Clinical genitourinary cancer · 2025
Second Malignancies and Non-Cancer Mortality in Long-Term Survivors of Stage I Testicular Cancer: A 30-Year Institutional Experience and Literature Review.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Capdevila Patricia, Aparicio Jorge
Аннотация
PURPOSE: To quantify long-term, competing-risk-adjusted absolute risks of non-germ-cell second malignant neoplasms and contralateral germ-cell tumor in stage I testicular germ-cell tumor survivors treated in the contemporary era, and to contextualize these estimates against prior population-based cohorts.
METHODS: Retrospective single-center cohort of consecutive stage I TGCT (1994-2023); time zero was orchiectomy. Primary endpoints were time to first non-germ-cell SMN and to contralateral TGCT (cGCT). Death was modeled as a competing event. Absolute risks were estimated with the Aalen-Johansen cumulative incidence function (CIF) with 95% CIs; follow-up by reverse Kaplan-Meier. CIFs were compared by initial strategy (surveillance vs. adjuvant therapy) using Gray's test.
RESULTS: Among 169 survivors, SMN occurred in 9 (5.3%; median latency 9.4 y) and cGCT in 8 (4.7%; median 7.7 y). The 10-year CIFs were 3.7% (95% CI, 0.7-7.2) for SMN and 4.6% (1.4-8.8) for cGCT; by 25 years, 11.1% (3.6-20.9) and 8.4% (2.9-16.8), respectively. There were no TGCT-related deaths; overall mortality was 5.3% (3 SMN-related; 6 non-cancer). No clear difference emerged between surveillance and adjuvant therapy (SMN, Gray's P = .9; cGCT curves overlapped).
CONCLUSIONS: In a contemporary, stage I cohort with long-term follow-up, late events were driven by competing risks. Absolute risks of late events were modest but clinically relevant (SMN ≈ 11% and cGCT ≈ 8% by 25 years), lower than historical series treated with high-dose radiotherapy.
IMPLICATIONS FOR CANCER SURVIVORS: Our findings support survivorship plans that prioritize targeted second-cancer screening, cardiometabolic prevention with early postcisplatin vigilance, and proactive mental-health support, while maintaining a minimum-effective-dose approach to initial and follow-up treatments.
METHODS: Retrospective single-center cohort of consecutive stage I TGCT (1994-2023); time zero was orchiectomy. Primary endpoints were time to first non-germ-cell SMN and to contralateral TGCT (cGCT). Death was modeled as a competing event. Absolute risks were estimated with the Aalen-Johansen cumulative incidence function (CIF) with 95% CIs; follow-up by reverse Kaplan-Meier. CIFs were compared by initial strategy (surveillance vs. adjuvant therapy) using Gray's test.
RESULTS: Among 169 survivors, SMN occurred in 9 (5.3%; median latency 9.4 y) and cGCT in 8 (4.7%; median 7.7 y). The 10-year CIFs were 3.7% (95% CI, 0.7-7.2) for SMN and 4.6% (1.4-8.8) for cGCT; by 25 years, 11.1% (3.6-20.9) and 8.4% (2.9-16.8), respectively. There were no TGCT-related deaths; overall mortality was 5.3% (3 SMN-related; 6 non-cancer). No clear difference emerged between surveillance and adjuvant therapy (SMN, Gray's P = .9; cGCT curves overlapped).
CONCLUSIONS: In a contemporary, stage I cohort with long-term follow-up, late events were driven by competing risks. Absolute risks of late events were modest but clinically relevant (SMN ≈ 11% and cGCT ≈ 8% by 25 years), lower than historical series treated with high-dose radiotherapy.
IMPLICATIONS FOR CANCER SURVIVORS: Our findings support survivorship plans that prioritize targeted second-cancer screening, cardiometabolic prevention with early postcisplatin vigilance, and proactive mental-health support, while maintaining a minimum-effective-dose approach to initial and follow-up treatments.