title: Long-term Relative Survival after Diagnosis of Testicular Germ Cell Tumor.
abstract: Long-term relative survival (RS) data for testicular germ cell tumor (TGCT) patients are scarce. We aimed to analyze long-term RS among TGCT patients diagnosed in Norway, between 1953 and 2012.
  
  
  
  Data sources were the Cancer Registry of Norway and the Norwegian Cause of Death Registry. TGCT patients diagnosed during 1953 to 2012 were classified by time of diagnosis, histology, age, and disease extent at diagnosis. Estimates for RS were obtained, and a test comparing overall RS was performed. Corresponding data were obtained for men diagnosed with localized malignant melanoma before age 50.
  
  
  
  A total of 8,736 TGCT patients were included. RS generally continued to decline with increasing follow-up time, particularly beyond 15 to 30 years, unlike in localized malignant melanoma. Although RS was generally higher for seminomas, the continuing decline was more pronounced than for nonseminomas, even when diagnosed with localized disease. TGCT patients diagnosed before 1980 or after age 40 had lower RS.
  
  
  
  Although TGCT RS has improved in recent decades, it continues to decline even beyond 30 years of follow-up, regardless of disease extent at diagnosis. The main cause is probably treatment-induced late effects, particularly affecting seminoma patients. The continued use of adjuvant radiotherapy in seminomas until year 2000 is suspected as a culprit.
  
  
  
  Long-term TGCT survivors should be closely monitored for the development of late comorbidity. The challenge is to reduce negative consequences of previous and current TGCT treatment on RS while maintaining the excellent cure rates. Further research on causes of long-term morbidity and mortality among TGCT survivors is warranted. Cancer Epidemiol Biomarkers Prev; 25(5); 773-9. ©2016 AACR.
authors.affiliation: The Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway. oivind.kvammen@stolav.no.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Kvammen
authors.affiliation: Department of Registration, Cancer Registry of Norway, Oslo, Norway.
authors.forename: Tor Å
authors.initials: TÅ
authors.lastname: Myklebust
authors.affiliation: The Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Solberg
authors.affiliation: Department of Registration, Cancer Registry of Norway, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Møller
authors.affiliation: Department of Oncology, Ålesund Hospital, Ålesund, Norway.
authors.forename: Olbjørn H
authors.initials: OH
authors.lastname: Klepp
authors.affiliation: National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway.
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.affiliation: The Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway.
authors.forename: Torgrim
authors.initials: T
authors.lastname: Tandstad
mesh_terms: D000328:Adult; D015331:Cohort Studies; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000401:mortality*