Table 4.
Summary of Studies Evaluating Mortality or Incidence of Second Solid Cancers After Chemotherapy for Testicular Cancer
| Study | Year of Publication | No. of Patients | Calendar Years of Diagnosis | Histology of Testicular Cancer | No. of Second Solid Cancers | Overall SMR or RR of Second Solid Cancers | 95% CI | Antecedent Chemotherapy in Patients With Second Solid Cancers | Site-Specific Risks Associated With Chemotherapy |
|---|---|---|---|---|---|---|---|---|---|
| Bokemeyer and Schmoll25 | 1993 | 413 | 1970-1990 | NS, S | 4 | SMR: 2.7 | 0.7 to 6.9 | PVB, BEP, Mtx, Mitox | Reported* |
| Wanderas et al13 | 1997 | 346 | 1952-1990 | NS, S | 4 | RR: 1.3 | 0.4 to 3.4 | Not available | Reported† |
| Travis et al10 | 2005 | 3,799 | 1943-2001 | NS | 28 | RR‡: 1.8 | 1.3 to 2.5 | Not available | Not reported |
| van den Belt-Dusebout et al11 | 2007 | 710 | 1965-1995 | NS, S | 21 | SIR§: 1.5 | 0.9 to 2.3 | PVB, BEP, dactinomycin, unknown | Reported‖ |
| Current article | 2013 | 6,013 | 1980-2008 | NS | 111 | SIR: 1.4 | 1.2 to 1.7 | Not available | Reported |
Abbreviations: BEP, bleomycin, cisplatin, and etoposide; Mitox, mitoxantrone; Mtx, methotrexate; NS, nonseminoma; PVB, cisplatin, bleomycin, and vinblastine; RR, relative risk; S, seminoma; SIR, standardized incidence ratio; SMR, standardized morbidity ratio.
Only the observed numbers of the total of four deaths were reported (without associated SMRs). There was one case each of gastric cancer, carcinoid tumor, rectum cancer, and rhabdomyosarcoma.
Site-specific cancer risks were as follows: GI: n = 1; RR, 1.72; 95% CI, 0.0 to 9.7; and melanoma of the skin: n = 2; RR, 6.26; 95% CI, 0.8 to 22.6. Site for the remaining one cancer was not indicated.
The reported RR included only 10-year survivors of testicular nonseminoma.
The reported SIR included only 5-year survivors of testicular cancer.
Site-specific cancer risks were as follows: digestive tract: n = 3; SIR, 0.8; 95% CI, 0.2 to 2.4; colon: n = 2; SIR, 1.9; 95% CI, 0.2 to 6.2; lung: n = 1; SIR, 0.3; 95% CI, 0.0 to 1.9; genitourinary tract: n = 5; SIR, 1.4; 95% CI, 0.4 to 3.3; prostate: n = 2; SIR, 1.2; 95% CI, 0.1 to 4.2; urinary bladder: n = 3; SIR, 4.7; 95% CI, 1.0 to 13.6; and melanoma: n = 6; SIR, 6.3; 95% CI, 2.3 to 13.8. Sites for the remaining six cancers were not indicated.