Dataset Information

Platinum exposure and cause-specific mortality among patients with testicular cancer.

ABSTRACT:

Background

Although testicular cancer (TC) treatment has been associated with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), cause-specific excess mortality has been rarely studied among patients treated in the platinum era.

Methods

In a large, multicenter cohort including 6042 patients with TC treated between 1976 and 2006, cause-specific mortality was compared with general population mortality rates. Associations with treatment were assessed with proportional hazards analysis.

Results

With a median follow-up of 17.6 years, 800 patients died; 40.3% of these patients died because of TC. The cumulative mortality was 9.6% (95% confidence interval [CI], 8.5%-10.7%) 25 years after TC treatment. In comparison with general population mortality rates, patients with nonseminoma experienced 2.0 to 11.6 times elevated mortality from lung, stomach, pancreatic, rectal, and kidney cancers, soft-tissue sarcomas, and leukemia; 1.9-fold increased mortality (95% CI, 1.3-2.8) from IHD; and 3.9-fold increased mortality (95% CI, 1.5-8.4) from pneumonia. Seminoma patients experienced 2.5 to 4.6 times increased mortality from stomach, pancreatic, bladder cancer and leukemia. Radiotherapy and chemotherapy were associated with 2.1 (95% CI, 1.8-2.5) and 2.5 times higher SMN mortality (95% CI, 2.0-3.1), respectively, in comparison with the general population. In a multivariable analysis, patients treated with platinum-containing chemotherapy had a 2.5-fold increased hazard ratio (HR; 95% CI, 1.8-3.5) for SMN mortality in comparison with patients without platinum-containing chemotherapy. The HR for SMN mortality increased 0.29 (95% CI, 0.19-0.39) per 100 mg/m² platinum dose administered (P_trend < .001). IHD mortality was increased 2.1-fold (95% CI, 1.5-4.2) after platinum-containing chemotherapy in comparison with patients without platinum exposure.

Conclusions

Platinum-containing chemotherapy is associated with a dose-dependent increase in the risk of SMN mortality.

SUBMITTER: Groot HJ

PROVIDER: S-EPMC7004069 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Platinum exposure and cause-specific mortality among patients with testicular cancer.

Groot Harmke J HJ van Leeuwen Flora E FE Lubberts Sjoukje S Horenblas Simon S de Wit Ronald R Witjes J Alfred JA Groenewegen Gerard G Poortmans Philip M PM Hulshof Maarten C C M MCCM Meijer Otto W M OWM de Jong Igle J IJ van den Berg Hetty A HA Smilde Tineke J TJ Vanneste Ben G L BGL Aarts Maureen J B MJB Jóźwiak Katarzyna K van den Belt-Dusebout Alexandra W AW Gietema Jourik A JA Schaapveld Michael M

Cancer 20191115 3

<h4>Background</h4>Although testicular cancer (TC) treatment has been associated with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), cause-specific excess mortality has been rarely studied among patients treated in the platinum era.<h4>Methods</h4>In a large, multicenter cohort including 6042 patients with TC treated between 1976 and 2006, cause-specific mortality was compared with general population mortality rates. Associations with treat ...[more]

PMID: 31730712

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Dataset Information

Platinum exposure and cause-specific mortality among patients with testicular cancer.

Background

Methods

Results

Conclusions

Publications

Platinum exposure and cause-specific mortality among patients with testicular cancer.

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