Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors
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- Haugnes, H.S., Aass, N., Fosså, S.D. et al. J Cancer Surviv (2008) 2: 128. doi:10.1007/s11764-008-0054-1
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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.