Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer: a population-based study
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Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer : a population-based study. / Kier, M G G; Lauritsen, Jakob; Almstrup, Kristian; Mortensen, Mette Saksø; Toft, Birgitte Grønkær; Meyts, Ewa Rajpert-De; Skakkebæk, Niels Erik; Rørth, Mikael Rahbek; von der Maase, Hans Rene Rostgaard; Agerbæk, Mads; Holm, N V; Andersen, K K; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Daugaard, Gedske.
In: Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, Vol. 26, No. 4, 04.2015, p. 737-742.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer
T2 - a population-based study
AU - Kier, M G G
AU - Lauritsen, Jakob
AU - Almstrup, Kristian
AU - Mortensen, Mette Saksø
AU - Toft, Birgitte Grønkær
AU - Meyts, Ewa Rajpert-De
AU - Skakkebæk, Niels Erik
AU - Rørth, Mikael Rahbek
AU - von der Maase, Hans Rene Rostgaard
AU - Agerbæk, Mads
AU - Holm, N V
AU - Andersen, K K
AU - Dalton, Susanne Oksbjerg
AU - Johansen, Christoffer
AU - Daugaard, Gedske
N1 - © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2015/4
Y1 - 2015/4
N2 - BACKGROUND: Screening programmes for contralateral carcinoma in situ (CIS) testis in patients with unilateral germ-cell cancer (GCC) have never been evaluated. We investigated the effect of screening for contralateral CIS in a large nation-wide, population-based study.PATIENTS AND METHODS: A contralateral single-site biopsy was offered to 4130 patients in whom GCC had been diagnosed in 1984-2007 (screened cohort); 462 patients in whom GCC was diagnosed in 1984-1988 comprised the unscreened cohort. Cases with CIS were offered radiotherapy. Initially CIS-negative biopsies in patients with metachronous GCC were revised according to today's standards. Risk for metachronous GCC was estimated using cumulative incidence and the Cox proportional hazards model.RESULTS: In the screened cohort, contralateral CIS was found in 181 (4.4%) patients. The cumulative incidence of metachronous GCC after 20 years was 1.9% in the screened cohort and 3.1% in the unscreened cohort (P = 0.097), hazard ratio (HR) for the unscreened cohort: 1.59 (P = 0.144). Expert revision with contemporary methodology of CIS-negative biopsy samples from patients with metachronous cancer revealed CIS in 17 out of 45 (38%) cases. Decreased risks for metachronous GCC were related to older age at diagnosis (HR 0.52 per 10 years, P < 0.001) and chemotherapy (HR 0.35, P = 0.002). Limitations include the small number of patients in the unscreened cohort and the retrospective study design.CONCLUSIONS: Our evaluation of a national population-based screening programme for contralateral CIS in patients with testicular cancer showed no significant difference in the risk for metachronous GCC between a screened and an unscreened cohort. Single-site biopsy including modern immunohistochemistry does not identify all cases of CIS.
AB - BACKGROUND: Screening programmes for contralateral carcinoma in situ (CIS) testis in patients with unilateral germ-cell cancer (GCC) have never been evaluated. We investigated the effect of screening for contralateral CIS in a large nation-wide, population-based study.PATIENTS AND METHODS: A contralateral single-site biopsy was offered to 4130 patients in whom GCC had been diagnosed in 1984-2007 (screened cohort); 462 patients in whom GCC was diagnosed in 1984-1988 comprised the unscreened cohort. Cases with CIS were offered radiotherapy. Initially CIS-negative biopsies in patients with metachronous GCC were revised according to today's standards. Risk for metachronous GCC was estimated using cumulative incidence and the Cox proportional hazards model.RESULTS: In the screened cohort, contralateral CIS was found in 181 (4.4%) patients. The cumulative incidence of metachronous GCC after 20 years was 1.9% in the screened cohort and 3.1% in the unscreened cohort (P = 0.097), hazard ratio (HR) for the unscreened cohort: 1.59 (P = 0.144). Expert revision with contemporary methodology of CIS-negative biopsy samples from patients with metachronous cancer revealed CIS in 17 out of 45 (38%) cases. Decreased risks for metachronous GCC were related to older age at diagnosis (HR 0.52 per 10 years, P < 0.001) and chemotherapy (HR 0.35, P = 0.002). Limitations include the small number of patients in the unscreened cohort and the retrospective study design.CONCLUSIONS: Our evaluation of a national population-based screening programme for contralateral CIS in patients with testicular cancer showed no significant difference in the risk for metachronous GCC between a screened and an unscreened cohort. Single-site biopsy including modern immunohistochemistry does not identify all cases of CIS.
U2 - 10.1093/annonc/mdu585
DO - 10.1093/annonc/mdu585
M3 - Journal article
C2 - 25542924
VL - 26
SP - 737
EP - 742
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 4
ER -
ID: 137985309