Journal of Cancer Survivorship

, Volume 2, Issue 3, pp 128–137 | Cite as

Predicted cardiovascular mortality and reported cardiovascular morbidity in testicular cancer survivors

  • H. S. Haugnes
  • N. Aass
  • S. D. Fosså
  • O. Dahl
  • O. Klepp
  • E. A. Wist
  • T. Wilsgaard
  • R. M. Bremnes
Article

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Testicular cancer Cisplatin Cardiovascular Mortality Morbidity SCORE 

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • H. S. Haugnes
    • 1
  • N. Aass
    • 2
  • S. D. Fosså
    • 3
    • 4
  • O. Dahl
    • 5
    • 6
  • O. Klepp
    • 7
  • E. A. Wist
    • 8
  • T. Wilsgaard
    • 9
  • R. M. Bremnes
    • 1
    • 10
  1. 1.Department of Oncology, Institute of Clinical MedicineUniversity of TromsøTromsøNorway
  2. 2.Department of OncologyRikshospitalet Medical CenterOsloNorway
  3. 3.Department of Clinical Cancer ResearchRikshospitalet Medical CenterOsloNorway
  4. 4.Medical FacultyUniversity of OsloOsloNorway
  5. 5.Section of Oncology, Institute of MedicineUniversity of BergenBergenNorway
  6. 6.Department of OncologyHaukeland University HospitalBergenNorway
  7. 7.Department of OncologySt. Olav University HospitalTrondheimNorway
  8. 8.Department of OncologyUllevål University HospitalOsloNorway
  9. 9.Institute of Community MedicineUniversity of TromsøTromsøNorway
  10. 10.Department of OncologyUniversity Hospital of North NorwayTromsøNorway

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