title: [Risk of second non-germ cell cancer after treatment of stage I-II testicular seminoma].
abstract: 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.
authors.affiliation: Département de Radiothérapie, Institut Claudius Regaud, Toulouse, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Bachaud
authors.forename: F
authors.initials: F
authors.lastname: Berthier
authors.forename: M
authors.initials: M
authors.lastname: Soulié
authors.forename: B
authors.initials: B
authors.lastname: Malavaud
authors.forename: P
authors.initials: P
authors.lastname: Plante
authors.forename: P
authors.initials: P
authors.lastname: Rischmann
authors.forename: C
authors.initials: C
authors.lastname: Chevreau
authors.forename: P
authors.initials: P
authors.lastname: Grosclaude
mesh_terms: 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