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World Journal of Urology

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02-08-2023 | Lymphoma | Original Article

Identification of risk factors and prediction models for secondary malignant neoplasms (SMNs)-free survival and SMNs-specific survival in testicular cancer survivors

Authors: Hangcheng Fu, Sriharsha Talluri, Samarpit Rai, Lifan Liang, Jaimin Trivedi, Murali K. Ankem

Published in: World Journal of Urology | Issue 9/2023

Abstract

Objective

This research endeavored to determine the key demographic and pathological factors tied to secondary malignant neoplasms (SMNs) in survivors of testicular cancer and to develop a predictive model.

Method

A total of 53,309 testicular cancer patients from the SEER national database (1975–2016) were included in our analysis. The primary outcome measured was SMNs-free survival, defined as the duration from testicular cancer diagnosis to the detection of a non-testicular malignancy. The secondary outcome was SMN-specific survival, defined as the period from testicular cancer diagnosis until the patient's death due to SMNs.

Findings

Of the patients in the SEER cohort, 2978 (5.6%) developed non-testicular cancer SMNs. Higher age, receipt of chemotherapy, and radiation treatment were all significantly associated with the development of SMNs in survivors of testicular cancer (all p < 0.001). Kaplan–Meier analysis revealed a worse SMNs-free survival and poor SMN-specific survival in patients who underwent radiation therapy (both p < 0.001). Multivariable Cox regression analysis found non-Hispanic Black ethnicity, higher age, chemotherapy, and radiation therapy to be significantly associated with worse SMNs-free survival (p = 0.002, p < 0.001, p < 0.001, and p < 0.001, respectively), while lymphoma histology was associated with better SMNs-free survival (p < 0.001). The most common SMN types in patients receiving radiation therapy were prostate, lung, and bladder cancers. Predictive nomograms for SMNs-free survival and SMNs-specific survival were developed, with a C-index of 0.776 and 0.824, respectively.

Conclusion

The age of diagnosis, non-Hispanic Black ethnicity, lymphoma histology, and treatment history with chemotherapy and radiation therapy were identified as prognostic factors for SMNs-free survival.

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Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69(1):7–34. https://doi.org/10.3322/caac.21551CrossRefPubMed

Travis LB, Demark Wahnefried W, Allan JM, Wood ME, Ng AK (2013) Aetiology, genetics and prevention of secondary neoplasms in adult cancer survivors. Nat Rev Clin Oncol 10(5):289–301. https://doi.org/10.1038/nrclinonc.2013.41CrossRefPubMed

Travis LB (2002) Therapy-associated solid tumors. Acta Oncol 41(4):323–333. https://doi.org/10.1080/028418602760169361CrossRefPubMed

Ng AK, Bernardo MP, Weller E et al (2002) Long-term survival and competing causes of death in patients with early-stage Hodgkin’s disease treated at age 50 or younger. J Clin Oncol 20(8):2101–2108. https://doi.org/10.1200/JCO.2002.08.021CrossRefPubMed

Dores GM, Metayer C, Curtis RE et al (2002) Second malignant neoplasms among long-term survivors of Hodgkin’s disease: a population-based evaluation over 25 years. J Clin Oncol 20(16):3484–3494. https://doi.org/10.1200/JCO.2002.09.038CrossRefPubMed

Hodgson DC, Gilbert ES, Dores GM et al (2007) Long-term solid cancer risk among 5-year survivors of Hodgkin’s lymphoma. J Clin Oncol 25(12):1489–1497. https://doi.org/10.1200/JCO.2006.09.0936CrossRefPubMed

Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356(18):1835–1841. https://doi.org/10.1056/NEJMoa067588CrossRefPubMed

Travis LB, Fossa SD, Schonfeld SJ et al (2005) Second cancers among 40,576 testicular cancer patients: focus on long-term survivors. J Natl Cancer Inst 97(18):1354–1365. https://doi.org/10.1093/jnci/dji278CrossRefPubMed

Hay JH, Duncan W, Kerr GR (1984) Subsequent malignancies in patients irradiated for testicular tumours. Br J Radiol 57(679):597–602. https://doi.org/10.1259/0007-1285-57-679-597CrossRefPubMed

10.

Travis LB, Andersson M, Gospodarowicz M et al (2000) Treatment-associated leukemia following testicular cancer. J Natl Cancer Inst 92(14):1165–1171. https://doi.org/10.1093/jnci/92.14.1165CrossRefPubMed

11.

Wanderas EH, Fossa SD, Tretli S (1997) Risk of subsequent non-germ cell cancer after treatment of germ cell cancer in 2006 Norwegian male patients. Eur J Cancer 33(2):253–262. https://doi.org/10.1016/s0959-8049(96)00458-3CrossRefPubMed

12.

