title: Sequelae of treatment in long-term survivors of testis cancer.
abstract: BACKGROUND
  Testicular cancer patients are often diagnosed at a young age, and because of the advances in the treatment of this disease, the vast majority have a normal life expectancy after therapy. Thus, recognition of the long-term sequelae of treatment (ie, surgery, radiation therapy, and chemotherapy) is particularly important in these patients.
  
  
  OBJECTIVE
  To review the adverse effects and the risk of secondary malignancy in long-term survivors of testicular cancer.
  
  
  METHODS
  We conducted a Medline search to identify original articles and reviews on the long-term effects of testicular cancer treatment. Although the search included articles from January 1948 to February 2011, the majority of the included articles were published in the last two decades.
  
  
  RESULTS
  All studies examining the long-term sequelae of treatment in testicular cancer are retrospective in nature, with most classified as cohort, case-control, and/or epidemiologic studies. Given that no standardized method of reporting long-term complications exists, evidence synthesis is limited.
  
  
  CONCLUSIONS
  Recent evidence suggests an increased risk of cardiovascular disease, neurotoxicity, and mild reductions in renal function in survivors of testicular cancer. Treatment of testicular malignancy can also negatively affect gonadal function and fertility and has been shown to result in an increased risk of solid malignancy and leukemia.
authors.affiliation: Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA. robert.abouassaly@UHhospitals.org
authors.forename: Robert
authors.initials: R
authors.lastname: Abouassaly
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fossa
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.forename: Christian
authors.initials: C
authors.lastname: Kollmannsberger
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Motzer
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Schmoll
authors.forename: Cora N
authors.initials: CN
authors.lastname: Sternberg
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D019317:Evidence-Based Medicine; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000209:etiology; D020258:Neurotoxicity Syndromes / Q000209:etiology; D009919:Orchiectomy / Q000009:adverse effects; D011832:Radiation Injuries / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013736:Testicular Neoplasms / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents