Second malignancies in long-term testicular cancer survivors

Ondruš, D; Ondrušová, Martina; Friedova, L

doi:10.1007/s11255-013-0554-4

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…[16][17][18] On the other hand, the incidence of secondary malignancies among testicular germ cell tumor (TGCT) survivors is higher compared to the general population. 19 However, among all second cancers described, liver tumors are seldom reported.…”

Section: Review and Discussionmentioning

confidence: 99%

“…A recent Slovakian study 18 retrospectively analyzed 1367 testicular cancer patients treated between 1970 and 2012 and found significantly higher incidence of second malignancies in that population. They were mostly abdominal or pelvic cancers regardless of treatment for primary testicular cancer, and occurred at a younger age in comparison with the general population.…”

Section: Review and Discussionmentioning

confidence: 99%

See 1 more Smart Citation

“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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Section: Review and Discussionmentioning

confidence: 99%

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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“…An increasing concern is the observation that, life threatening conditions such as second malignancy and cardiovascular disease, occur more frequently in TC patients than in the general population. Long-term monitoring of TC survivors is necessary for possibility of the development of late side effects of the treatment modalities [27,28].…”

Section: Tc -Testicular Cancermentioning

confidence: 99%

Recent Trends in Survival of Testicular Cancer Patients – Nation-wide Population Based Study

Ondruš¹,

Ondrušová²,

Suchansky³

2018

Klin Onkol

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Moderate improvement in survival for TC patients in the Slovak Republic is probably influenced by diagnostic and therapeutic progress, including multidisciplinary care and patients concentration in specialized centers. The long-term follow-up of TC survivors can also help to prevent late side effects of the treatment modalities and to detect second malignancies.Key words: testicular cancer - seminoma - non-seminoma - age at diagnosis - survival.

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“…An increased risk for gastro-intestinal cancers, mainly CRC, pancreatic and gastric cancer, has also been described in childhood cancer survivors treated with platinum-based chemotherapy [8]. Other studies have also reported an increased incidence of CRC following TC treatment with a RR varying between 1.3 and 2.3 compared with the general population [9][10][11][12][13][14][15]. The risk of developing CRC remained significantly elevated for a long period after TC treatment with elevated risks reported even after 35 years [12,13,16].…”

Section: Introductionmentioning

confidence: 98%

Diagnostic yield of colonoscopy surveillance in testicular cancer survivors treated with platinum-based chemotherapy: study protocol of a prospective cross-sectional cohort study

et al. 2021

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Background Testicular cancer (TC) survivors have an increased risk of various second primary malignancies. A recent cohort study detected an increased risk of colorectal cancer (CRC) in TC survivors treated with platinum-based chemotherapy with a hazard ratio of 3.9. CRC risk increased with higher cisplatin-dose. We know that colonoscopy surveillance in high-risk populations results in reduced incidence and mortality of CRC. TC survivors treated with platinum-based chemotherapy can potentially benefit from colonoscopy surveillance; however, to which extent is unknown. Furthermore, the pathogenesis of these secondary CRCs is unknown, and better insights into the carcinogenesis may affect surveillance decisions. Methods This prospective multicenter study will be performed in four Dutch hospitals. TC survivors are eligible if treated with ≥ 3 cycles of cisplatin before age 50. Colonoscopy will be performed ≥ 8 years after initial treatment (minimum and maximum ages at colonoscopy, 35 and 75 years, respectively). The primary aim of the study is the diagnostic yield of advanced neoplasia detected during colonoscopy. As secondary aim, we will evaluate the molecular profile of advanced colorectal neoplasia and will assess current platinum levels in blood and urine and correlate blood-platinum levels with prevalence of colorectal lesions. Furthermore, we will investigate effectiveness of fecal immunochemical testing (FIT) and burden of colonoscopy by two questionnaires. Demographic data, previous history, results of colonoscopy, hemoglobin level of FIT and results of molecular and platinum levels will be obtained. Yield of colonoscopy will be determined by detection rate of adenoma and serrated lesions, advanced adenoma detection rate and CRC detection rate. The MISCAN model will be used for cost-effectiveness analyses of CRC surveillance. With 234 participants undergoing colonoscopy, we can detect an absolute difference of 6% of advanced neoplasia with 80% power. Discussion TC survivors treated with cisplatin-based chemotherapy can benefit from CRC surveillance. Evaluation of the diagnostic performance and patient acceptance of CRC surveillance is of importance to develop surveillance recommendations. Insight into the carcinogenesis of cisplatin-related advanced colorectal lesions will contribute to CRC prevention in the increasing number of TC survivors. The results may also be important for the many other cancer survivors treated with platinum-based chemotherapy. Trial registration Clinical Trials: NCT04180033, November 27, 2019, https://clinicaltrials.gov/ct2/show/NCT04180033.

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Second malignancies in long-term testicular cancer survivors

Abstract: Preliminary analyses indicate increased SM occurrence in patients with primary TC in comparison with the general population, and it also occurs in younger age at the time of SM diagnosis.

Cited by 10 publications

References 13 publications

“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

“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

Recent Trends in Survival of Testicular Cancer Patients – Nation-wide Population Based Study

Diagnostic yield of colonoscopy surveillance in testicular cancer survivors treated with platinum-based chemotherapy: study protocol of a prospective cross-sectional cohort study

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