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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

3157 - Increased risk of non-germ cell second cancer (SC) after cisplatin-based chemotherapy (CBCT) in 1-year testicular cancer (TC) survivors (TCS)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Tumour Site

Germ Cell Tumours

Presenters

Ragnhild Hellesnes

Citation

Annals of Oncology (2018) 29 (suppl_8): viii303-viii331. 10.1093/annonc/mdy283

Authors

R. Hellesnes1, Ø. Kvammen2, R.M. Bremnes3, A. Karlsdottir4, T.Å. Myklebust5, H. Negaard6, T. Tandstad7, T. Wilsgaard8, S.D. Fosså9, H.S. Haugnes1

Author affiliations

  • 1 Department Of Oncology, University Hospital of North Norway, 9019 - Tromso/NO
  • 2 Department Of Oncology, Ålesund Hospital, 6026 - Ålesund/NO
  • 3 Department Of Clinical Medicine, UiT The Arctic University of Norway, 9037 - Tromsø/NO
  • 4 Department Of Oncology, Haukeland University Hospital, 5021 - Bergen/NO
  • 5 Department Of Registration, Cancer Registry of Norway, 0304 - Oslo/NO
  • 6 Department Of Oncology, Oslo University Hospital, 0424 - Oslo/NO
  • 7 The Cancer Clinic, St. Olav´s Hospital, 7006 - Trondheim/NO
  • 8 Institute Of Community Medicine, UiT The Arctic University of Norway, 9037 - Tromsø/NO
  • 9 National Advisory Unit On Late Effects After Cancer Treatment, Oslo University Hospital, Radiumhospitalet, 0424 - Oslo/NO
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Resources

Abstract 3157

Background

Previous studies have documented that TCS have a 1.7 to 3.5-fold increased risk of developing SC compared with an age-matched general population after chemotherapy (CT) and/or radiotherapy (RT), but no increased risk after surgery only. Previous studies lack treatment details, and/or include patients treated before the introduction of cisplatin.

Methods

All Norwegian 1-year TCS diagnosed with their first TC 1980-2009 and with no prior history of cancer (n = 5625), were identified through the Cancer Registry of Norway (CRN). Clinical parameters, including detailed information on all cancer treatment given initially and in case of a relapse, were extracted from medical records and linked with data from CRN. The TCS were categorized into treatment groups: Surgery only (24.8%), CT (43.9%), RT (27.4%) and CT and RT combined ((CT + RT) 3.9%). Age-adjusted Cox regression models were performed to evaluate the impact of cancer treatment on the risk of SC, stratified according to decade of diagnosis.

Results

Median observation time was 16.6 years (IQR 10.9-23.8), during which 572 TCS (10.2%) were diagnosed with a non-germ cell SC. Median time to SC was 18.1 years (IQR 11.1-24.2). Overall, compared with surgery only, there was an elevated risk of SC after RT (Hazard Ratio (HR) 1.36, 95% CI 1.07-1.73) and RT + CT (HR 1.64 95% CI 1.10-2.46). When excluding TCS with <10 years observation time, all treatment groups had increased risks for SC (CT: HR 1.57, 95% CI 1.14-2.16; RT: HR 1.77, 95% CI 1.31-2.39; RT + CT: HR 1.83, 95% CI 1.14-2.96). There was an increased risk for SC with increasing number of cisplatin-based CT (CBCT), significant for 4 cycles (HR 1.35, 95% CI 1.01-1.81) and ≥5 cycles (HR 1.69, 95% CI 1.06-2.70). The risk for bladder cancer increased after CBCT (HR 3.81, 95% CI 1.29-11.21) and RT (HR 2.93, 95% CI 1.00-8.60). RT + CT was associated with elevated risks for leukemia (HR 13.82, 95% CI 1.20-159.67) and cancers of the stomach (HR 6.79, 95% CI 1.60-28.70) and thyroid (HR 8.71, 95% CI 1.56-52.08).

Conclusions

Cytotoxic treatment increases the risk of SC in TCS. After CBCT, the risk significantly increases after ≥4 cycles. Long-term follow-up of TCS focusing on prevention and early detection of SC seem to be important.

Clinical trial identification

Legal entity responsible for the study

Translational Cancer Research Group, Deapartment of Clinical Medicine, UiT The Arctic University of Norway.

Funding

Helse Nord RHF.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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