Testicular cancer: treatment raises risk for 2nd primary malignancy

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Takeaway
  • No increased risk for second malignant neoplasm (SMN) in patients with testicular germ cell cancer (GCC) followed by surveillance. 
  • SMN risk and mortality increased after retroperitoneal radiotherapy (RT), bleomycin, etoposide, and cisplatin (BEP), or 1 line of treatment (MTOL).

Why this matters

  • Adjuvant RT not recommended for patients with stage I seminoma. 
  • Follow-up programs needed. 
  • Role of late effects clinics should be established.

Key results

  • Incidence of SMN at 20 y with death as a competing risk was 7.8% with surveillance only, 7.6% with BEP, 13.5% with RT, 9.2% with MTOL, and 7.0% in control patients. 
  • Risk increased after BEP (HR, 1.7) RT (HR, 1.8), and MTOL (HR, 3.7), but not after surveillance (HR, 1.0). 
  • 1 line of BEP showed increased risks for...