Evidence map›Paper›PMID 34388002›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021

Testicular Cancer in the Cisplatin Era: Causes of Death and Mortality Rates in a Population-Based Cohort.

Ragnhild Hellesnes, Tor Åge Myklebust, Sophie D Fosså, Roy M Bremnes, Ása Karlsdottir, Øivind Kvammen, Torgrim Tandstad, Tom Wilsgaard, Helene F S Negaard, Hege S Haugnes

Registry-linked trialOpen access · greenAbstract read
PubMed Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07498959 (Testicular Cancer Treatment), which is not on this map. Cited by 41 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 1 pooled it
14.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07498959 narecruitingnot on this mapstarted 2026, after this paper: background citation

Testicular Cancer Treatment: Assessing Quality of Life in Good Prognosis Metastastic Disease

TypeinterventionalSponsorSahlgrenska University HospitalRan2026 to 2032Enrolled160ConditionsTesticular Cancer, Seminoma, Quality of Life, De-escalationArmsprimary RPLND for low-stage metasatatic seminoma, 3 courses of chemotherapy, Blemocin, Etoposide and Platinum (BEP)
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Long-term side effects of testicular cancer and treatment (observational study of mortality and morbidity in testicular cancer survivors).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Observational
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 1 country.

Ragnhild HellesnesDepartment of Oncology, University Hospital of North Norway, Tromsø, Norway.ORCID 0000-0001-5992-3801
Tor Åge MyklebustDepartment of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.ORCID 0000-0003-4645-1635
Sophie D FossåDepartment of Registration, Cancer Registry of Norway, Oslo, Norway.ORCID 0000-0002-3729-2217
Roy M BremnesDepartment of Oncology, University Hospital of North Norway, Tromsø, Norway.
Ása KarlsdottirDepartment of Oncology, Haukeland University Hospital, Bergen, Norway.ORCID 0000-0001-6434-3537
Øivind KvammenDepartment of Oncology, Ålesund Hospital, Ålesund, Norway.ORCID 0000-0003-0192-3264
Torgrim TandstadThe Cancer Clinic, St Olavs University Hospital, Trondheim, Norway.
Tom WilsgaardDepartment of Community Medicine, UiT The Arctic University, Tromsø, Norway.
Helene F S NegaardDepartment of Oncology, Oslo University Hospital, Oslo, Norway.ORCID 0000-0002-8073-2900
Hege S HaugnesDepartment of Oncology, University Hospital of North Norway, Tromsø, Norway.ORCID 0000-0002-9813-0561
University Hospital of North Norway · NOÅlesund Hospital · NOOslo University Hospital · NOHaukeland University Hospital · NONorwegian University of Science and Technology · NOUiT The Arctic University of Norway · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUsing complete information regarding testicular cancer (TC) treatment burden, this study aimed to investigate cause-specific non-TC mortality with impact on previous treatment with platinum-based chemotherapy (PBCT) or radiotherapy (RT).

methodsOverall, 5,707 men identified by the Cancer Registry of Norway diagnosed with TC from 1980 to 2009 were included in this population-based cohort study. By linking data with the Norwegian Cause of Death Registry, standardized mortality ratios (SMRs), absolute excess risks (AERs; [(observed number of deaths - expected number of deaths)/person-years of observation] ×10,000), and adjusted hazard ratios (HRs) were calculated.

resultsMedian follow-up was 18.7 years, during which non-TC death was registered for 665 (12%) men. Overall excess non-TC mortality was 23% (SMR, 1.23; 95% CI, 1.14 to 1.33; AER, 11.14) compared with the general population, with increased risks after PBCT (SMR, 1.23; 95% CI, 1.07 to 1.43; AER, 7.68) and RT (SMR, 1.28; 95% CI, 1.15 to 1.43; AER, 19.55). The highest non-TC mortality was observed in those < 20 years at TC diagnosis (SMR, 2.27; 95% CI, 1.32 to 3.90; AER, 14.42). The most important cause of death was non-TC second cancer with an overall SMR of 1.53 (95% CI, 1.35 to 1.73; AER, 7.94), with increased risks after PBCT and RT. Overall noncancer mortality was increased by 15% (SMR, 1.15; 95% CI, 1.04 to 1.27; AER, 4.71). Excess suicides appeared after PBCT (SMR, 1.65; 95% CI, 1.01 to 2.69; AER, 1.39). Compared with surgery, increased non-TC mortality appeared after 3 (HR, 1.47; 95% CI, 0.91 to 2.39), 4 (HR, 1.41; 95% CI, 1.01 to 1.99), and more than four (HR, 2.04; 95% CI, 1.25 to 3.35) cisplatin-based chemotherapy cycles after > 10 years of follow-up.

conclusionTC treatment with PBCT or RT is associated with a significant excess risk of non-TC mortality, and increased risks emerged after more than two cisplatin-based chemotherapy cycles after > 10 years of follow-up.

Indexed as

AdolescentAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCause of DeathCisplatinHumansIncidenceMaleMiddle AgedNorwayRegistriesRisk AssessmentRisk FactorsTesticular NeoplasmsCisplatin

Identifiers

PMID34388002
OpenAlexW3166517967

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.