Groot HJ, van Leeuwen FE, Lubberts S, et al. - Given the association of testicular cancer (TC) treatment with severe late morbidities, including second malignant neoplasms (SMNs) and ischemic heart disease (IHD), researchers sought to determine cause-specific excess mortality among patients treated in the platinum era. In this large, multicenter cohort study of 6,042 patients with TC treated between 1976 and 2006, the death of 800 patients was reported during a median follow-up period of 17.6 years. Death because of TC was reported in 40.3% of these patients. Twenty-five years following TC treatment, the cumulative mortality of 9.6% was observed. Relative to general population mortality rates, patients with nonseminoma had 2.0 to 11.6 times raised mortality from lung, stomach, pancreatic, rectal, and kidney cancers, soft-tissue sarcomas, and leukemia; 1.9-fold heightened mortality from IHD; and 3.9-fold heightened mortality from pneumonia. Mortality from stomach, pancreatic, bladder cancer and leukemia was 2.5 to 4.6 times higher among seminoma patients. They observed an association of radiotherapy and chemotherapy with 2.1 and 2.5 times higher SMN mortality, respectively, in comparison with the general population. The multivariable analysis revealed that treatment with platinum-containing chemotherapy is related to a 2.5-fold increased hazard ratio for SMN mortality in comparison with patients without platinum-containing chemotherapy. They noted an increase in IHD mortality by 2.1-fold after platinum-containing chemotherapy in comparison with patients without platinum exposure. The analysis revealed an association of platinum-containing chemotherapy with a dose-dependent increase in the risk of SMN mortality.