Risk of secondary malignancies in testicular tumors
Abstract:
The work is aimed at the occurrence of secondary malignancies after therapy for primary testicular tumors. The target of the work was determination of the number and type of secondary tumors, their effect on the survival and comparison of relative risk of the origination of secondary tumors depending on particular treatment modalities. Total of 313 patients with testicular tumors were assessed, who experienced orchiectomy in 1968 to 1998 with subsequent irradiation, chemotherapy or combination of the two modalities. Total of 22 secondary tumors, i.e. 7%, were found in the group. The relative risk of the secondary malignancy development was of 1.04. The median time till the secondary tumor occurrence was of 143 months. Total of 213 patients were subjected to radiotherapy, which was associated with enhanced risk of the secondary tumor development (RR = 8.38); the risk in 100 patients treated by chemotherapy was lower (RR = 0.38). The relative risk of the origination of the secondary malignancy located in the region of preceding irradiation is low (RR = 0.52). In the case of the occurrence of secondary malignancies, the median symptomless survival and the total survival decreased from 271 months to 187.3 and 199.8 months, respectively. Most patients with testicular tumors have favourable long-term prognosis and thus, it is desirable to know the risk of secondary malignancies and to include it into plan of long-term subsequent follow-up.