Complications of therapy for testicular cancer.
Of 244 patients with testis cancer seen between January 1970 and December 1987 (mean followup 70 months) 88 (36.1%) experienced 1 or more early complications (within 1 year), while 16 (6.6%) had a late (greater than 1 year) complication. Chemotherapy-related complications occurred in 55 of 141 patients (39%), including 6 (4.3%) treatment-related deaths. Chemotherapy-related complications were correlated to the initial extent of disease (p equals 0.021) and to more than 4 cycles of cisplatin-based therapy (p equals 0.001). Retroperitoneal lymphadenectomy-related complications occurred in 48 of 148 patients (32.4%) without surgical mortality and were not statistically increased in those performed after chemotherapy. Kidney loss occurred in 6 patients (4.1%) after retroperitoneal lymphadenectomy. Nine of 110 patients (8.2%) treated with radiotherapy experienced an early therapy-related complication, while late complications included 3 gastrointestinal strictures requiring surgical intervention 8 to 10 years after radiotherapy. Only 1 secondary malignancy (other than contralateral testis cancer) was discovered in this review. Initial extent of disease was the best predictor for over-all complication rate and higher over-all complications were noted in the cisplatin era (1979 to 1987) but these associations were not necessarily present for complication rates of individual therapies.
Moul
J W
JW
Division of Urology, Duke University Medical Center, Durham, North Carolina.
Robertson
J E
JE
George
S L
SL
Paulson
D F
DF
Walther
P J
PJ
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D013997:Time Factors
D002945:Cisplatin