Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors

Jörg T. Hartmann, Sophie D. Fossa, Craig R. Nichols, Jean Paul Droz, Alan Horwich, Arthur Gerl, Jörg Beyer, Jörg Pont, Karim Fizazi, Hartmut Hecker, Lothar Kanz, Lawrence Einhorn, Carsten Bokemeyer

Research output: Contribution to journalArticle

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Abstract

Background: The frequency of subsequent testicular cancer (referred to as metachronous testicular cancer) in men who have had previous testicular cancer is relatively high. The rate of metachronous testicular cancer in men with extragonadal germ cell tumors (EGCTs), however, is largely unknown. We conducted a retrospective study of EGCT patients to determine the incidence, cumulative risk, and specific risk factors for metachronous testicular cancers. Methods: A standardized questionnaire about patient characteristics, the extent of EGCT disease, any second malignancies, and treatments received was completed for 635 patients with EGCTs identified from the medical records of 11 cancer centers in Europe and the United States from 1975 through 1996. Comparisons with age group-specific data from the Saarland, Germany, population-based cancer registry were used to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to analyze survival data and cumulative risk. All statistical tests were two-sided. Results: Sixteen EGCT patients (4.1%) developed metachronous testicular cancers, with a median time between diagnoses of 60 months (range, 14-102 months). The risk of developing metachronous testicular cancers was statistically significantly increased in patients with EGCTs (observed = 16; expected = 0.26; SIR = 62; 95% confidence interval [CI] = 36 to 99) and in subsets of EGCT patients with mediastinal location (SIR = 31; 95% CI = 8 to 59), retroperitoneal location (SIR = 100; 95% CI = 54 to 172), and nonseminomatous histology (SIR = 75; 95% CI = 43 to 123). The cumulative risk of developing a metachronous testicular cancer 10 years after a diagnosis of EGCT was 10.3% (95% CI = 4.9% to 15.6%) and was higher among patients with nonseminomatous EGCTs (14.3%; 95% CI = 6.7% to 21.9%) and retroperitoneal EGCTs (14.2%; 95% CI = 5.6% to 22.8%) than among patients with seminomatous EGCTs (1.4%; 95% CI = 0.0% to 4.2%) and mediastinal EGCTs (6.2%; 95% CI = 0.1% to 12.2%). Conclusions: Patients with EGCTs, particularly those with retroperitoneal or nonseminomatous tumors, but also those with primary mediastinal EGCTs, are at an increased risk of metachronous testicular cancer.

Original languageEnglish
Pages (from-to)1733-1738
Number of pages6
JournalJournal of the National Cancer Institute
Volume93
Issue number22
StatePublished - Nov 21 2001

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Germ Cell and Embryonal Neoplasms
Testicular Neoplasms
Incidence
Confidence Intervals
Neoplasms
Second Primary Neoplasms
Survival Analysis
Medical Records
Germany
Registries
Histology
Retrospective Studies
Age Groups

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hartmann, J. T., Fossa, S. D., Nichols, C. R., Droz, J. P., Horwich, A., Gerl, A., ... Bokemeyer, C. (2001). Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors. Journal of the National Cancer Institute, 93(22), 1733-1738.

Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors. / Hartmann, Jörg T.; Fossa, Sophie D.; Nichols, Craig R.; Droz, Jean Paul; Horwich, Alan; Gerl, Arthur; Beyer, Jörg; Pont, Jörg; Fizazi, Karim; Hecker, Hartmut; Kanz, Lothar; Einhorn, Lawrence; Bokemeyer, Carsten.

In: Journal of the National Cancer Institute, Vol. 93, No. 22, 21.11.2001, p. 1733-1738.

