Clinical Disparities for Minorities and Foreign-Born Men With Undescended Versus Descended Testicular Germ Cell Tumors

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Abstract

Few reports have been published regarding the outcomes of patients who develop an undescended testicular malignancy (UTM). Patients with a diagnosis of nonseminomatous or seminomatous testicular cancer were identified in the Surveillance, Epidemiology, and End Results (SEER) database to analyze the sociodemographic and survival outcomes of patients with UTM and those with descended testicular malignancy (DTM). Patients with UTM were more likely to be older, married, 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.

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.

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