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Risk Of Contralateral Testicular Cancer Appears Low
2005-07-21
NEW YORK (Reuters Health) - Although the risk of a second metachronous cancer of the testicles is elevated following diagnosis of a first, the overall risk is low and survival remains high, study results show. These findings, the authors suggest, "provide support for continuing the usual clinical practice of not subjecting the contralateral testis to routine biopsy."
Dr. Sophie D. Fossa, from the Norwegian Radium Hospital in Oslo, and her colleagues analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. They report their findings in the July 20th Journal of the National Cancer Institute.
Involved were 28,045 men with unilateral testicular germ cell cancer diagnosed between 1973 and 2001 and who had at least 2 months of follow-up. Metachronous contralateral testicular cancer was subsequently diagnosed in 287.
The 15-year cumulative risk of developing a metachronous contralateral testicular cancer was 1.9%, the authors report, which is 12.4-fold higher than the risk in the general population. The risk is higher for men diagnosed at less than 30 years of age (3.1% versus 1.2% among older men).
The investigators found that risk declines with time. For example, the risk up to 4 years after first diagnosis is 13.8-fold higher than the general population, while the risk at 15 years or more is just 3.0 times higher.
The 10-year survival rate following diagnosis of a metachronous contralateral testicular cancer is 93%, Dr. Fossa's group notes, which is not significantly different than in the absence of a second diagnosis. Ten-year survival with a metachronous cancer is actually higher than that for patients with synchronous contralateral testicular cancer (85%).
The authors advise clinicians to "encourage all unilateral testicular cancer patients, especially those not receiving chemotherapy, to perform regular self-examination and, possibly, undergo regular testicular ultrasonography." If the second tumor is diagnosed early enough to perform testis-sparing surgery, the problems associated with androgen substitution after bilateral orchiectomy could thus be avoided.
They qualify these recommendations by adding that a testicular biopsy followed by counseling and treatment, "may be justified for high-risk patients, especially those with a history of testicular maldescent, infertility, or testicular atrophy or a family history of testicular cancer."
J Natl Cancer Inst 2005;97:1056-1066
2005-07-21
NEW YORK (Reuters Health) - Although the risk of a second metachronous cancer of the testicles is elevated following diagnosis of a first, the overall risk is low and survival remains high, study results show. These findings, the authors suggest, "provide support for continuing the usual clinical practice of not subjecting the contralateral testis to routine biopsy."
Dr. Sophie D. Fossa, from the Norwegian Radium Hospital in Oslo, and her colleagues analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. They report their findings in the July 20th Journal of the National Cancer Institute.
Involved were 28,045 men with unilateral testicular germ cell cancer diagnosed between 1973 and 2001 and who had at least 2 months of follow-up. Metachronous contralateral testicular cancer was subsequently diagnosed in 287.
The 15-year cumulative risk of developing a metachronous contralateral testicular cancer was 1.9%, the authors report, which is 12.4-fold higher than the risk in the general population. The risk is higher for men diagnosed at less than 30 years of age (3.1% versus 1.2% among older men).
The investigators found that risk declines with time. For example, the risk up to 4 years after first diagnosis is 13.8-fold higher than the general population, while the risk at 15 years or more is just 3.0 times higher.
The 10-year survival rate following diagnosis of a metachronous contralateral testicular cancer is 93%, Dr. Fossa's group notes, which is not significantly different than in the absence of a second diagnosis. Ten-year survival with a metachronous cancer is actually higher than that for patients with synchronous contralateral testicular cancer (85%).
The authors advise clinicians to "encourage all unilateral testicular cancer patients, especially those not receiving chemotherapy, to perform regular self-examination and, possibly, undergo regular testicular ultrasonography." If the second tumor is diagnosed early enough to perform testis-sparing surgery, the problems associated with androgen substitution after bilateral orchiectomy could thus be avoided.
They qualify these recommendations by adding that a testicular biopsy followed by counseling and treatment, "may be justified for high-risk patients, especially those with a history of testicular maldescent, infertility, or testicular atrophy or a family history of testicular cancer."
J Natl Cancer Inst 2005;97:1056-1066
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