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dc.contributor.authorHellesnes, Ragnhild
dc.contributor.authorMyklebust, Tor Åge
dc.contributor.authorBremnes, Roy M.
dc.contributor.authorKarlsdottir, Åsa
dc.contributor.authorKvammen, Øivind
dc.contributor.authorNegaard, Helene Francisca Stigter
dc.contributor.authorTandstad, Torgrim
dc.contributor.authorWilsgaard, Tom
dc.contributor.authorFosså, Sophie Dorothea
dc.contributor.authorHaugnes, Hege Sagstuen
dc.date.accessioned2021-04-12T09:21:44Z
dc.date.available2021-04-12T09:21:44Z
dc.date.issued2020-12-23
dc.description.abstractPURPOSE - It is hypothesized that cisplatin-based chemotherapy (CBCT) reduces the occurrence of metachronous contralateral (second) germ cell testicular cancer (TC). However, studies including treatment details are lacking. The aim of this study was to assess the second TC risk, emphasizing the impact of previous TC treatment.<p> <p>PATIENTS AND METHODS - Based on the Cancer Registry of Norway, 5,620 men were diagnosed with first TC between 1980 and 2009. Treatment data regarding TC were retrieved from medical records. Cumulative incidences of second TC were estimated, and standardized incidence ratios were calculated. The effect of treatment intensity was investigated using Cox proportional hazard regression.<p> <p>RESULTS - Median follow-up was 18.0 years, during which 218 men were diagnosed with a second TC after median 6.2 years. Overall, the 20-year crude cumulative incidence was 4.0% (95% CI, 3.5 to 4.6), with lower incidence after chemotherapy (CT) (3.2%; 95% CI, 2.5 to 4.0) than after surgery only (5.4%; 95% CI, 4.2 to 6.8). The second TC incidence was also lower for those age ≥ 30 years (2.8%; 95% CI, 2.3 to 3.4) at first TC diagnosis than those age < 30 years (6.0%; 95% CI, 5.0 to 7.1). Overall, the second TC risk was 13-fold higher compared with the risk of developing TC in the general male population (standardized incidence ratio, 13.1; 95% CI, 11.5 to 15.0). With surgery only as reference, treatment with CT significantly reduced the second TC risk (hazard ratio [HR], 0.55). For each additional CBCT cycle administered, the second TC risk decreased significantly after three, four, and more than four cycles (HRs, 0.53, 0.41, and 0.21, respectively).<p> <p>CONCLUSION - Age at first TC diagnosis and treatment intensity influenced the second TC risk, with significantly reduced risks after more than two CBCT cycles.en_US
dc.identifier.citationHellesnes, Myklebust TÅ, Bremnes, Karlsdottir, Kvammen, Negaard, Tandstad, Wilsgaard, Fosså SD, Haugnes. Metachronous Contralateral Testicular Cancer in the Cisplatin Era: A Population-Based Cohort Study. Journal of Clinical Oncology. 2020;39(4):308-318en_US
dc.identifier.cristinIDFRIDAID 1867577
dc.identifier.doi10.1200/jco.20.02713
dc.identifier.issn0732-183X
dc.identifier.issn1527-7755
dc.identifier.urihttps://hdl.handle.net/10037/20855
dc.language.isoengen_US
dc.publisherAmerican Society of Clinical Oncologyen_US
dc.relation.ispartofHellesnes, R. (2021). Testicular cancer survivors in the cisplatin era: Metachronous contralateral testicular cancer, second cancer and causes of death. (Doctoral thesis). <a href=https://hdl.handle.net/10037/22955>https://hdl.handle.net/10037/22955</a>.
dc.relation.journalJournal of Clinical Oncology
dc.rights.accessRightsopenAccessen_US
dc.rights.holder© 2020 by American Society of Clinical Oncologyen_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleMetachronous Contralateral Testicular Cancer in the Cisplatin Era: A Population-Based Cohort Studyen_US
dc.type.versionpublishedVersion
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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