Risk of second primary cancers after testicular cancer in East and West Germany: A focus on contralateral testicular cancers

Abstract

Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type (seminoma and non-seminoma) among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany (1961–1989 and 1996–2008) and Saarland (a federal state in West Germany; 1970–2008), respectively. We estimated the risk of a second primary cancer using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 (SIR: 1.9; 95% CI: 1.7–2.1), and 159 cancers (any location) were observed between 1996 and 2008 (SIR: 1.7; 95% CI: 1.4–2.0). The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.

Polygenic susceptibility to testicular cancer: implications for personalised health care

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Common variants identified in genome‐wide association studies of testicular germ cell tumour: an update, biological insights and clinical application

“…Cure rates for TGCT are high, owing to the sensitivity of malignant testicular germ cells to platinum‐based chemotherapies. However, this is at the cost of considerable survivorship issues secondary to side effects from treatments administered at a comparatively young age: these include a reported increased risk of metabolic syndrome, infertility and secondary cancers (Bujan et al ., ; de Haas et al ., ; Rusner et al ., ). Furthermore, there are limited options for patients who demonstrate platinum resistance, a group for whom the long‐term survival rate is only 10–15% (Nitzsche et al ., ).…”

Intratumoural immune cell landscape in germinoma reveals multipotent lineages and exhibits prognostic significance

“…Adjuvant chemo‐ and radiotherapy are the current standard of care to achieve long‐time survival . However, as germinoma occurs predominantly in patients of paediatric and adolescent ages, and because these treatments can have side effects that include cognitive dysfunction and secondary malignancy among others, the search for alternative treatment options has long been a priority .…”