ArticleInternational journal of cancer2025
Pulmonary toxicity in children, adolescents, and young adults with testicular germ cell tumors: A population-based retrospective matched cohort study.
Article in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Pulmonary toxicity in children, adolescents, and young adults with testicular germ cell tumors: A population-based retrospective matched cohort study.International journal of cancer · 2025Article
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9 authors.
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Abstract
While testicular germ cell tumors (TGCT) are highly curable, survivors experience toxicities. Pulmonary outcomes post-TGCT are not well understood, particularly among children, adolescents, and young adults (CAYA). Using provincial cancer registries, we identified all CAYA (aged 11-21 years) diagnosed with a TGCT from 1992 to 2021 in Ontario, Canada, and matched them (1:5) to general population males (controls). We linked CAYA to health administrative databases to identify pulmonary disease and pulmonary disease healthcare visits (PDV) and classified PDV severity as low (outpatient family physician/pediatrician), medium (outpatient respirologist/internist), or high (hospitalization/emergency department). We assessed acute (<5 years from diagnosis) and late (≥5 years after diagnosis) toxicities using the cumulative incidence function and cause-specific hazard models. We identified 748 patients (404 chemotherapy-treated) and 3740 controls. Patients' median age at diagnosis was 19.0 years [interquartile range (IQR):18.0-21.0] and 29.7 years (IQR:25.0-37.6) at end of follow-up. Non-chemotherapy-treated patients had higher risk of acute toxicities (obstructive lung disease, medium severity PDV, hospitalizations) but similar risk of late toxicities to controls. Chemotherapy-treated patients had higher risk than controls of most acute pulmonary toxicities (except asthma and low severity PDV) and several late toxicities: asthma [hazard ratio (HR) = 2.0, 95%CI:1.1-3.8], pulmonary embolism/infarction (HR = 7.3, 95%CI:1.2-44.3), medium severity PDV (HR = 3.9, 95%CI:2.1-7.3), and high severity PDV (HR = 1.7, 95%CI:1.0-2.8), particularly hospitalizations (HR = 4.1, 95%CI:1.7-9.5). CAYA TGCT survivors treated with chemotherapy are at risk for late asthma, pulmonary embolism, pulmonary fibrosis, and specialist and hospital-based pulmonary care. Further follow-up is needed to characterize late pulmonary outcomes as survivors age.
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