Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors
- H. S. HaugnesAffiliated withDepartment of Oncology, Institute of Clinical Medicine, University of Tromsø Email author
- , N. AassAffiliated withDepartment of Oncology, Rikshospitalet Medical Center
- , S. D. FossåAffiliated withDepartment of Clinical Cancer Research, Rikshospitalet Medical CenterMedical Faculty, University of Oslo
- , O. DahlAffiliated withSection of Oncology, Institute of Medicine, University of BergenDepartment of Oncology, Haukeland University Hospital
- , O. KleppAffiliated withDepartment of Oncology, St. Olav University Hospital
- , E. A. WistAffiliated withDepartment of Oncology, Ullevål University Hospital
- , T. WilsgaardAffiliated withInstitute of Community Medicine, University of Tromsø
- , R. M. BremnesAffiliated withDepartment of Oncology, Institute of Clinical Medicine, University of TromsøDepartment of Oncology, University Hospital of North Norway
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We examined if testicular cancer (TC) treatment is associated with any risk for cardiovascular morbidity or predicted mortality according to the SCORE model, in which a 10-year future risk of ≥5% for developing a fatal cardiovascular event qualify for high-risk status.
One thousand one hundred thirty-four TC survivors treated 1980–1994 participated in this study (1998–2002). Patients were categorised in four treatment groups: surgery (n = 225), radiotherapy (n = 445), and two chemotherapy groups: cumulative cisplatin dose ≤850 mg (n = 375) and >850 mg (cis>850, n = 89). Patients with cardiovascular disease, diabetes or SCORE ≥5% constituted a high-risk group, and those with SCORE >1% an intermediate/high risk group.
Age-adjusted mean SCORE was 0.93% for the surgery group. In comparison, chemotherapy treated patients had significantly higher SCORE (1.07%, p = 0.01). Only 15% of patients were scored to be at high-risk, while 53% qualified for the intermediate/high risk group. Patients in the cis>850 group had increased odds for having intermediate/high risk, compared with the surgery group (OR 3.4, 95% CI 1.3–8.7). Only 23 cardiovascular events had occurred since the testicular cancer diagnosis.
The SCORE model indicates that patients treated with cisplatin-based chemotherapy have a significantly increased future risk of a fatal cardiovascular event.
Implications for cancer survivors
TC survivors should be followed regularly with respect to cardiovascular risk profile beyond the routine 10-year clinical follow-up.
KeywordsTesticular cancer Cisplatin Cardiovascular Mortality Morbidity SCORE
- Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors
Journal of Cancer Survivorship
Volume 2, Issue 3 , pp 128-137
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- Springer US
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- Testicular cancer
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- Author Affiliations
- 1. Department of Oncology, Institute of Clinical Medicine, University of Tromsø, 9037, Tromsø, Norway
- 2. Department of Oncology, Rikshospitalet Medical Center, Montebello, 0310, Oslo, Norway
- 3. Department of Clinical Cancer Research, Rikshospitalet Medical Center, Montebello, 0310, Oslo, Norway
- 4. Medical Faculty, University of Oslo, 0316, Oslo, Norway
- 5. Section of Oncology, Institute of Medicine, University of Bergen, 5007, Bergen, Norway
- 6. Department of Oncology, Haukeland University Hospital, 5053, Bergen, Norway
- 7. Department of Oncology, St. Olav University Hospital, 7030, Trondheim, Norway
- 8. Department of Oncology, Ullevål University Hospital, 0407, Oslo, Norway
- 9. Institute of Community Medicine, University of Tromsø, 9037, Tromsø, Norway
- 10. Department of Oncology, University Hospital of North Norway, 9038, Tromsø, Norway