Testicular cancer survivorship: Research strategies and recommendations Journal Article
| Authors: | Travis, L. B.; Beard, C.; Allan, J. M.; Dahl, A. A.; Feldman, D. R.; Oldenburg, J.; Daugaard, G.; Kelly, J. L.; Dolan, M. E.; Hannigan, R.; Constine, L. S.; Oeffinger, K. C.; Okunieff, P.; Armstrong, G.; Wiljer, D.; Miller, R. C.; Gietema, J. A.; van Leeuwen, F. E.; Williams, J. P.; Nichols, C. R.; Einhorn, L. H.; Fossa, S. D. |
| Article Title: | Testicular cancer survivorship: Research strategies and recommendations |
| Abstract: | Testicular cancer represents the most curable solid tumor, with a 10-year survival rate of more than 95%. Given the young average age at diagnosis, it is estimated that effective treatment approaches, in particular, platinum-based chemotherapy, have resulted in an average gain of several decades of life. This success, however, is offset by the emergence of considerable long-term morbidity, including second malignant neoplasms, cardiovascular disease, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, decreased fertility, and psychosocial problems. Data on underlying genetic or molecular factors that might identify those patients at highest risk for late sequelae are sparse. Genome-wide association studies and other translational molecular approaches now provide opportunities to identify testicular cancer survivors at greatest risk for therapy-related complications to develop evidence-based long-term follow-up guidelines and interventional strategies. We review research priorities identified during an international workshop devoted to testicular cancer survivors. Recommendations include 1) institution of lifelong follow-up of testicular cancer survivors within a large cohort setting to ascertain risks of emerging toxicities and the evolution of known late sequelae, 2) development of comprehensive risk prediction models that include treatment factors and genetic modifiers of late sequelae, 3) elucidation of the effect(s) of decades-long exposure to low serum levels of platinum, 4) assessment of the overall burden of medical and psychosocial morbidity, and 5) the eventual formulation of evidence-based long-term follow-up guidelines and interventions. Just as testicular cancer once served as the paradigm of a curable malignancy, comprehensive follow-up studies of testicular cancer survivors can pioneer new methodologies in survivorship research for all adult-onset cancer. © 2010 The Author. Published by Oxford University Press. All rights reserved. |
| Keywords: | adult; survival rate; young adult; fatigue; paresthesia; cisplatin; antineoplastic agents; clinical trials as topic; note; neurotoxicity; follow up; evidence-based medicine; genetic predisposition to disease; quality of life; lung toxicity; nephrotoxicity; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; genome-wide association study; kidney failure; practice guideline; vinblastine; cancer survivor; risk assessment; survivors; sexuality; models, statistical; cardiovascular disease; cardiovascular diseases; genetic susceptibility; testicular neoplasms; bleomycin; cognition; cancer relapse; cognitive defect; neoplasms, second primary; second cancer; platinum compounds; hypogonadism; testis cancer; population surveillance; pulmonary fibrosis; mental health; employment; long term exposure; subfertility; infertility, male |
| Journal Title: | JNCI: Journal of the National Cancer Institute |
| Volume: | 102 |
| Issue: | 15 |
| ISSN: | 0027-8874 |
| Publisher: | Oxford University Press |
| Date Published: | 2010-08-04 |
| Start Page: | 1114 |
| End Page: | 1130 |
| Language: | English |
| DOI: | 10.1093/jnci/djq216 |
| PUBMED: | 20585105 |
| PROVIDER: | scopus |
| PMCID: | PMC2914759 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: JNCIA" - "Source: Scopus" |
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