[Risk of second non-germ cell cancer after treatment of stage I-II testicular seminoma].
OBJECTIVE
To determine the incidence of second non-germ-cell cancers (SNGC) in patients treated for stage I-II testicular seminoma.


METHODS
This study is based on 131 evaluable patients treated at the Institut Claudius Regaud between 1970 and 1990. Treatment modalities, including salvage therapy for 6 patients developing recurrence, were as follows: infradiaphragmatic irradiation (infraDI) only in 55 cases, infra- and supradiaphragmatic irradiation (infraDI + supraDI) in 64 cases, and irradiation and chemotherapy (IC) in 12 cases. Five patients were lost to follow-up 4 months to 14 years after primary treatment (mean follow-up: 11 years). The cumulative incidence of SNGC was compared to the overall cancer incidence in the age-matched male population reported in the Tarn Cancer Registry. The relative risk was expressed as the Standardized Incidence Ratio (SIR).


RESULTS
The cumulative incidence of SNGC was 10.7% (14/131 patients). SIR was equal to 2.81 (p < 0.001) and increased with the duration of follow-up. SIR was significantly increased in 64 patients treated with infraDI + supraDI (SIR) = 3.25; p = 0.002), but not in the 55 patients treated with infraDI only (SIR = 0.62; p = 0.8). The 12 treated patients with IC had an SIR of 26.2 (p < 0.001). Three of the 4 patients who developed a haematological malignancy belonged to the IC group.


CONCLUSIONS
The risk of SNGC is increased after infraDI + supraDI. The risk of SNGC after infraDI only is not increased with a median follow-up of 6 years, but this follow-up is too short to allow any definitive conclusions. The risk of SNGC and particularly haematological malignancy appears to be increased by the combination of radiotherapy and chemotherapy.
Bachaud
J M
JM
Département de Radiothérapie, Institut Claudius Regaud, Toulouse, France.
Berthier
F
F
Soulié
M
M
Malavaud
B
B
Plante
P
P
Rischmann
P
P
Chevreau
C
C
Grosclaude
P
P
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology*; D009919:Orchiectomy; D011879:Radiotherapy Dosage; D012307:Risk Factors; D018239:Seminoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D013997:Time Factors