Second cancer risk following testicular cancer: a follow-up study of 1,909 patients.

Leeuwen, Flora E. van; Stiggelbout, Anne M.; Belt-Dusebout, Alexandra W. van den; Noyon, R.; Eliel, Miriam R.; Kerkhoff, E. H. M. Van; Delemarre, J. F. M.; Somers, R.

doi:10.1200/jco.1993.11.3.415

Cited by 241 publications

(130 citation statements)

References 44 publications

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“…Our study describes side effects in patients with testicular seminoma stage I after radiotherapy and is in concordance with similar studies (11,31). According to a large multicentre studies, 4 % to 7 % of patients developed the secondary cancer after radiotherapy of testicular cancer, of which the highest risk was for gastrointestinal cancers (9,32). In the past, however, irradiation fi elds were larger and so was the total dose of irradiation (33,34).…”

Section: Resultssupporting

confidence: 73%

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Gamulin

Grgić

Bišof

2011

Archives of Industrial Hygiene and Toxicology

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In this study we followed up the side effects of adjuvant radiotherapy in patients with testicular seminoma stage I over a period from 13 to 84 months (median 28 months). The most frequent side effects during radiotherapy were gastrointestinal (nausea/vomiting), psychological, cognitive, and minor sexual problems. The reported side effects were treated by antiemetics and anxiolytics. After radiotherapy, the side effects persisted in 6 % of patients, but only a few of them required additional treatment. Healthy children were born to 76 % of patients in the 18 to 39 years age group. This study shows that adjuvant radiotherapy of the para-aortic lymph nodes with the total dosage of 24 Gy in 16 daily fractions administered to testicular seminoma patients causes acceptable side effects, does not adversely affect quality of life and fertility, if the approach to treatment is individual and family consulting is provided. This makes adjuvant radiotherapy of the para-aortic lymph nodes an acceptable treatment for testicular seminoma stage I patients. Testicular germ cell tumours are relatively rare, appearing in 1 % of all tumours in male patients (1). Most of these tumours originate in germ cells (seminoma and non-seminoma germ cell testicular tumours, sometimes the combination of these two groups), and more than 70 % of patients are diagnosed the disease while it is still in stage I. These malignancies represent the most common solid tumours in young men aged 25 to 35 years and are highly curable. KEY WORDS: early stage seminoma, follow-up, para-aortic radiotherapy, quality of life, radiation toxicityPure seminoma is the most common variant of testicular germ cell tumours, accounting for in about 40 % of all cases. Seminoma is highly radiosensitive and chemosensitive (2). Adjuvant radiotherapy of the para-aortic lymph nodes after orchidectomy is one of the three approaches to management, which include surveillance, adjuvant radiotherapy (infradiaphragmatic 20 Gy to 25 Gy to include the para-aortic nodes), and adjuvant chemotherapy with carboplatin with area under the curve =7, (AUC=7) x 1 cycle or AUC=7 x 2 cycles (3-6).Many surveillance studies suggest that 15 % to 20 % of these patients develop a metastatic disease. The adjuvant therapy is successful in 96 % to 100 % of patients (4,7,8). Many studies suggest that carboplatin is not inferior to adjuvant radiotherapy in preventing metastatic relapse. The estimation of the therapy success, however, should include the quality of life during as well as after therapy. To improve the quality of life , it is therefore advisable to know which side effects to expect and how to prevent them).

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Section: Resultssupporting

confidence: 73%

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Gamulin

Grgić

Bišof

2011

Archives of Industrial Hygiene and Toxicology

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“…Testicular cancer patients may be less likely to know of cancers in the grandparents than in their first-degree relatives. On the other hand, it may be that there is a deficit of factors predisposing to common (Kaldor et al, 1987;Fossa et al, 1990;Moller H. et al, 1993;Jacobsen et al, 1993;van-Leeuwen et al, 1993 (Newman et al, 1988;Claus et al, 1991;Iselius et al, 1991Iselius et al, , 1992. If we set the gene frequency to 1:200-1:300, the expected number of breast(-ovarian) families would be 3-5.…”

Section: Discussionmentioning

confidence: 99%

Risk of cancer in relatives of testicular cancer patients

Heimdal

Olsson²,

Tretli³

et al. 1996

Br J Cancer

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“…4,5 Patients with unilateral testicular germ cell tumor (TGCT) are at increased risk of developing a metachronous contralateral TGCT, with a cumulative incidence of 1-5%, [6][7][8] and a relative risk ranging from 12 to 36 compared to TGCT development in the general population. [7][8][9][10][11][12] Age below 30 years has been shown to be an important risk factor, whereas results regarding histology of the first primary (seminoma vs. nonseminoma) as risk factor for a second TGCT have been inconsistent. [6][7][8][9]12,13 Recent years' publications have addressed whether modern cisplatin-based chemotherapy might influence the effect of risk factors, but these results have also been inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Risk of metachronous contralateral testicular germ cell tumors: A population‐based study of 7,102 Norwegian patients (1953–2007)

Andreassen

Grotmol

Cvancarova

et al. 2011

Intl Journal of Cancer

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The purpose of the study was to identify overall incidence and risk of developing a metachronous contralateral testicular germ cell tumor (TGCT) and compare the risk for patients treated before and after 1980 (cisplatin became available for patients with metastatic TGCT). Our hypothesis was that the risk of metachronous TCGT would be reduced for patients with metastatic disease diagnosed after 1980. We included 7,102 men with unilateral TGCT, recorded in the Cancer Registry of Norway. Allowing for competing risk, cumulative incidence and adjusted hazard ratio (HR) were estimated for different subgroups, and the diagnostic periods 1953 -1979 (I) and 1980. Relative risks were assessed by standardized incidence ratio (SIR). In Period I and Period II, 38 and 137 males, respectively, were diagnosed with metachronous contralateral TGCT. Corresponding 20-year cumulative incidences were 1.9% and 3.9%. In Period II, risk of a second TGCT was halved [HR 5 0.5, 95% confidence interval (95% CI) 5 0.33-0.77] for patients with metastatic compared to localized disease. For patients presenting with localized and metastatic disease, the SIRs for Period I were 14.6 (95% CI 5 9.6-21.2) and 25.3 (95% CI 5 12.1-46.5), respectively. In Period II, the corresponding numbers were 19.0 (95% CI 5 15.6-22.9) and 9.8 (95% CI 5 6.4-14.5). In conclusion, the risk of metachronous contralateral TGCT was halved for patients with metastatic compared to localized disease in Period II, whereas this protective effect of extent of disease lacked significance for Period I. These findings support our hypothesis that cisplatin-based chemotherapy reduced the risk of a second TGCT for patients with metastatic TGCT diagnosed after 1980.

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Second cancer risk following testicular cancer: a follow-up study of 1,909 patients.

Cited by 241 publications

References 44 publications

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Side Effects of Adjuvant Radiotherapy in Men with Testicular Seminoma Stage I

Risk of cancer in relatives of testicular cancer patients

Risk of metachronous contralateral testicular germ cell tumors: A population‐based study of 7,102 Norwegian patients (1953–2007)

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