Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

M Schaapveld; AW van den Belt-Dusebout; JA Gietema; Ronald de Wit; S Horenblas; JA Witjes; HJ Hoekstra; LALM Kiemeney; Woutera Louwman; Gabey Ouwens; BMP Aleman; FE van Leeuwen

doi:10.1038/bjc.2012.448

Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

M Schaapveld, AW van den Belt-Dusebout, JA Gietema, Ronald de Wit, S Horenblas, JA Witjes, HJ Hoekstra, LALM Kiemeney, Woutera Louwman, Gabey Ouwens, BMP Aleman, FE van Leeuwen

Research output: Contribution to journal › Article › Academic › peer-review

22 Citations (Scopus)

Abstract

BACKGROUND: Testicular germ cell tumour (TGCT) patients are at increased risk of developing a contralateral testicular germ cell tumour (CTGCT). It is unclear whether TGCT treatment affects CTGCT risk. METHODS: The risk of developing a metachronous CTGCT (a CTGCT diagnosed >= 6 months after a primary TGCT) and its impact on patient's prognosis was assessed in a nationwide cohort comprising 3749 TGCT patients treated in the Netherlands during 1965-1995. Standardised incidence ratios (SIRs), comparing CTGCT incidence with TGCT incidence in the general population, and cumulative CTGCT incidence were estimated and CTGCT risk factors assessed, accounting for competing risks. RESULTS: Median follow-up was 18.5 years. Seventy-seven metachronous CTGCTs were diagnosed. The SIR for metachronous CTGCTs was 17.6 (95% confidence interval (95% CI) 13.9-22.0). Standardised incidence ratios remained elevated for up to 20 years, while the 20-year cumulative incidence was 2.2% (95% CI 1.8-2.8%). Platinum-based chemotherapy was associated with a lower CTGCT risk among non-seminoma patients (hazard ratio 0.37, 95% CI 0.18-0.72). The CTGCT patients had a 2.3- fold (95% CI 1.3-4.1) CONCLUSION: The TGCT patients remain at increased risk of a CTGCT for up to 20 years. Treatment with platinum-based chemotherapy reduces this risk. British Journal of Cancer (2012) 107, 1637-1643. doi:10.1038/bjc.2012.448 www.bjcancer.com Published online 11 October 2012 (c) 2012 Cancer Research UK

Original language	Undefined/Unknown
Pages (from-to)	1637-1643
Number of pages	7
Journal	British Journal of Cancer
Volume	107
Issue number	9
DOIs	https://doi.org/10.1038/bjc.2012.448
Publication status	Published - 2012

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10.1038/bjc.2012.448

http://hdl.handle.net/1765/71187

Cite this

Schaapveld, M., van den Belt-Dusebout, AW., Gietema, JA., de Wit, R., Horenblas, S., Witjes, JA., Hoekstra, HJ., Kiemeney, LALM., Louwman, W., Ouwens, G., Aleman, BMP., & van Leeuwen, FE. (2012). Risk and prognostic significance of metachronous contralateral testicular germ cell tumours. British Journal of Cancer, 107(9), 1637-1643. https://doi.org/10.1038/bjc.2012.448

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title = "Risk and prognostic significance of metachronous contralateral testicular germ cell tumours",

abstract = "BACKGROUND: Testicular germ cell tumour (TGCT) patients are at increased risk of developing a contralateral testicular germ cell tumour (CTGCT). It is unclear whether TGCT treatment affects CTGCT risk. METHODS: The risk of developing a metachronous CTGCT (a CTGCT diagnosed >= 6 months after a primary TGCT) and its impact on patient's prognosis was assessed in a nationwide cohort comprising 3749 TGCT patients treated in the Netherlands during 1965-1995. Standardised incidence ratios (SIRs), comparing CTGCT incidence with TGCT incidence in the general population, and cumulative CTGCT incidence were estimated and CTGCT risk factors assessed, accounting for competing risks. RESULTS: Median follow-up was 18.5 years. Seventy-seven metachronous CTGCTs were diagnosed. The SIR for metachronous CTGCTs was 17.6 (95% confidence interval (95% CI) 13.9-22.0). Standardised incidence ratios remained elevated for up to 20 years, while the 20-year cumulative incidence was 2.2% (95% CI 1.8-2.8%). Platinum-based chemotherapy was associated with a lower CTGCT risk among non-seminoma patients (hazard ratio 0.37, 95% CI 0.18-0.72). The CTGCT patients had a 2.3- fold (95% CI 1.3-4.1) CONCLUSION: The TGCT patients remain at increased risk of a CTGCT for up to 20 years. Treatment with platinum-based chemotherapy reduces this risk. British Journal of Cancer (2012) 107, 1637-1643. doi:10.1038/bjc.2012.448 www.bjcancer.com Published online 11 October 2012 (c) 2012 Cancer Research UK",

author = "M Schaapveld and {van den Belt-Dusebout}, AW and JA Gietema and {de Wit}, Ronald and S Horenblas and JA Witjes and HJ Hoekstra and LALM Kiemeney and Woutera Louwman and Gabey Ouwens and BMP Aleman and {van Leeuwen}, FE",

