ESMO Virtual Congress 2020: Metachronous Contralateral Testicular Cancer in the Cisplatin Era

(UroToday.com) The diagnosis of testicular cancer is associated with a long-term cumulative incidence of contralateral testicular cancer of 1.9-3.9% over a 15-20-year time span. While it has been hypothesized that patients who receive platinum chemotherapy as part of the management of their testicular cancer have a lower incidence of contralateral testicular cancer, data to answer this question are lacking. To address this question, Dr. Ragnhild Hellesnes and colleagues utilized the cancer registry of Norway, which includes 5,620 men diagnosed with testicular cancer between 1980 and 2009.


Within this cohort, 218 men were diagnosed with a contralateral testicular tumor after a median of 6.2 years (IQR 3.3 – 10.6 years), corresponding to a 20-year cumulative incidence of 4.0% and total standardized incidence ratio of 13.1. Patients diagnosed with their first testicular cancer before aged 30 had a higher incidence of contralateral testicular cancer (6%) relative to those diagnosed with their first tumor after aged 30 (2.8%). Second testicular cancer incidence was also lower if patients received platinum chemotherapy (3.2%) versus those that did not (5.4%). The hazard ratio for second testicular cancer after platinum chemotherapy was 0.55 (95% CI 0.40 – 0.76). The hazard ratio for second testicular cancer decreased with an increasing number of cycles of platinum chemotherapy.

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In summary, this presentation provided important data on the incidence of second contralateral testicular cancers using a large population database of men in Norway. Secondary cancers were more common if the first diagnosis was made at age < 30, and less common if patients received platinum chemotherapy as part of the management of their first diagnosis.

Presented by: Ragnhild Hellesnes, MD, Department of Oncology, University Hospital of North Norway and the University of Tromso, Norway

Written by: Alok Tewari, MD, PhD, Medical Oncologist at the Dana-Farber Cancer Institute, at the 2020 European Society for Medical Oncology Virtual Congress (#ESMO20), September 19th-September 21st, 2020.