PURPOSE: Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminoma patients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. PATIENTS AND METHODS: Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. RESULTS: Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). CONCLUSION: To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility.
PURPOSE: Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminomapatients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. PATIENTS AND METHODS: Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. RESULTS: Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). CONCLUSION: To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility.
Authors: A J Swerdlow; M J Schoemaker; R Allerton; A Horwich; J A Barber; D Cunningham; T A Lister; A Z Rohatiner; G Vaughan Hudson; M V Williams; D C Linch Journal: J Clin Oncol Date: 2001-03-15 Impact factor: 44.544
Authors: Hye Jeong Kim; Na Kyung Kim; Ji Hun Choi; Seo Young Sohn; Se Won Kim; Sang-Man Jin; Hye Won Jang; Sunghwan Suh; Yong-Ki Min; Jae Hoon Chung; Sun Wook Kim Journal: Clin Endocrinol (Oxf) Date: 2013-01 Impact factor: 3.478
Authors: L B Travis; M Andersson; M Gospodarowicz; F E van Leeuwen; K Bergfeldt; C F Lynch; R E Curtis; B A Kohler; T Wiklund; H Storm; E Holowaty; P Hall; E Pukkala; D T Sleijfer; E A Clarke; J D Boice; M Stovall; E Gilbert Journal: J Natl Cancer Inst Date: 2000-07-19 Impact factor: 13.506
Authors: T Pal; F D Vogl; P O Chappuis; R Tsang; J Brierley; H Renard; K Sanders; T Kantemiroff; S Bagha; D E Goldgar; S A Narod; W D Foulkes Journal: J Clin Endocrinol Metab Date: 2001-11 Impact factor: 5.958
Authors: Lois B Travis; Mary Gospodarowicz; Rochelle E Curtis; E Aileen Clarke; Michael Andersson; Bengt Glimelius; Timo Joensuu; Charles F Lynch; Flora E van Leeuwen; Eric Holowaty; Hans Storm; Ingrid Glimelius; Eero Pukkala; Marilyn Stovall; Joseph F Fraumeni; John D Boice; Ethel Gilbert Journal: J Natl Cancer Inst Date: 2002-02-06 Impact factor: 13.506
Authors: Graça M Dores; Catherine Metayer; Rochelle E Curtis; Charles F Lynch; E Aileen Clarke; Bengt Glimelius; Hans Storm; Eero Pukkala; Flora E van Leeuwen; Eric J Holowaty; Michael Andersson; Tom Wiklund; Timo Joensuu; Mars B van't Veer; Marilyn Stovall; Mary Gospodarowicz; Lois B Travis Journal: J Clin Oncol Date: 2002-08-15 Impact factor: 44.544
Authors: Marie E Wood; Victor Vogel; Andrea Ng; Lewis Foxhall; Pamela Goodwin; Lois B Travis Journal: J Clin Oncol Date: 2012-09-24 Impact factor: 44.544
Authors: Pavlos Msaouel; Mehmet A Bilen; Miao Zhang; Matthew Campbell; Jennifer Wang; Shi-Ming Tu Journal: Curr Opin Oncol Date: 2017-05 Impact factor: 3.645
Authors: Sara J Schonfeld; Diana M Merino; Rochelle E Curtis; Amy Berrington de González; Megan M Herr; Ruth A Kleinerman; Sharon A Savage; Margaret A Tucker; Lindsay M Morton Journal: JNCI Cancer Spectr Date: 2019-06-20
Authors: Gregory J Nason; Ricardo A Rendon; Lori Wood; Robert A Huddart; Peter Albers; Lawrence H Einhorn; Craig R Nichols; Christian Kollmannsberger; Lynn Anson-Cartwright; Padraig Warde; Michael A S Jewett; Peter Chung; Philippe L Bedard; Aaron R Hansen; Robert J Hamilton Journal: Can Urol Assoc J Date: 2021-01 Impact factor: 1.862
Authors: Sara J Schonfeld; Lindsay M Morton; Amy Berrington de González; Rochelle E Curtis; Cari M Kitahara Journal: Cancer Epidemiol Date: 2019-12-26 Impact factor: 2.984