The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors

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

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

BACKGROUND. Apart from a recognized association between extragonadal mediastinal germ cell tumors (GCT) and the occurrence of hematologic malignancies, the risk of developing second nongerminal solid tumors after the diagnosis or treatment of extragonadal GCT is unknown. METHODS. Six hundred thirty-five consecutive patients with extragonadal GCT treated at 11 centers in the U.S. and Europe during the era of cisplatin-based chemotherapy (1975-1996) were included into a large database. These patients were evaluated for the occurrence of second malignancies. RESULTS. No treatment- related leukemia was observed in 611 patients treated with chemotherapy. In 7 patients, second solid tumors were observed, resulting in a frequency of 1.86% (95% confidence interval [95% CI], 1.79-1.93%) after a median follow-up of 55 months (95% CI, 50-60 months) (annual incidence, 0.30% [95% CI, 0.14- 0.59]). Four solid tumors (57%) developed in patients with primary mediastinal and 3 tumors (43%) developed in patients with retroperitoneal GCT. Three patients (43%) had a nonseminomatous and 4 patients (57%) had a seminomatous histology. Six patients had been treated with chemotherapy and one patient with radiotherapy. Six of 7 solid tumors (86%) had developed within 5 years and 7 of 7 solid tumors within 10 years of diagnosis. The median time period to the occurrence of neoplasia was 47 months (range, 9-145 months). Four cutaneous tumors were observed (melanoma, two patients; basal cell carcinoma, one patient; and squamous cell carcinoma, one patient); the other three tumors were angiosarcoma, nonsmall cell lung carcinoma, and colorectal carcinoma. The overall risk for developing a second tumor was not increased compared with an age-matched general population with a standard incidence ratio (SIR) of 1.49 (95% CI, 0.603.06). An elevated risk for skin tumors was observed in all extragonadal GCT patients (SIR, 4.00 [95% CI, 1.09-10.24]), as well as in the subgroup of patients treated with chemotherapy (SIR, 5.33 [95% CI, 1.45-13.65]). CONCLUSIONS. This analysis excludes an increased biologic risk of developing second solid malignancies in patients with extragonadal GCT except for the previously reported association between primary mediastinal nonseminoma and hematologic disorders. The overall risk of developing second malignancies in extragonadaI GCT patients appears to be comparable to that in patients with primary testicular carcinoma. The incremental occurrence of skin malignancies in patients treated with chemotherapy should be investigated further. (C) 2000 American Cancer Society.

Original languageEnglish
Pages (from-to)2629-2635
Number of pages7
JournalCancer
Volume88
Issue number11
DOIs
StatePublished - Jun 1 2000

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Second Primary Neoplasms
Germ Cell and Embryonal Neoplasms
Neoplasms
Confidence Intervals
Drug Therapy
Incidence
Skin
Carcinoma
Hemangiosarcoma
Basal Cell Carcinoma

Keywords

  • Chemotherapy
  • Extragonadal germ cell tumors
  • Incidence
  • Radiotherapy
  • Relative risk
  • Second nongerminal malignancies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hartmann, J. T., Nichols, C. R., Droz, J. P., Horwich, A., Gerl, A., Fossa, S. D., ... Bokemeyer, C. (2000). The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors. Cancer, 88(11), 2629-2635. https://doi.org/10.1002/1097-0142(20000601)88:11<2629::AID-CNCR27>3.0.CO;2-F

The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors. / Hartmann, Jörg T.; Nichols, Craig R.; Droz, Jean P.; Horwich, Alan; Gerl, Arthur; Fossa, Sophie D.; Beyer, Jörg; Pont, Jörg; Einhorn, Lawrence; Kanz, Lothar; Bokemeyer, Carsten.

In: Cancer, Vol. 88, No. 11, 01.06.2000, p. 2629-2635.

