Failure Analysis in Irradiated Stage I Testicular Seminoma

Me, Stein; Drumea, Keren; Moshkowitz, B.; Nativ, Ofer; Kuten, A

doi:10.1159/000283064

Cited by 6 publications

(5 citation statements)

References 11 publications

(14 reference statements)

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“…Long‐term follow‐up studies have indicated an increased risk of secondary cancers in the gastrointestinal tract, as well as in the bladder (3), and of leukaemia (4). In a recent study from Israel (5), the cumulative risk of developing a secondary primary cancer was calculated to be 10% after 20 years. Another major concern with regard to chronic toxicity after radiotherapy is gastrointestinal disease.…”

mentioning

confidence: 99%

Surveillance in stage I testicular cancer

Daugaard

Petersen

Rørth

2003

APMIS

131

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Treatment results on 695 stage I testicular cancer patients followed with surveillance are described. Seminoma (SGCT) was present in 394 patients and nonseminoma (NSGCT) in 301 patients. Relapses were detected in 155 patients (22%), in 69 patients with SGCT (17%) and 86 with NSGCT (29%). In patients with vascular invasion, relapse was detected in 54% of patients with NSGCT and 38% of patients with SGCT. Time to relapse was median 13 months (range 1 to 84 months) for SGCT and 5 months (range 1 to 171 months) for NSGCT. Forty-nine percent of relapses in SGCT patients were seen within the first year, 87% of the relapses were diagnosed within the first two years, and 98% of the relapses were detected within 5 years. The figures for NSGCT were 80%, 89% and 95%, respectively. Forty-five patients had carcinoma in situ in the contralateral testis, 62% had this together with a seminoma in the other testis. Ten patients died during the follow-up period. None of these deaths were caused by the germ cell tumour or the treatment. The overall survival for patients with stage I disease is 98.6%, and the cause specific survival 100%.

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mentioning

confidence: 99%

Surveillance in stage I testicular cancer

Daugaard

Petersen

Rørth

2003

APMIS

131

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“…[11][12][13][14] A recent retrospective review conducted by Hallemeier et al at the Mayo clinic confirmed excellent outcome in patient with stage I testicular seminoma treated with radiotherapy, even though cardiovascular (12%) and oncologic (19%) late morbidities 15 proved to be not uncommon.…”

Section: Review and Discussionmentioning

confidence: 99%

“Hockey Stick” may Strike Back: Hepatocellular Carcinoma on Noncirrhotic Liver as a Late Toxicity of Lombo-Aortic Radiotherapy for Seminoma. A Review Triggered by an Unusual Case

Korenbaum

Barthélémy

Onéa

et al. 2016

Journal of Clinical and Experimental Hepatology

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Most patients with testicular seminoma have been treated with a curative intent for decades. Second cancers after radiotherapy for testicular seminoma before 1990 are a growing issue, and are related to previous generation of dose planning and delineating strategies. Among those cancers, hepatocellular carcinoma is an extremely rare occurrence, especially when affecting patients with healthy, noncirrhotic liver. Here, we describe such a case in a patient of our institution, and subsequently review the relevant literature and large epidemiologic studies. Understanding those late and serious toxicity features may help cancer care teams to screen and treat those patients appropriately. ( J CLIN EXP HEPATOL 2016;6:54-58) M ajor improvement in testicular cancer treatment in the second half of the 20th century made it a curable disease, mainly thanks to platinum-based chemotherapy and radiation therapy. 1,2 Cancer of the testis has one of the best 5-year survival rate. 3,4 Avoiding long-term iatrogenic morbidity is now part of the treatment plan. Among the many malignancies arising from the radiotherapy field of previously treated testicular cancer patients, hepatocellular carcinoma is a rare occurrence. We describe a case of a patient presenting with in-field hepatocellular carcinoma 34 years after radiotherapy for testicular seminoma. CASE REPORTA 62-year-old man presented in April 2013 with dehydration and acute renal failure. Relevant medical history reported a left testicular seminoma in 1979, for which he underwent left orchidectomy, adjuvant platinum-based chemotherapy, and radiotherapy. Other history included transient ischemic attack in 2002. He had lost 8 kg over the past 8 months. On examination, there was no symptom of portal hypertension or chronic liver failure. Abdominal ultrasound (US) found a heterogeneous liver mass. Thoracic and abdominal computerized tomography scan (CT scan) found a 16 cm great axis tumor occupying left liver lobe almost entirely, associated with left portal thrombosis (Figure 1). The thrombus was believed to be of tumorous nature. Angio-CT scan of the liver confirmed the invasion of the left portal vein branch by the tumor. The Right liver lobe was not affected and presented normal radiological features. No distant metastases were found. Gastroscopy and colonoscopy showed no suspicious lesions. Alphafetoprotein level was 374,000 ng/mL. Other tumor markers were within normal range. Liver biopsies were performed. Pathology report came to the conclusion of a well-differentiated hepatocarcinoma (Figure 2). Liver function test were unaffected. Every major cause of cirrhosis and liver disease was ruled out including alcoholic cirrhosis, autoimmune hepatitis, hemochromatosis, Non-Alcoholic Steato-Hepatitis (NASH) or fatty liver disease, primary biliary cirrhosis, sclerosing cholangitis, and Wilson's disease. Viral serologies were negative for hepatitis B (HBs antigen and HBc antibody), hepatitis C, and cytomegalovirus (CMV), and there were no clinical suspicions of viral hepatitis. N...

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“…Because the patient could reasonably have expected to recover entirely from the seminoma, and thereafter enjoy a normal life expectancy, the possibility of a cancer secondary to curative therapy was a serious concern. Estimates have suggested a cumulative risk of approximately 10% over 20 years following treatment 16 . Gastric, colon, rectal and bladder malignancies and leukaemias have been reported secondary to curative radiotherapy, with a recent review suggesting that structures located near field margins may be particularly at risk 3,4 .…”

Section: Discussionmentioning

confidence: 99%

Stage I seminoma in a 15‐year‐old boy

Geake

Potter

Borg

et al. 2007

Australasian Radiology

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Seminomas are very rare tumours in children and adolescents. We describe a case of seminoma in a 15-year-old boy who was managed with orchidectomy but no adjuvant therapy. He remains relapse-free 8 years after surgery as determined by clinical, radiological and serological surveillance. This study emphasizes the uncertainty over the need for adjuvant treatment in the management of seminoma in the adolescent patient, in particular in prepubescent children.

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Failure Analysis in Irradiated Stage I Testicular Seminoma

Cited by 6 publications

References 11 publications

Surveillance in stage I testicular cancer

Surveillance in stage I testicular cancer

“Hockey Stick” may Strike Back: Hepatocellular Carcinoma on Noncirrhotic Liver as a Late Toxicity of Lombo-Aortic Radiotherapy for Seminoma. A Review Triggered by an Unusual Case

Stage I seminoma in a 15‐year‐old boy

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