Table 4.
Multivariable Cox Regression Analyses of Cardiovascular Disease Deaths in Men Diagnosed With Testicular Nonseminoma According to Baseline Characteristics
| Variable | All Cardiovascular Deaths (n = 104) |
||
|---|---|---|---|
| HR | 95% CI | P | |
| Initial treatment by time since TC diagnosis | |||
| < 1 year | |||
| Surgery (no RT) | — | — | Ref |
| Chemotherapy (no RT) | 4.86* | 1.25 to 32.08 | .04 |
| 1-4 years | |||
| Surgery (no RT) | — | — | Ref |
| Chemotherapy (no RT) | 1.35 | 0.54 to 3.45 | .53 |
| ≥ 5 years | |||
| Surgery (no RT) | — | — | Ref |
| Chemotherapy (no RT) | 0.90 | 0.51 to 1.58 | .72 |
| Age at diagnosis, years | |||
| < 30 | — | — | Ref |
| 30-39 | 3.47* | 1.99 to 6.13 | < .01 |
| 40-49 | 8.97* | 4.73 to 17.02 | < .01 |
| ≥ 50 | 34.26* | 17.81 to 66.17 | < .01 |
| Calendar year of diagnosis | |||
| 1980-1989 | — | — | Ref |
| 1990-1999 | 0.78 | 0.46 to 1.32 | .35 |
| 2000-2010 | 0.67 | 0.35 to 1.30 | .23 |
| Extent of disease | |||
| Localized | — | — | Ref |
| Regional | 1.45 | 0.87 to 2.40 | .15 |
| Distant | 1.91* | 1.02 to 3.55 | .04 |
| Unknown | 0.93 | 0.05 to 4.30 | .94 |
| Race | |||
| White | — | — | Ref |
| Nonwhite | 1.31 | 0.51 to 2.76 | .53 |
| County education level† | |||
| Education 1 (low) | — | — | Ref |
| Education 2 (medium) | 0.94 | 0.60 to 1.49 | .78 |
| Education 3 (high) | 0.83 | 0.46 to 1.48 | .54 |
| Marital status‡ | |||
| Never married | — | — | Ref |
| Married | 0.76 | 0.48 to 1.24 | .27 |
| Separated/divorced/widowed | 1.08 | 0.47 to 2.23 | .85 |
| Unmarried/domestic partner/unknown | 1.52 | 0.45 to 3.86 | .44 |
Abbreviations: HR, hazard ratio; Ref, reference; RT, radiotherapy.
HR with P < .05.
County education level was categorized based on tertiles of distribution, as follows: education 1 represents the lowest level (composed of counties with ≥ 25% of men without a high school education); education 2 represents the medium level (counties with 15% to < 25% of men without a high school education); and education 3 represents the highest level (counties with < 15% of men without a high school education). One person with unknown county education level and who had no cardiovascular event was excluded from the multivariable regression model.
In the multivariable model, the association of marital status with cardiovascular disease death was no longer significant, likely as a result of adjustment for age at testicular cancer diagnosis, because married or separated/divorced/widowed patients were older than never-married men (median ages, 33.2, 36.3, and 24.5 years, respectively).