CISPLATIN-BASED CHEMOTHERAPY CHANGES THE INCIDENCE OF BILATERAL TESTICULAR CANCER

Background: The introduction of cisplatin-based chemotherapy has remar kably increased the survival of testicular cancer patients. With this success, the concern for a contraIateral testicular tumor has increase d. The aim of this study was to investigate whether the risk for contr alateral testicular tumor development was influenced by cisplatin-base d chemotherapy, Methods: The incidence of a contralateraI testicular t umor among 365 consecutive patients with a nonseminoma testicular tumo r, diagnosed in the period 1980 and 1995, was established and related to previous therapy. Results: Eleven of 365 men (3%) developed a contr alateral testicular tumor, After a total of 2403 person-pears at risk, 4 of 225 chemotherapy-treated patients (1.8%) developed a contralater aI testicular tumor, and 7 of 140 patients (5%) treated with orchidect omy alone developed a contralateraI tumor. In comparison to this surve illance subgroup, patients previously treated with chemotherapy have a relative risk of 0.30 to develop a second testicular tumor. Conclusio ns: In Dutch men with a nonseminoma testicular tumor, the incidence of a contralateral testicular tumor is 3%, which is 60-fold the expected incidence rate of testicular cancer, A three times lower incidence ra te of a contralateral testicular tumor was found in the chemotherapy s ubgroup compared with those on surveillance. This supports the hypothe sis that cisplatin-based chemotherapy may eradicate carcinoma in situ or early testicular cancer.