Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up Academic Article uri icon


MeSH Major

  • Antineoplastic Agents
  • Neoplasms, Germ Cell and Embryonal
  • Radiotherapy
  • Survivors
  • Testicular Neoplasms


  • Germ cell testicular cancer (TC) represents a malignancy with high cure rates. Since the introduction of cisplatin-based chemotherapy in the late 1970s, the 5-year survival rate has increased considerably, and it is currently above 95%. Because TC is usually diagnosed before the age of 40 years, these men can expect to live for another 40 to 50 years after being successfully treated. This success, however, is hampered by an increased risk of long-term and late effects of treatment. Secondary malignant neoplasms and cardiovascular disease represent the most common potentially life-threatening late effects, typically occurring more than 10 years after treatment. Other long-term effects include pulmonary toxicity, nephrotoxicity, neurotoxicity, decreased fertility, hypogonadism, and psychosocial problems. The incidence and time to onset of these various adverse effects vary according to treatment type and intensity. There is still little knowledge about underlying mechanisms and genetic susceptibility of the various adverse effects. Apart from treatment burden, it is not yet possible to identify patients who are at high risk for certain late effects after TC treatment. In this clinical review, we present the current status regarding different somatic and psychosocial long-term late effects after treatment for TC, based on Medline searches and our own research. Moreover, we postulate recommendations for general medical evaluations that should begin after treatment is completed and continue during follow-up.

publication date

  • October 20, 2012



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1200/JCO.2012.43.4431

PubMed ID

  • 23008318

Additional Document Info

start page

  • 3752

end page

  • 63


  • 30


  • 30