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Cognitive impairment in testicular cancer survivors 2 to 7 years after treatment

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Abstract

Purpose

The aim of the present study was to determine the prevalence of cognitive impairment (CI) in a group of testicular (TC) survivors by comparing their neuropsychological test scores with normative data and to assess their performance in specific cognitive domains.

Methods

Seventy-two TC survivors were evaluated 2 to 7 years post-treatment with a neuropsychological test battery that assessed multiple cognitive domains—attention and working memory, processing speed, verbal fluency, learning and memory, and executive functioning. Test scores were compared with normative data, and CI status was calculated for each participant.

Results

In group-level analyses, survivors exhibited significantly impaired scores on a majority (9/12) of the neuropsychological outcomes (p < 0.01). In individual-level analyses, 62.5 % of the survivors were classified as having CI, significantly exceeding the expected normative frequency of 25 % (binomial test: p < 0.001). In particular, CI was observed in multiple outcomes related to verbal learning and memory (29 to 33 % of participants), visual learning and memory (14–28 %), processing speed (8–24 %), executive functioning (17 %), and attention and working memory (4–15 %). No association was found between treatment modality (surgery ± chemotherapy) and CI.

Conclusions

The prevalence of CI in TC survivors was unexpectedly high, with survivors performing significantly worse than expected on a majority of the neuropsychological outcomes. While the findings are preliminary in nature, they still have important implications for the diagnosis and treatment of CI in TC survivors.

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Acknowledgments

The study was supported by grants from the Danish Cancer Society and by Saværksejer Jeppe Juhls og Hustru Ovita Juhls Mindelegat. We thank all the TC survivors who participated in this study for their time and dedication.

Conflict of interest

The authors declare that there is no conflict of interest. They also state that they have full control of primary data and that they agree to allow the journal to review their data if requested.

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Authors and Affiliations

  1. Unit for Psycho Oncology and Health Psychology, Aarhus University Hospital and Aarhus University, Aarhus C, Denmark

    Ali Amidi, Mimi Mehlsen, Christina Gundgaard Pedersen & Robert Zachariae

  2. Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Lisa M. Wu

  3. Vejlefjord Rehabilitation, Stouby, Denmark

    Anders Degn Pedersen

  4. Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark

    Philip Rossen & Mads Agerbæk

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  1. Ali Amidi
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  2. Lisa M. Wu
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  3. Anders Degn Pedersen
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  4. Mimi Mehlsen
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  5. Christina Gundgaard Pedersen
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  7. Mads Agerbæk
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  8. Robert Zachariae
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Correspondence to Ali Amidi.

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Amidi, A., Wu, L.M., Pedersen, A.D. et al. Cognitive impairment in testicular cancer survivors 2 to 7 years after treatment. Support Care Cancer 23, 2973–2979 (2015). https://doi.org/10.1007/s00520-015-2663-3

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  • DOI: https://doi.org/10.1007/s00520-015-2663-3

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