Research output: Contribution to journalArticle

Hartmann, JT, Nichols, CR, Droz, JP, Horwich, A, Gerl, A, Fossa, SD, Beyer, J, Pont, J, Einhorn, L, Kanz, L & Bokemeyer, C 2000, 'The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors', Cancer, vol. 88, no. 11, pp. 2629-2635. https://doi.org/10.1002/1097-0142(20000601)88:11<2629::AID-CNCR27>3.0.CO;2-F
Hartmann, Jörg T. ; Nichols, Craig R. ; Droz, Jean P. ; Horwich, Alan ; Gerl, Arthur ; Fossa, Sophie D. ; Beyer, Jörg ; Pont, Jörg ; Einhorn, Lawrence ; Kanz, Lothar ; Bokemeyer, Carsten. / The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors. In: Cancer. 2000 ; Vol. 88, No. 11. pp. 2629-2635.
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abstract = "BACKGROUND. Apart from a recognized association between extragonadal mediastinal germ cell tumors (GCT) and the occurrence of hematologic malignancies, the risk of developing second nongerminal solid tumors after the diagnosis or treatment of extragonadal GCT is unknown. METHODS. Six hundred thirty-five consecutive patients with extragonadal GCT treated at 11 centers in the U.S. and Europe during the era of cisplatin-based chemotherapy (1975-1996) were included into a large database. These patients were evaluated for the occurrence of second malignancies. RESULTS. No treatment- related leukemia was observed in 611 patients treated with chemotherapy. In 7 patients, second solid tumors were observed, resulting in a frequency of 1.86{\%} (95{\%} confidence interval [95{\%} CI], 1.79-1.93{\%}) after a median follow-up of 55 months (95{\%} CI, 50-60 months) (annual incidence, 0.30{\%} [95{\%} CI, 0.14- 0.59]). Four solid tumors (57{\%}) developed in patients with primary mediastinal and 3 tumors (43{\%}) developed in patients with retroperitoneal GCT. Three patients (43{\%}) had a nonseminomatous and 4 patients (57{\%}) had a seminomatous histology. Six patients had been treated with chemotherapy and one patient with radiotherapy. Six of 7 solid tumors (86{\%}) had developed within 5 years and 7 of 7 solid tumors within 10 years of diagnosis. The median time period to the occurrence of neoplasia was 47 months (range, 9-145 months). Four cutaneous tumors were observed (melanoma, two patients; basal cell carcinoma, one patient; and squamous cell carcinoma, one patient); the other three tumors were angiosarcoma, nonsmall cell lung carcinoma, and colorectal carcinoma. The overall risk for developing a second tumor was not increased compared with an age-matched general population with a standard incidence ratio (SIR) of 1.49 (95{\%} CI, 0.603.06). An elevated risk for skin tumors was observed in all extragonadal GCT patients (SIR, 4.00 [95{\%} CI, 1.09-10.24]), as well as in the subgroup of patients treated with chemotherapy (SIR, 5.33 [95{\%} CI, 1.45-13.65]). CONCLUSIONS. This analysis excludes an increased biologic risk of developing second solid malignancies in patients with extragonadal GCT except for the previously reported association between primary mediastinal nonseminoma and hematologic disorders. The overall risk of developing second malignancies in extragonadaI GCT patients appears to be comparable to that in patients with primary testicular carcinoma. The incremental occurrence of skin malignancies in patients treated with chemotherapy should be investigated further. (C) 2000 American Cancer Society.",
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T1 - The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors

AU - Hartmann, Jörg T.

AU - Nichols, Craig R.

AU - Droz, Jean P.

AU - Horwich, Alan

AU - Gerl, Arthur

AU - Fossa, Sophie D.

