Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

Schaapveld, Michael; Belt-Dusebout, Alexandra W. van den; Gietema, Jourik A.; Wit, Ronald de; Horenblas, Simon; Witjes, J. Alfred; Hoekstra, Harald J.; Kiemeney, Lambertus A.; Louwman, Marieke W. J.; Ouwens, Gabey M.; Aleman, Berthe M.P.; Leeuwen, Flora E. van

doi:10.1038/bjc.2012.448

Cited by 30 publications

(33 citation statements)

References 22 publications

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“…Hartmann's et al analysis covers the period between 1975 and 1996 when CTH was not standard treatment method for patients with mediastinal germ cell tumors. Patients with testicular cancers treated with CTH were found to have lower risk of developing metachronous testicular cancer than those treated without CTH (20,21). Therefore, the application of CTH in patients with extragonadal germ cell tumors might have a similar influence on risk of developing testicular cancers during follow-up but this hypothesis must be further verified in the future.…”

Section: Discussionmentioning

confidence: 97%

Primary mediastinal seminoma

et al. 2018

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Section: Discussionmentioning

confidence: 97%

Primary mediastinal seminoma

et al. 2018

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“…One potential advantage of carboplatin discussed in the MRC/EORTC study has been that of a lower risk of primary germ cell tumours in the contralateral testis with adjuvant carboplatin as opposed to RT. Although the results are promising, longer follow‐up has shown that the contralateral risk is not completely eliminated and the possibility that later occurrences of contralateral primary tumour may be seen with longer follow‐up .…”

Section: Discussionmentioning

confidence: 99%

Treatment burden in stage I seminoma: a comparison of surveillance and adjuvant radiation therapy

et al. 2013

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Objective• To examine the management and outcomes of patients with stage I seminoma and to relate these to overall treatment burden. Patients and Methods• A total of 764 patients with stage I seminoma underwent surveillance or adjuvant radiation therapy (RT) at a single institution.• First relapse on surveillance was managed with RT alone, or with combination chemotherapy (ChT) for more extensive recurrence. Second relapse was managed with ChT. • Relapse after adjuvant RT was treated with ChT.• The treatment burden was measured, according to the specific treatment undertaken after orchiectomy, by defining treatment episodes as follows: surgery -one episode; one course of RT -one episode; one course of ChT -one episode. Results• In all, 484 patients underwent surveillance and 280 received adjuvant RT.• The 5-and 10-year overall survival rates were 98.6 and 97.7% for surveillance, and 97.2 and 91.4% for adjuvant RT.• A total of 72 (15%) patients in the surveillance group relapsed; treatment for relapse was RT (n = 56), ChT (n = 15) and surgery (n = 1). Second relapse occurred in six patients; these patients were treated with ChT.• Of the patients in the adjuvant RT group, 14 (5%) relapsed:salvage treatment was 10 -ChT (n = 10) surgery (n = 1) and further RT (n = 3).• The overall treatment burden represented by number of treatment episodes per patient was 0.16 in the surveillance group and 1.05 in the adjuvant RT group. Conclusions• Surveillance reduces the overall treatment burden in patients with stage I seminoma and is the preferred management option.• The selective use of RT at first relapse for patients on surveillance leads to a similar requirement for subsequent ChT to that for patients on adjuvant RT.

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“…5 The unusual feature of the patient reported here is the development of a third primary tumour. Of the 403 case reports indexed in MEDLINE under both the MeSH headings "testicular neoplasm" and "neoplasms, multiple primaries," none in the last 25 years included patients with 3 or more metachronous primary testicular neoplasms.…”

Section: Discussionmentioning

confidence: 92%

Three primary testicular tumours: Trials and tribulations of testicular preservation

Forbes

Metcalfe

Murray

et al. 2013

CUAJ

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Balancing recurrence risk, side effects and patient preference in the treatment of multiple metachronous testicular tumours can be challenging. We present the case of a young male patient who developed 3 different primary testicular neoplasms over an 8-year period, each associated with retroperitoneal lymphadenopathy requiring chemotherapy. The first tumour at age 19 was managed with radical orchiectomy. Four years later, a partial orchiectomy was performed to remove 2 small lesions. Another 4 years later, a complete orchiectomy was required for an additional tumour. This case highlights the caveats of testis-sparing surgery for testis cancer and the need for careful surveillance in these patients.

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Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

Cited by 30 publications

References 22 publications

Primary mediastinal seminoma

Primary mediastinal seminoma

Treatment burden in stage I seminoma: a comparison of surveillance and adjuvant radiation therapy

Three primary testicular tumours: Trials and tribulations of testicular preservation

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