scholarly journals Risk of Second Malignant Neoplasms Among Long-term Survivors of Testicular Cancer

1997 ◽  
Vol 89 (19) ◽  
pp. 1429-1439 ◽  
Author(s):  
L. B. Travis ◽  
R. E. Curtis ◽  
J. F. Fraumeni ◽  
J. D. Boice ◽  
H. Storm ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Long Term Survivors

scholarly journals Balancing cure and long-term risks in acute lymphoblastic leukemia

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Lewis B. Silverman
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Late Effects ◽  
Pediatric Patients ◽  
Lymphoblastic Leukemia ◽  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Current Therapies ◽  
Cure Rates ◽  
Long Term Survivors

Abstract Cure rates for children and adolescents with acute lymphoblastic leukemia (ALL) have improved dramatically over the last few decades. With this success has come increasing recognition of the adverse late effects of treatment. The significant long-term sequelae in the earliest cohort of long-term survivors treated in the 1970s and 1980s are well documented. To reduce the incidence of these late effects, the majority of pediatric patients treated on more contemporary regimens receive less intensive treatment than did those treated 30-40 years ago. However, current therapies are not risk free; children treated with contemporary regimens remain at risk for developing long-term toxicities, including cardiac dysfunction, osteonecrosis, neurocognitive impairment, and second malignant neoplasms. One of the great challenges facing clinical investigators today is to identify interventions that will reduce the frequency and severity of long-term toxicities without adversely affecting cure rates. The use of dexrazoxane as a cardioprotectant (to prevent anthracycline-associated cardiotoxicity) and alternate-week dosing of dexamethasone (to reduce the risk of osteonecrosis) are examples of 2 such successful strategies. This article provides an overview of the long-term toxicities associated with current therapies and reviews results of clinical trials designed to minimize the burden of cure in long-term survivors.

Second Malignant Neoplasms in Long-Term Survivors of Childhood Rhabdomyosarcoma

Cancer ◽  
1995 ◽  
Vol 76 (10) ◽  
pp. 1860-1867 ◽  
Author(s):  
Andromachi Scaradavou ◽  
Glenn Heller ◽  
Charles A. Sklar ◽  
Leigh Ren ◽  
Fereshteh Ghavimi
Keyword(s):  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Childhood Rhabdomyosarcoma ◽  
Long Term Survivors

Treatment-Specific Risks of Second Malignancies and Cardiovascular Disease in 5-Year Survivors of Testicular Cancer

2007 ◽  
Vol 25 (28) ◽  
pp. 4370-4378 ◽  
Author(s):  
Alexandra W. van den Belt-Dusebout ◽  
Ronald de Wit ◽  
Jourik A. Gietema ◽  
Simon Horenblas ◽  
Marieke W.J. Louwman ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Cox Regression ◽  
Late Complication ◽  
Late Complications ◽  
Malignant Neoplasms ◽  
Second Malignancies ◽  
Similar Extent ◽  
Second Malignant Neoplasms

Purpose To compare radiotherapy and chemotherapy effects on long-term risks of second malignant neoplasms (SMNs) and cardiovascular diseases (CVDs) in testicular cancer (TC) survivors. Patients and Methods In our nationwide cohort comprising 2,707 5-year TC survivors, incidences of SMNs and CVDs were compared with general-population rates by calculating standardized incidence ratios (SIRs) and absolute excess risks (AERs). Treatment effects on risks of SMN and CVD were quantified in multivariable Cox regression and competing risks analyses. Results After a median follow-up time of 17.6 years, 270 TC survivors developed SMNs. The SIR of SMN overall was 1.7 (95% CI, 1.5 to 1.9), with an AER of 32.3 excess occurrences per 10,000 person-years. SMN risk was 2.6-fold (95% CI, 1.7- to 4.0-fold) increased after subdiaphragmatic radiotherapy and 2.1-fold (95% CI, 1.4- to 3.1-fold) increased after chemotherapy, compared with surgery only. Subdiaphragmatic radiotherapy increased the risk of a major late complication (SMN or CVD) 1.8-fold (95% CI, 1.3- to 2.4-fold), chemotherapy increased the risk of a major late complication 1.9-fold (95% CI, 1.4- to 2.5-fold), and smoking increased the risk of a major late complication 1.7-fold (95% CI, 1.4- to 2.1-fold), compared with surgery only. The median survival time was 1.4 years after SMN and 4.7 years after CVD. Conclusion Radiotherapy and chemotherapy increased the risk of developing SMN or CVD to a similar extent as smoking. Subdiaphragmatic radiotherapy strongly increases the risk of SMNs but not of CVD, whereas chemotherapy increases the risks of both SMNs and CVDs. Prolonged follow-up after chemotherapy is needed to reliably compare the late complications of radiotherapy and chemotherapy after 20 years.

