Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany; Center for Primary Health Care Research, Lund University, Malmö; Center for Family and Community Medicine, Karolinska Institute, Huddinge, Sweden.
Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
Ann Oncol. 2010 Jul;21(7):1546-1551. doi: 10.1093/annonc/mdp562. Epub 2009 Dec 17.
Testicular cancer treatment has become standardized in the 1980s involving radiotherapy preferentially for seminoma and chemotherapy for nonseminoma. The late effects of these therapeutic practices have not been properly evaluated because of the relatively short time since their application.
We conducted a study among 5533 survivors of testicular cancer on the basis of Swedish Family-Cancer Database for which the cancer data were retrieved from the nationwide Cancer Registry. Standardized incidence ratios (SIRs) of second cancer were calculated by comparing with the rates of the first cancers. The follow-up was started in 1980 and carried on through 2006.
A total of 370 second cancers (6.7% of all patients) were recorded, more in seminoma than in nonseminoma patients. Second testicular cancer showed an SIR of 29 after seminoma and an SIR of 13 after nonseminoma. A total of 10 discordant sites were increased after seminoma compared with seven sites after nonseminoma. Gastrointestinal tract cancers occurred mainly after seminoma and bladder cancers (SIR 8.6 when diagnosis before age 30) occurred after nonseminoma.
Of the selective affected second tumors, it will be important to confirm the association of bladder cancer with nonseminoma treatment.
睾丸癌的治疗在 20 世纪 80 年代已经标准化，精原细胞瘤优先采用放疗，非精原细胞瘤采用化疗。由于这些治疗方法应用时间相对较短，其晚期效应尚未得到适当评估。
我们基于瑞典家族癌症数据库，对 5533 例睾丸癌幸存者进行了一项研究，该数据库中的癌症数据来自全国癌症登记处。通过与首次癌症的发病率进行比较，计算了第二种癌症的标准化发病比（SIR）。随访于 1980 年开始，持续至 2006 年。
共记录了 370 例（所有患者的 6.7%）第二原发癌，精原细胞瘤患者多于非精原细胞瘤患者。精原细胞瘤后第二睾丸癌的 SIR 为 29，非精原细胞瘤后 SIR 为 13。与非精原细胞瘤相比，精原细胞瘤后增加了 10 个不一致的部位。胃肠道癌症主要发生在精原细胞瘤后，膀胱癌（30 岁前诊断时 SIR 为 8.6）发生在非精原细胞瘤后。
对于选择性影响的第二肿瘤，证实膀胱癌与非精原细胞瘤治疗之间的关联将非常重要。
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