Bokemeyer C, Schmoll HJ (1993) Secondary neoplasms following treatment of malignant germ cell tumors. J Clin Oncol 11(9):1703–1709. https://doi.org/10.1200/JCO.1993.11.9.1703CrossRefPubMed

13.

van den Belt-Dusebout AW, de Wit R, Gietema JA et al (2007) Treatment-specific risks of second malignancies and cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol 25(28):4370–4378. https://doi.org/10.1200/JCO.2006.10.5296CrossRefPubMed

14.

Tarin TV, Sonn G, Shinghal R (2009) Estimating the risk of cancer associated with imaging related radiation during surveillance for stage I testicular cancer using computerized tomography. J Urol 181(2):627–632. https://doi.org/10.1016/j.juro.2008.10.005CrossRefPubMed

15.

Curreri SA, Fung C, Beard CJ (2015) Secondary malignant neoplasms in testicular cancer survivors. Urol Oncol 33(9):392–398. https://doi.org/10.1016/j.urolonc.2015.05.002CrossRefPubMed

16.

Travis LB, Gospodarowicz M, Curtis RE et al (2002) Lung cancer following chemotherapy and radiotherapy for Hodgkin’s disease. J Natl Cancer Inst 94(3):182–192. https://doi.org/10.1093/jnci/94.3.182CrossRefPubMed

17.

Bermejo JL, Sundquist J, Hemminki K (2009) Bladder cancer in cancer patients: population-based estimates from a large Swedish study. Br J Cancer 101(7):1091–1099. https://doi.org/10.1038/sj.bjc.6605325CrossRefPubMedPubMedCentral

18.

Mudie NY, Swerdlow AJ, Higgins CD et al (2006) Risk of second malignancy after non-Hodgkin’s lymphoma: a British Cohort Study. J Clin Oncol 24(10):1568–1574. https://doi.org/10.1200/JCO.2005.04.2200CrossRefPubMed

19.

Swerdlow AJ, Higgins CD, Smith P et al (2011) Second cancer risk after chemotherapy for Hodgkin’s lymphoma: a collaborative British cohort study. J Clin Oncol 29(31):4096–4104. https://doi.org/10.1200/JCO.2011.34.8268CrossRefPubMed

20.

Pedersen-Bjergaard J, Daugaard G, Hansen SW, Philip P, Larsen SO, Rorth M (1991) Increased risk of myelodysplasia and leukaemia after etoposide, cisplatin, and bleomycin for germ-cell tumours. Lancet 338(8763):359–363. https://doi.org/10.1016/0140-6736(91)90490-gCrossRefPubMed

21.

Boshoff C, Begent RH, Oliver RT et al (1995) Secondary tumours following etoposide containing therapy for germ cell cancer. Ann Oncol 6(1):35–40. https://doi.org/10.1093/oxfordjournals.annonc.a059037CrossRefPubMed

22.

Gajendran VK, Nguyen M, Ellison LM (2005) Testicular cancer patterns in African-American men. Urology 66(3):602–605. https://doi.org/10.1016/j.urology.2005.03.071CrossRefPubMed

23.

Cheah CY, Wirth A, Seymour JF (2014) Primary testicular lymphoma. Blood 123(4):486–493. https://doi.org/10.1182/blood-2013-10-530659CrossRefPubMed

24.

International Bladder Cancer Nomogram C, Bochner BH, Kattan MW, Vora KC (2006) Postoperative nomogram predicting risk of recurrence after radical cystectomy for bladder cancer. J Clin Oncol 24(24):3967–3972. https://doi.org/10.1200/JCO.2005.05.3884CrossRef

25.

Brockman JA, Alanee S, Vickers AJ et al (2015) Nomogram predicting prostate cancer-specific mortality for men with biochemical recurrence after radical prostatectomy. Eur Urol 67(6):1160–1167. https://doi.org/10.1016/j.eururo.2014.09.019CrossRefPubMed

Title: Identification of risk factors and prediction models for secondary malignant neoplasms (SMNs)-free survival and SMNs-specific survival in testicular cancer survivors
Authors: Hangcheng Fu
Sriharsha Talluri
Samarpit Rai
Lifan Liang
Jaimin Trivedi
Murali K. Ankem
Publication date: 02-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Lymphoma
Cytostatic Therapy
Published in: World Journal of Urology / Issue 9/2023
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04515-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identification of risk factors and prediction models for secondary malignant neoplasms (SMNs)-free survival and SMNs-specific survival in testicular cancer survivors

Abstract

Objective

Method

Findings

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Method

Findings

Conclusion

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