scholarly journals Second malignant neoplasms in long-term survivors of osteosarcoma

Cancer ◽  
2002 ◽  
Vol 95 (8) ◽  
pp. 1728-1734 ◽  
Author(s):  
LeLe Aung ◽  
Richard G. Gorlick ◽  
Weiji Shi ◽  
Howard Thaler ◽  
Nicholas A. Shorter ◽  
...  
Keyword(s):  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Long Term Survivors

“Second Malignant Neoplasms Among Long-Term Survivors of Hodgkinʼs Disease

2002 ◽  
Vol 24 (12) ◽  
pp. 89-90 ◽  
Author(s):  
Graça M. Dores ◽  
Catherine Metayer ◽  
Rochelle E. Curtis
Keyword(s):  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
Long Term Survivors

Second malignant neoplasms following treatment for Wilm's tumor: a report from the National Wilms' Tumor Study Group.

1995 ◽  
Vol 13 (8) ◽  
pp. 1851-1859 ◽  
Author(s):  
N E Breslow ◽  
J R Takashima ◽  
J A Whitton ◽  
J Moksness ◽  
G J D'Angio ◽  
...  
Keyword(s):  
Wilms Tumor ◽  
Treatment Protocol ◽  
Great Majority ◽  
Initial Therapy ◽  
Incidence Rates ◽  
Malignant Neoplasms ◽  
Tumor Study ◽  
Second Malignant Neoplasms ◽  
Long Term Survivors

PURPOSE The study was undertaken to determine the incidence of second malignant neoplasms (SMNs) in patients treated for Wilms' tumor and demonstrate how the incidence varied with the initial treatment protocol. PATIENTS AND METHODS Between October 1969 and December 1991, 5,278 assessable patients were enrolled onto the National Wilms' Tumor Study (NWTS) and by the end of 1993 had contributed 39,461 person-years to a follow-up study. Expected numbers of second cancers were calculated by applying national incidence rates to person-years classified by age, sex, and calendar year. RESULTS Forty-three SMNs were observed, whereas only 5.1 were expected (standardized incidence ratio [SIR], 8.4; 95% confidence interval [CI], 6.1 to 11.4). Fifteen years after the Wilms' tumor diagnosis, the cumulative incidence of a SMN was 1.6% and increasing steadily. Abdominal irradiation received as part of the initial therapy increased the risk of a SMN (SIR, 1.43/10 Gy; 95% CI, 1.13 to 1.81). Doxorubicin potentiated the radiation effect. Among 234 patients who received doxorubicin and greater than 35 Gy of abdominal radiation, eight SMNs were observed, whereas only 0.22 were expected (SIR, 36; 95% CI, 16 to 72). Treatment for relapse further increased the SMN risk by a factor of 4 to 5. CONCLUSION These results demonstrate the importance of current efforts to limit the use of intensive chemotherapy and radiation therapy, which are now applied only to patients with the most aggressive disease. Continuing close surveillance of the great majority of Wilms' tumor patients who become long-term survivors is essential for early diagnosis of SMNs and other late sequelae of therapy.

scholarly journals Testicular Cancer Survivorship

2019 ◽  
Vol 17 (12) ◽  
pp. 1557-1568 ◽  
Author(s):  
Chunkit Fung ◽  
Paul C. Dinh ◽  
Sophie D. Fossa ◽  
Lois B. Travis
Keyword(s):  
Testicular Cancer ◽  
Cancer Survivorship ◽  
Relative Survival ◽  
Future Research ◽  
Malignant Neoplasms ◽  
Long Term Effects ◽  
Long Term Treatment ◽  
Second Malignant Neoplasms

