Incidence and clinical pattern of contralateral synchronous and metachronous germ cell testicular cancer
Por:
Maroto, P, del Muro, X, Valverde, C, Pinto, A, Sanchez, A, Guma, J, Alonso, T, del Prado, P, Vazquez, S, Mellado, B, Aparicio, J, Fernandez-Aramburo, A, Girones, R, Terrasa, J and Spanish Germ Cell Canc Grp
Publicada:
1 feb 2021
Ahead of Print:
1 ene 2021
Resumen:
Background: Incidence of a second testicular tumor is higher in patients diagnosed with testicular cancer than in the general population. As incidence of unilateral germ cell cancer is increasing worldwide and most of these patients are cured, a growing number of patients at risk of developing a contralateral testis cancer is expected.
Objective: To analyze clinical and histological characteristics, as well as the absolute and cumulative incidence of a second testicular cancer in a cohort of 3,834 patients diagnosed with germ cell testicular cancer between I/1994 and I/2018 in 18 referral hospitals of the Spanish Germ Cell Cancer Group.
Methods: Patients were treated according to stage and year of diagnoses. Contralateral testis biopsy was not routinely performed, according to European Association of Urology rules. Follow-up of the contra lateral testis consists of a physical exam only and an annual optional testicular ultrasound for 10 years.
Results: Median age of the patients included was 32 years (18-82). With a median follow-up of 61 months (0-240), 67/3,834 patients (1.74%) were diagnosed with a second testicular tumor. The second testicular tumor was synchronic (diagnosed within 6 months of the first orchiectomy) in 19 patients, and metachronous in 48. Pathology of the second tumor was reported as a seminomatous testis tumor in 47 patients and a nonseminomatous cancer in 20. Cumulative incidence of contralateral testicular cancer was 2% at 5 years, and 4% (IC 95% 3%-5%) at 14 years. Younger age was a risk factor for developing a second testicular tumor (P = 0.006), whereas chemotherapy reduced the risk for a metachronous testicular cancer (P = 0.046). Within our cohort, 6 families with testicular cancer aggregation (more than 2 tumors in the same family) were identified.
Conclusions: Incidence of second testicular neoplasm in this cohort of 3,834 patients was similar to that which has been reported in other countries. Metachronous tumors and seminomas are more common. Follow-up of the contralateral testis is mandatory, as well as adequate information for patients to prevent a second neoplasm if feasible, and to detect and treat it as soon as possible. (C) 2020 Elsevier Inc. All rights reserved.
Filiaciones:
Maroto, P:
Hosp Santa Creu & St Pau Barcelona, Barcelona, Spain
del Muro, X:
Hosp Univ Bellvitge, Barcelona, Spain
Valverde, C:
Hosp Valle De Hebron, Barcelona, Spain
Pinto, A:
Hosp Univ La Paz, Madrid, Spain
:
Hosp Reg Univ Malaga, Malaga, Spain
Guma, J:
Hosp Univ St Joan Reus, Reus, Spain
Alonso, T:
Hosp Univ La Paz, Madrid, Spain
del Prado, P:
Hosp Univ Basurto, Bilbao, Spain
Vazquez, S:
Hosp Univ Lucus Augusti, Lugo, Spain
Mellado, B:
Hosp Clin Barcelona, Barcelona, Spain
Aparicio, J:
Hosp Univ & Politecn La Fe, Valencia, Spain
Fernandez-Aramburo, A:
Complejo Hosp Univ Albacete, Albacete, Spain
Girones, R:
Hosp Gen Univ Alacant, Alicante, Spain
Terrasa, J:
Hosp Son Dureta, Palma De Mallorca, Spain
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