Research output: Contribution to journalArticle

Hartmann, JT, Fossa, SD, Nichols, CR, Droz, JP, Horwich, A, Gerl, A, Beyer, J, Pont, J, Fizazi, K, Hecker, H, Kanz, L, Einhorn, L & Bokemeyer, C 2001, 'Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors', Journal of the National Cancer Institute, vol. 93, no. 22, pp. 1733-1738.
Hartmann JT, Fossa SD, Nichols CR, Droz JP, Horwich A, Gerl A et al. Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors. Journal of the National Cancer Institute. 2001 Nov 21;93(22):1733-1738.
Hartmann, Jörg T. ; Fossa, Sophie D. ; Nichols, Craig R. ; Droz, Jean Paul ; Horwich, Alan ; Gerl, Arthur ; Beyer, Jörg ; Pont, Jörg ; Fizazi, Karim ; Hecker, Hartmut ; Kanz, Lothar ; Einhorn, Lawrence ; Bokemeyer, Carsten. / Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors. In: Journal of the National Cancer Institute. 2001 ; Vol. 93, No. 22. pp. 1733-1738.
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title = "Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors",
abstract = "Background: The frequency of subsequent testicular cancer (referred to as metachronous testicular cancer) in men who have had previous testicular cancer is relatively high. The rate of metachronous testicular cancer in men with extragonadal germ cell tumors (EGCTs), however, is largely unknown. We conducted a retrospective study of EGCT patients to determine the incidence, cumulative risk, and specific risk factors for metachronous testicular cancers. Methods: A standardized questionnaire about patient characteristics, the extent of EGCT disease, any second malignancies, and treatments received was completed for 635 patients with EGCTs identified from the medical records of 11 cancer centers in Europe and the United States from 1975 through 1996. Comparisons with age group-specific data from the Saarland, Germany, population-based cancer registry were used to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to analyze survival data and cumulative risk. All statistical tests were two-sided. Results: Sixteen EGCT patients (4.1{\%}) developed metachronous testicular cancers, with a median time between diagnoses of 60 months (range, 14-102 months). The risk of developing metachronous testicular cancers was statistically significantly increased in patients with EGCTs (observed = 16; expected = 0.26; SIR = 62; 95{\%} confidence interval [CI] = 36 to 99) and in subsets of EGCT patients with mediastinal location (SIR = 31; 95{\%} CI = 8 to 59), retroperitoneal location (SIR = 100; 95{\%} CI = 54 to 172), and nonseminomatous histology (SIR = 75; 95{\%} CI = 43 to 123). The cumulative risk of developing a metachronous testicular cancer 10 years after a diagnosis of EGCT was 10.3{\%} (95{\%} CI = 4.9{\%} to 15.6{\%}) and was higher among patients with nonseminomatous EGCTs (14.3{\%}; 95{\%} CI = 6.7{\%} to 21.9{\%}) and retroperitoneal EGCTs (14.2{\%}; 95{\%} CI = 5.6{\%} to 22.8{\%}) than among patients with seminomatous EGCTs (1.4{\%}; 95{\%} CI = 0.0{\%} to 4.2{\%}) and mediastinal EGCTs (6.2{\%}; 95{\%} CI = 0.1{\%} to 12.2{\%}). Conclusions: Patients with EGCTs, particularly those with retroperitoneal or nonseminomatous tumors, but also those with primary mediastinal EGCTs, are at an increased risk of metachronous testicular cancer.",
author = "Hartmann, {J{\"o}rg T.} and Fossa, {Sophie D.} and Nichols, {Craig R.} and Droz, {Jean Paul} and Alan Horwich and Arthur Gerl and J{\"o}rg Beyer and J{\"o}rg Pont and Karim Fizazi and Hartmut Hecker and Lothar Kanz and Lawrence Einhorn and Carsten Bokemeyer",
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T1 - Incidence of metachronous testicular cancer in patients with extragonadal germ cell tumors

AU - Hartmann, Jörg T.

AU - Fossa, Sophie D.

AU - Nichols, Craig R.