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Schaapveld, M, van den Belt-Dusebout, AW, Gietema, JA, de Wit, R, Horenblas, S, Witjes, JA, Hoekstra, HJ, Kiemeney, LALM, Louwman, W, Ouwens, G, Aleman, BMP & van Leeuwen, FE 2012, 'Risk and prognostic significance of metachronous contralateral testicular germ cell tumours', British Journal of Cancer, vol. 107, no. 9, pp. 1637-1643. https://doi.org/10.1038/bjc.2012.448

TY - JOUR

T1 - Risk and prognostic significance of metachronous contralateral testicular germ cell tumours

AU - Schaapveld, M

AU - van den Belt-Dusebout, AW

AU - Gietema, JA

AU - de Wit, Ronald

AU - Horenblas, S

AU - Witjes, JA

AU - Hoekstra, HJ

AU - Kiemeney, LALM

AU - Louwman, Woutera

AU - Ouwens, Gabey

AU - Aleman, BMP

AU - van Leeuwen, FE

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Testicular germ cell tumour (TGCT) patients are at increased risk of developing a contralateral testicular germ cell tumour (CTGCT). It is unclear whether TGCT treatment affects CTGCT risk. METHODS: The risk of developing a metachronous CTGCT (a CTGCT diagnosed >= 6 months after a primary TGCT) and its impact on patient's prognosis was assessed in a nationwide cohort comprising 3749 TGCT patients treated in the Netherlands during 1965-1995. Standardised incidence ratios (SIRs), comparing CTGCT incidence with TGCT incidence in the general population, and cumulative CTGCT incidence were estimated and CTGCT risk factors assessed, accounting for competing risks. RESULTS: Median follow-up was 18.5 years. Seventy-seven metachronous CTGCTs were diagnosed. The SIR for metachronous CTGCTs was 17.6 (95% confidence interval (95% CI) 13.9-22.0). Standardised incidence ratios remained elevated for up to 20 years, while the 20-year cumulative incidence was 2.2% (95% CI 1.8-2.8%). Platinum-based chemotherapy was associated with a lower CTGCT risk among non-seminoma patients (hazard ratio 0.37, 95% CI 0.18-0.72). The CTGCT patients had a 2.3- fold (95% CI 1.3-4.1) CONCLUSION: The TGCT patients remain at increased risk of a CTGCT for up to 20 years. Treatment with platinum-based chemotherapy reduces this risk. British Journal of Cancer (2012) 107, 1637-1643. doi:10.1038/bjc.2012.448 www.bjcancer.com Published online 11 October 2012 (c) 2012 Cancer Research UK

AB - BACKGROUND: Testicular germ cell tumour (TGCT) patients are at increased risk of developing a contralateral testicular germ cell tumour (CTGCT). It is unclear whether TGCT treatment affects CTGCT risk. METHODS: The risk of developing a metachronous CTGCT (a CTGCT diagnosed >= 6 months after a primary TGCT) and its impact on patient's prognosis was assessed in a nationwide cohort comprising 3749 TGCT patients treated in the Netherlands during 1965-1995. Standardised incidence ratios (SIRs), comparing CTGCT incidence with TGCT incidence in the general population, and cumulative CTGCT incidence were estimated and CTGCT risk factors assessed, accounting for competing risks. RESULTS: Median follow-up was 18.5 years. Seventy-seven metachronous CTGCTs were diagnosed. The SIR for metachronous CTGCTs was 17.6 (95% confidence interval (95% CI) 13.9-22.0). Standardised incidence ratios remained elevated for up to 20 years, while the 20-year cumulative incidence was 2.2% (95% CI 1.8-2.8%). Platinum-based chemotherapy was associated with a lower CTGCT risk among non-seminoma patients (hazard ratio 0.37, 95% CI 0.18-0.72). The CTGCT patients had a 2.3- fold (95% CI 1.3-4.1) CONCLUSION: The TGCT patients remain at increased risk of a CTGCT for up to 20 years. Treatment with platinum-based chemotherapy reduces this risk. British Journal of Cancer (2012) 107, 1637-1643. doi:10.1038/bjc.2012.448 www.bjcancer.com Published online 11 October 2012 (c) 2012 Cancer Research UK

U2 - 10.1038/bjc.2012.448

DO - 10.1038/bjc.2012.448

M3 - Article

VL - 107

SP - 1637

EP - 1643

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 9

ER -