ANALYSIS OF THE INCREASED INCIDENCE OF AGGRESSIVE PROSTATE CANCER AFTER PRIOR TESTICULAR CANCER

Abstract

Introduction

Some recent studies have suggested that testicular cancer survivors are at increased risk of developing aggressive prostate cancer compared to the general population while others have not found this link. The objective of this study is to determine if testicular cancer survivors are predisposed to higher incidence of aggressive prostate cancer later in life and greater risks of prostate cancer specific mortality.

Methods

This was a retrospective case-control study of patients who developed prostate cancer and who previously had either testicular cancer or a control group cancer greater than five years prior. We used the Surveillance, Epidemiology, and End Results (SEER) database to access national cancer patient data from 1975-2020 and identify if patients with a history of testicular cancer have an earlier development of more aggressive secondary prostate cancer with higher mortality compared to those in the control group. Due to the high 5-year relative survival of testicular cancer, the control group included breast, bladder, cranial nerves and nervous system (excluding the brain), eye/orbital, oral cavity, skin, renal, thyroid cancers. Patient morbidity and mortality was assessed using Gleason scores, PSA, tumor stage, and survival time and stratified into low, moderate, and high risk accordingly. Cox regression models were used to determine the risk of mortality.

Results

We identified that prostate cancer does occur globally more in patients with testicular cancer compared to controls. The mean age in years of prostate cancer diagnosis for the testicular cancer group was 61.62 +/- 7.88, while the control group was 66.66 +/- 8.8. By the age of 60, we found that 10.7% of patients in the testicular cancer group had developed prostate cancer, compared to 6.8% of the control group. Patients in the testicular cancer group saw a decreased survival time in months (105) compared to the control (136).

Conclusions

We determined that patients with a history of testicular cancer may be at an increased risk of developing prostate cancer earlier with a higher mortality rate compared to other cancer survivors. Confirmatory studies are warranted.