecognized healthcare disparity that might represent a lack of diagnosis and access to care.
KW - Clinical outcomes
KW - SEER
KW - Socioeconomic factors
KW - Testicular malignancy
KW - Undescended testis
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U2 - 10.1016/j.clgc.2015.08.004
DO - 10.1016/j.clgc.2015.08.004
M3 - Article
C2 - 26428610
AN - SCOPUS:84948809071
SN - 1558-7673
VL - 14
SP - e251-e255
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
ER -