Increased mortality rates in young and middle-aged patients with malignant germ cell tumours

Fosså, Sophie D.; Aass, Nina; Harvei, S.; Tretli, Steinar

doi:10.1038/sj.bjc.6601558

Cited by 81 publications

(50 citation statements)

References 29 publications

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“…However, these findings should be interpreted with caution in view of the limited number of patients with long-term follow-up. Fossa et al (2004) reported mortality rates in patients treated in Norway below age 56 years between 1962 and 1997, and found that among those not dying from malignant germ cell tumours there were significantly increased SMRs for diseases of the circulatory system, benign gastrointestinal disorders, and non germ cell malignancies. However, the mortality from non germ cell cancers was higher in those treated between 1970 and 1997 than in those treated in the 1960s.…”

Section: Discussionmentioning

confidence: 99%

Mortality and incidence of second cancers following treatment for testicular cancer

2007

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We studied 5555 seminoma patients and 3733 patients with nonseminomatous testicular cancers diagnosed in Southeast England between 1960 and 2004. For both groups survival improved over time: 10-year relative survival increased from 78% in 1960 -1969 to 99% in 1990 -2004 for seminomas, and from 55 to 95% for nonseminomas. In the early period mortality was still significantly increased more than 15 years after diagnosis in both groups, whereas in more recent periods the excess deaths mainly occurred in the first 5 years after diagnosis. For seminomas, there was a significant excess of cancers of the colon (standardised incidence ratio (SIR) 2.36; 95% confidence interval (CI) 1.13 -4.35), soft tissue (SIR 13.64; CI 1.65 -49.28) and bladder (SIR 4.28; CI 2.28 -7.31) in the long term (20 þ years after diagnosis), of pancreatic cancer in both the medium (10 -19 years) (SIR 2.91; CI 1.26 -5.73) and long term (SIR 5.48; CI 2.37 -10.80), of leukaemia in both the short (0 -9 years) (SIR 3.01; CI 1.44 -5.54) and long term (SIR 4.48; CI 1.64 -9.75), and of testis cancer in both the short (SIR 6.69;) and medium term (SIR 3.96; CI 1.08 -10.14). For nonseminomas, significant excesses were found in the long term for cancers of the stomach (SIR 5.13; CI 1.40 -13.13), rectum (SIR 4.49;) and pancreas , and for testis cancer in the medium term (SIR 5.94;. Leukaemia was significantly increased in the short term (SIR 6.78; CI 2.93 -13.36). The better survival observed is largely attributable to improved treatment, and the trend in reducing the toxicity of therapy should continue to reduce future health risks in testicular cancer survivors.

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Section: Discussionmentioning

confidence: 99%

Mortality and incidence of second cancers following treatment for testicular cancer

2007

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“…[83][84][85] As CRP is recognized as a significant biomarker for various disorders, including cardiovascular disease 35 and malignancies, CRP acts as a predictor for the subsequent development of these disorders.…”

Section: Crp As a Prognosticator For Late Complications In Testicularmentioning

confidence: 99%

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Saito

Kihara

2012

Int J of Urology

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Abbreviations & AcronymsAbstract: Based on increasing evidence of the association between cancer-related inflammation and the progression of cancer, the external symptoms of systemic inflammatory response has been shown to be an indicator for the prognosis of many malignancies, including urological cancers. C-reactive protein, a representative acute-phase reactant, is a significant and sensitive inflammatory marker that can be objectively measured using reliable assays in clinical practice worldwide. C-reactive protein has been shown to be significant in the prediction of outcomes of urological cancers. The elevation of C-reactive protein levels, which indicate the presence of cancer-associated systemic inflammatory response, is linked to poorer survival in patients with urological cancers, including renal cell carcinoma, upper urinary tract and bladder cancers, and prostate cancer. With this strong prognostic ability, C-reactive protein can be incorporated into prognostic models and will make them simpler and improve their predictive accuracy. Furthermore, the longitudinal change of C-reactive protein level, C-reactive protein kinetics, provides additional information on patient survival outcomes. As such, C-reactive protein can be used to monitor treatment efficacy and disease course using serial measurements. In testicular cancer, C-reactive protein is associated with a risk of late complications, such as cardiovascular disease, and with the development of second non-germ-cell cancer. Taken together, these findings show that C-reactive protein can act as an important biomarker for urological cancers. This review discusses the importance of C-reactive protein as a prognostic biomarker in urological cancers on the basis of the currently available evidence.

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“…Previous studies have shown that secondary malignancies have emerged as the leading cause of death among testicular cancer survivors. 26,27 In our study, only one of the 18 patients with chemotherapy relapsed (5.6%). The cumulative 4-year recurrence-free rate was 100%, and grade 3/4 chemotherapy-related toxicity was not found.…”

Section: Discussionmentioning

confidence: 51%

Clinical outcomes in patients with stage I non-seminomatous germ cell cancer

Lv¹,

Wu²,

Dong³

et al. 2013

Asian J Androl

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This study assesses the long-term outcomes in Han Chinese patients with clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT) treated with surveillance, retroperitoneal lymph node dissection (RPLND) and adjuvant chemotherapy. We retrospectively evaluated 89 patients with a mean age of 26.5 years. After orchiectomy, 37 patients were treated with surveillance, 34 underwent RPLND and 18 were managed with chemotherapy. The overall survival rate, the recurrence-free survival rate and the risk factors were evaluated. The median follow-up length was 92 months (range: 6-149 months). Thirteen of the 89 patients (14.6%) had relapses, and one died by the evaluation date. The overall survival rate was 98.9%. The cumulative 4-year recurrence-free rates were 80.2%, 92.0% and 100% for the surveillance, RPLND and chemotherapy groups, respectively. The disease-free period tended to be briefer in patients with a history of cryptorchidism and those with stage Is. Therefore, surveillance, RPLND and adjuvant chemotherapy might be reliable strategies in compliant patients with CSI NSGCT. Surveillance should be recommended for patients with the lowest recurrence rate, especially those without lymphovascular invasion. This study might aid the establishment of a standard therapy for CSI NSGCT in China.

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Increased mortality rates in young and middle-aged patients with malignant germ cell tumours

Cited by 81 publications

References 29 publications

Mortality and incidence of second cancers following treatment for testicular cancer

Mortality and incidence of second cancers following treatment for testicular cancer

Role of C‐reactive protein in urological cancers: A useful biomarker for predicting outcomes

Clinical outcomes in patients with stage I non-seminomatous germ cell cancer

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