Continuing increased risk of second cancer in long‐term testicular cancer survivors after treatment in the cisplatin era

R Hellesnes, Ø Kvammen, TÅ Myklebust… - … journal of cancer, 2020 - Wiley Online Library
R Hellesnes, Ø Kvammen, TÅ Myklebust, RM Bremnes, Á Karlsdottir, HFS Negaard…
International journal of cancer, 2020Wiley Online Library
Using complete information on total treatment burden, this population‐based study aimed to
investigate second cancer (SC) risk in testicular cancer survivors (TCS) treated in the
cisplatin era. The Cancer Registry of Norway identified 5,625 1‐year TCS diagnosed 1980–
2009. Standardized incidence ratios (SIRs) were calculated to evaluate the total and site‐
specific incidence of SC compared to the general population. Cox regression analyses
evaluated the effect of treatment on the risk of SC. After a median observation time of 16.6 …
Using complete information on total treatment burden, this population‐based study aimed to investigate second cancer (SC) risk in testicular cancer survivors (TCS) treated in the cisplatin era. The Cancer Registry of Norway identified 5,625 1‐year TCS diagnosed 1980–2009. Standardized incidence ratios (SIRs) were calculated to evaluate the total and site‐specific incidence of SC compared to the general population. Cox regression analyses evaluated the effect of treatment on the risk of SC. After a median observation time of 16.6 years, 572 TCS developed 651 nongerm cell SCs. The SC risk was increased after surgery only (SIR 1.28), with site‐specific increased risks of thyroid cancer (SIR 4.95) and melanoma (SIR 1.94). After chemotherapy (CT), we observed 2.0‐ to 3.7‐fold increased risks for cancers of the small intestine, bladder, kidney and lung. There was a 1.6‐ to 2.1‐fold increased risk of SC after ≥2 cycles of cisplatin‐based CT. Radiotherapy (RT) was associated with 1.5‐ to 4.4‐fold increased risks for cancers of the stomach, small intestine, liver, pancreas, lung, kidney and bladder. After combined CT and RT, increased risks emerged for hematological malignancies (SIR 3.23). TCS treated in the cisplatin era have an increased risk of developing SC, in particular after treatment with cisplatin‐based CT and/or RT.
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