Testicular cancer (TC) is the most common cancer among men aged 18 to 39 years. It is highly curable, with a 10-year relative survival approaching 95% due to effective cisplatin-based chemotherapy. Given the increasing incidence of TC and improved survival, TC survivors (TCS) now account for approximately 4% of all US male cancer survivors. They have also become a valuable cohort for adult-onset cancer survivorship research, given their prolonged survival. Commensurately, long-term treatment-related complications have emerged as important survivorship issues. These late effects include life-threatening conditions, such as second malignant neoplasms and cardiovascular disease. Moreover, TCS can also experience hearing loss, tinnitus, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, infertility, anxiety, depression, cognitive impairment, and chronic cancer-related fatigue. Characterization of the number and severity of long-term adverse health outcomes among TCS remains critical to develop risk-stratified, evidence-based follow-up guidelines and to inform the development of preventive measures and interventions. In addition, an improved understanding of the long-term effects of TC treatment on mortality due to noncancer causes and second malignant neoplasms remains paramount. Future research should focus on the continued development of large, well-characterized clinical cohorts of TCS for lifelong follow-up. These systematic, comprehensive approaches can provide the needed infrastructure for further investigation of long-term latency patterns of various medical and psychosocial morbidities and for more in-depth studies investigating associated etiopathogenetic pathways. Studies examining premature physiologic aging may also serve as new frontiers in TC survivorship research.

Damage of hormonal function and bone metabolism in long-term survivors of testicular cancer

Neoplasma ◽  
2009 ◽  
Vol 56 (6) ◽  
pp. 473-479 ◽  
Author(s):  
M. ONDRUSOVA ◽  
D. ONDRUS ◽  
L. DUSEK ◽  
B. SPANIKOVA
Keyword(s):  
Testicular Cancer ◽  
Bone Metabolism ◽  
Hormonal Function ◽  
Long Term Survivors

scholarly journals Risk of developing second malignant neoplasms in patients with neuroblastoma: a population study of the US SEER database

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hongnan Zhen ◽  
Hui Guan ◽  
Jiabin Ma ◽  
Wenhui Wang ◽  
Shen Jing ◽  
...  
Keyword(s):  
Risk Factor ◽  
Digestive System ◽  
Survival Rates ◽  
Endocrine System ◽  
Malignant Neoplasms ◽  
Seer Database ◽  
The Us ◽  
Second Malignant Neoplasms ◽  
Risk Patients

Abstract Background Neuroblastoma is a common extracranial malignant tumor in children. Its main treatment modality is a combination of chemotherapy, radiotherapy, and surgery. Given the advances in chemotherapy regimens and the widespread use of bone marrow transplantation over the decades, there has been improvement in treatment efficacy, which has led to prolonged patient survival. Accordingly, long-term complications have become a growing concern among physicians and patients. This study aimed to analyze the survival rate of patients with neuroblastoma and the risk factors for developing second malignant neoplasms (SMNs). Methods The SEER 18 Regs (1973–2015) and SEER 9 Regs (1973–2015) data of the surveillance, epidemiology, and end results (SEER) database of the US National Cancer Institute were adopted for survival and SMN analysis. Results The 5-, 10-, and 20-year overall survival rates of patients with neuroblastoma were 67%, 65%, and 62%, respectively. Among 38 patients with neuroblastoma who presented with SMNs, those with abdomen as the primary site accounted for the majority (63.2%), followed by those with thorax (26.3%) and other sites (10.5%). SMNs occurred more commonly in non-specific neuroblastoma (incidence: 0.87%) than ganglioneuroblastoma (incidence: 0.3%). Compared with the general population, the risk of SMN is significantly higher (SIR = 4.36). The risk of developing SMNs was significantly higher in the digestive system (SIR = 7.29), bones and joints (SIR = 12.91), urinary system (SIR = 23.48), brain and other nervous systems (SIR = 5.70), and endocrine system (SIR = 5.84). Multivariate analysis revealed that the year of diagnosis (OR = 2.138, 95% CI = 1.634–2.797, p < 0.001) was the only independent risk factor for developing SMNs. Conclusion This study identifies the risk factor for developing SMNs in patients with neuroblastoma, which could facilitate individualized screening for high-risk patients, to allow early diagnosis and treatment of SMNs.

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