XXXX among @entity5 survivors.

@entity1 @entity10711 @entity5
BACKGROUND: @entity1 on active surveillance for clinical stage I @entity10711 ( @entity10711 ) undergo frequent computed tomography imaging to avoid delayed detection of disease. Irradiation from frequent imaging and chemotherapy upon progression may place @entity1 at increased risk of a second @entity5 . In this study, the authors sought to identify such an increased risk among @entity1 who chose initial surveillance for @entity10711 . METHODS: The authors utilized data from the Surveillance, Epidemiology and End Results Program and stratified the cohort based on whether they underwent retroperitoneal lymph node dissection (RPLND). A propensity-score model was used to adjust for covariates, and a competing-risks regression analysis was performed to estimate cumulative incidence rates of second @entity5 . Incidence risk ratios were predicted by using the cumulative incidence rates per 10,000 @entity1 . RESULTS: There was no statistically significant increase in the incidence of a secondary @entity5 for the entire cohort of testicular @entity5 survivors. However, when the analysis was restricted to @entity1 with clinical stage I @entity10711 , nonsurgical management only in those aged >45 years was an independent predictor of developing a second @entity5 . For every 10,000 @entity1 with stage I @entity10711 who chose to forego RPLND, an absolute excess incidence of 22, 52, and 73 secondary @entity5 would be diagnosed at 5 years, 10 years, and 15 years, respectively. CONCLUSIONS: The current results indicated that @entity1 aged >45 years who forego RPLND for T1 or T2 clinical stage I @entity10711 are more likely to develop a second @entity5 than those who do undergo RPLND. Nonsurgical management of @entity10711 may be associated with more long-term health risks than primary RPLND.