AU - Beyer, Jörg

AU - Pont, Jörg

AU - Einhorn, Lawrence

AU - Kanz, Lothar

AU - Bokemeyer, Carsten

PY - 2000/6/1

Y1 - 2000/6/1

N2 - BACKGROUND. Apart from a recognized association between extragonadal mediastinal germ cell tumors (GCT) and the occurrence of hematologic malignancies, the risk of developing second nongerminal solid tumors after the diagnosis or treatment of extragonadal GCT is unknown. METHODS. Six hundred thirty-five consecutive patients with extragonadal GCT treated at 11 centers in the U.S. and Europe during the era of cisplatin-based chemotherapy (1975-1996) were included into a large database. These patients were evaluated for the occurrence of second malignancies. RESULTS. No treatment- related leukemia was observed in 611 patients treated with chemotherapy. In 7 patients, second solid tumors were observed, resulting in a frequency of 1.86% (95% confidence interval [95% CI], 1.79-1.93%) after a median follow-up of 55 months (95% CI, 50-60 months) (annual incidence, 0.30% [95% CI, 0.14- 0.59]). Four solid tumors (57%) developed in patients with primary mediastinal and 3 tumors (43%) developed in patients with retroperitoneal GCT. Three patients (43%) had a nonseminomatous and 4 patients (57%) had a seminomatous histology. Six patients had been treated with chemotherapy and one patient with radiotherapy. Six of 7 solid tumors (86%) had developed within 5 years and 7 of 7 solid tumors within 10 years of diagnosis. The median time period to the occurrence of neoplasia was 47 months (range, 9-145 months). Four cutaneous tumors were observed (melanoma, two patients; basal cell carcinoma, one patient; and squamous cell carcinoma, one patient); the other three tumors were angiosarcoma, nonsmall cell lung carcinoma, and colorectal carcinoma. The overall risk for developing a second tumor was not increased compared with an age-matched general population with a standard incidence ratio (SIR) of 1.49 (95% CI, 0.603.06). An elevated risk for skin tumors was observed in all extragonadal GCT patients (SIR, 4.00 [95% CI, 1.09-10.24]), as well as in the subgroup of patients treated with chemotherapy (SIR, 5.33 [95% CI, 1.45-13.65]). CONCLUSIONS. This analysis excludes an increased biologic risk of developing second solid malignancies in patients with extragonadal GCT except for the previously reported association between primary mediastinal nonseminoma and hematologic disorders. The overall risk of developing second malignancies in extragonadaI GCT patients appears to be comparable to that in patients with primary testicular carcinoma. The incremental occurrence of skin malignancies in patients treated with chemotherapy should be investigated further. (C) 2000 American Cancer Society.

AB - BACKGROUND. Apart from a recognized association between extragonadal mediastinal germ cell tumors (GCT) and the occurrence of hematologic malignancies, the risk of developing second nongerminal solid tumors after the diagnosis or treatment of extragonadal GCT is unknown. METHODS. Six hundred thirty-five consecutive patients with extragonadal GCT treated at 11 centers in the U.S. and Europe during the era of cisplatin-based chemotherapy (1975-1996) were included into a large database. These patients were evaluated for the occurrence of second malignancies. RESULTS. No treatment- related leukemia was observed in 611 patients treated with chemotherapy. In 7 patients, second solid tumors were observed, resulting in a frequency of 1.86% (95% confidence interval [95% CI], 1.79-1.93%) after a median follow-up of 55 months (95% CI, 50-60 months) (annual incidence, 0.30% [95% CI, 0.14- 0.59]). Four solid tumors (57%) developed in patients with primary mediastinal and 3 tumors (43%) developed in patients with retroperitoneal GCT. Three patients (43%) had a nonseminomatous and 4 patients (57%) had a seminomatous histology. Six patients had been treated with chemotherapy and one patient with radiotherapy. Six of 7 solid tumors (86%) had developed within 5 years and 7 of 7 solid tumors within 10 years of diagnosis. The median time period to the occurrence of neoplasia was 47 months (range, 9-145 months). Four cutaneous tumors were observed (melanoma, two patients; basal cell carcinoma, one patient; and squamous cell carcinoma, one patient); the other three tumors were angiosarcoma, nonsmall cell lung carcinoma, and colorectal carcinoma. The overall risk for developing a second tumor was not increased compared with an age-matched general population with a standard incidence ratio (SIR) of 1.49 (95% CI, 0.603.06). An elevated risk for skin tumors was observed in all extragonadal GCT patients (SIR, 4.00 [95% CI, 1.09-10.24]), as well as in the subgroup of patients treated with chemotherapy (SIR, 5.33 [95% CI, 1.45-13.65]). CONCLUSIONS. This analysis excludes an increased biologic risk of developing second solid malignancies in patients with extragonadal GCT except for the previously reported association between primary mediastinal nonseminoma and hematologic disorders. The overall risk of developing second malignancies in extragonadaI GCT patients appears to be comparable to that in patients with primary testicular carcinoma. The incremental occurrence of skin malignancies in patients treated with chemotherapy should be investigated further. (C) 2000 American Cancer Society.

KW - Chemotherapy

KW - Extragonadal germ cell tumors

KW - Incidence

KW - Radiotherapy

KW - Relative risk

KW - Second nongerminal malignancies

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