AU - Droz, Jean Paul

AU - Horwich, Alan

AU - Gerl, Arthur

AU - Beyer, Jörg

AU - Pont, Jörg

AU - Fizazi, Karim

AU - Hecker, Hartmut

AU - Kanz, Lothar

AU - Einhorn, Lawrence

AU - Bokemeyer, Carsten

PY - 2001/11/21

Y1 - 2001/11/21

N2 - Background: The frequency of subsequent testicular cancer (referred to as metachronous testicular cancer) in men who have had previous testicular cancer is relatively high. The rate of metachronous testicular cancer in men with extragonadal germ cell tumors (EGCTs), however, is largely unknown. We conducted a retrospective study of EGCT patients to determine the incidence, cumulative risk, and specific risk factors for metachronous testicular cancers. Methods: A standardized questionnaire about patient characteristics, the extent of EGCT disease, any second malignancies, and treatments received was completed for 635 patients with EGCTs identified from the medical records of 11 cancer centers in Europe and the United States from 1975 through 1996. Comparisons with age group-specific data from the Saarland, Germany, population-based cancer registry were used to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to analyze survival data and cumulative risk. All statistical tests were two-sided. Results: Sixteen EGCT patients (4.1%) developed metachronous testicular cancers, with a median time between diagnoses of 60 months (range, 14-102 months). The risk of developing metachronous testicular cancers was statistically significantly increased in patients with EGCTs (observed = 16; expected = 0.26; SIR = 62; 95% confidence interval [CI] = 36 to 99) and in subsets of EGCT patients with mediastinal location (SIR = 31; 95% CI = 8 to 59), retroperitoneal location (SIR = 100; 95% CI = 54 to 172), and nonseminomatous histology (SIR = 75; 95% CI = 43 to 123). The cumulative risk of developing a metachronous testicular cancer 10 years after a diagnosis of EGCT was 10.3% (95% CI = 4.9% to 15.6%) and was higher among patients with nonseminomatous EGCTs (14.3%; 95% CI = 6.7% to 21.9%) and retroperitoneal EGCTs (14.2%; 95% CI = 5.6% to 22.8%) than among patients with seminomatous EGCTs (1.4%; 95% CI = 0.0% to 4.2%) and mediastinal EGCTs (6.2%; 95% CI = 0.1% to 12.2%). Conclusions: Patients with EGCTs, particularly those with retroperitoneal or nonseminomatous tumors, but also those with primary mediastinal EGCTs, are at an increased risk of metachronous testicular cancer.

AB - Background: The frequency of subsequent testicular cancer (referred to as metachronous testicular cancer) in men who have had previous testicular cancer is relatively high. The rate of metachronous testicular cancer in men with extragonadal germ cell tumors (EGCTs), however, is largely unknown. We conducted a retrospective study of EGCT patients to determine the incidence, cumulative risk, and specific risk factors for metachronous testicular cancers. Methods: A standardized questionnaire about patient characteristics, the extent of EGCT disease, any second malignancies, and treatments received was completed for 635 patients with EGCTs identified from the medical records of 11 cancer centers in Europe and the United States from 1975 through 1996. Comparisons with age group-specific data from the Saarland, Germany, population-based cancer registry were used to calculate the standardized incidence ratio (SIR). The Kaplan-Meier method was used to analyze survival data and cumulative risk. All statistical tests were two-sided. Results: Sixteen EGCT patients (4.1%) developed metachronous testicular cancers, with a median time between diagnoses of 60 months (range, 14-102 months). The risk of developing metachronous testicular cancers was statistically significantly increased in patients with EGCTs (observed = 16; expected = 0.26; SIR = 62; 95% confidence interval [CI] = 36 to 99) and in subsets of EGCT patients with mediastinal location (SIR = 31; 95% CI = 8 to 59), retroperitoneal location (SIR = 100; 95% CI = 54 to 172), and nonseminomatous histology (SIR = 75; 95% CI = 43 to 123). The cumulative risk of developing a metachronous testicular cancer 10 years after a diagnosis of EGCT was 10.3% (95% CI = 4.9% to 15.6%) and was higher among patients with nonseminomatous EGCTs (14.3%; 95% CI = 6.7% to 21.9%) and retroperitoneal EGCTs (14.2%; 95% CI = 5.6% to 22.8%) than among patients with seminomatous EGCTs (1.4%; 95% CI = 0.0% to 4.2%) and mediastinal EGCTs (6.2%; 95% CI = 0.1% to 12.2%). Conclusions: Patients with EGCTs, particularly those with retroperitoneal or nonseminomatous tumors, but also those with primary mediastinal EGCTs, are at an increased risk of metachronous testicular cancer.

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