Ondrus D, Ondrusova M, Friedova L
1st Department of Oncology, Faculty of Medicine, St. Elisabeth Cancer Institute, Comenius University, Heydukova 10, 812 50, Bratislava, Slovak Republic,
Int Urol Nephrol. 2014 Apr;46(4):749-56. doi: 10.1007/s11255-013-0554-4. Epub 2013 Oct 6.
The objective of the present study is to analyze long-term testicular cancer (TC) survivors focusing on the correlation of therapeutic modalities used, the age of patients and second malignancy (SM) occurrence.
A total of 1,367 patients with TC and different subsequent therapeutic procedures were followed up between 1970 and 2012. The occurrence of SM was analyzed by standard incidence ratios (SIR). SM occurred in 96 (7.0 %) patients with primary TC.
The most frequent SM was TC (SIR 27.4, n = 64); a significantly higher occurrence was observed after primary testicular seminoma. Prostate cancer appeared in 10 patients (SIR 5.2), with a mean age 54.9 years, while the typical age of patients in Slovakia was 71.4 years. Kidney cancer developed in 6 patients, a significant higher SIR was registered only after primary non-seminomas. The mean patient's age was 48.5 years, while the typical age of all male patients in Slovakia was 62.4 years. Other SM had no significantly higher SIR. Colorectal cancer appeared in 8 patients with primary TC, with a mean age 56.0 years, while the typical age of male patients with primary colorectal cancer in Slovakia was 67.1 years. Other non-testicular tumors appeared in 8 patients. SM occurs in 1.5 % of patients following orchiectomy alone, in 4.3 % following radiotherapy, 5.0 % following chemotherapy and in 4.4 % following combined chemo-radiotherapy.
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.
本研究的目的是分析长期睾丸癌（TC）幸存者，重点关注所采用的治疗方式、患者年龄与第二原发恶性肿瘤（SM）发生之间的相关性。
1970年至2012年间，对1367例患有TC且接受了不同后续治疗程序的患者进行了随访。通过标准化发病比（SIR）分析SM的发生情况。96例（7.0%）原发性TC患者发生了SM。
最常见的SM是TC（SIR 27.4，n = 64）；原发性睾丸精原细胞瘤后观察到其发生率显著更高。10例患者出现前列腺癌（SIR 5.2），平均年龄54.9岁，而斯洛伐克患者的典型年龄为71.4岁。6例患者发生肾癌，仅在原发性非精原细胞瘤后SIR显著更高。患者的平均年龄为48.5岁，而斯洛伐克所有男性患者的典型年龄为62.4岁。其他SM的SIR没有显著更高。8例原发性TC患者出现结直肠癌，平均年龄56.0岁，而斯洛伐克原发性结直肠癌男性患者的典型年龄为67.1岁。8例患者出现其他非睾丸肿瘤。单纯睾丸切除术后1.5%的患者发生SM，放疗后为4.3%，化疗后为5.0%，放化疗联合后为4.4%。
初步分析表明，与普通人群相比，原发性TC患者中SM的发生率增加，且在SM诊断时年龄更小。
