Risk Factors and Impact on QoL in TC Survivors with Cardiovascular Disease

The following is a summary of “Cardiovascular Disease in Testicular Cancer Survivors: Identification of Risk Factors and Impact on Quality of Life,” published in the July 2023 issue of Oncology by Lubberts, et al.

For a study, researchers sought to assess cardiometabolic risk factors and quality of life (QoL) in testicular cancer (TC) survivors to develop preventive strategies for cardiovascular disease (CVD).

A multicenter cohort study was conducted on 4,748 TC patients treated between 1976 and 2007 at 12-50 years old—the incidence of coronary artery disease, myocardial infarction, and heart failure after TC treatment was evaluated. Patients who developed CVD and a random sample from the cohort (subcohort) completed a questionnaire on cardiometabolic risk factors and QoL. A subgroup of responders in the subcohort also underwent clinical evaluation of cardiovascular risk factors.

After a median follow-up of 16 years, 272 patients had developed CVD. Combination chemotherapy with cisplatin was associated with an increased risk of CVD compared to orchidectomy only (hazard ratio [HR], 1.9; 95% CI, 1.1 to 3.1). TC survivors who were obese or smokers at diagnosis developed Raynaud’s phenomenon or dyslipidemia or had a positive family history of CVD and had a higher risk of CVD. TC survivors with CVD reported inferior QoL on physical domains compared to those who did not develop CVD. Among 304 TC survivors who underwent clinical evaluation, a high percentage had dyslipidemia (86%), hypertension (50%), and metabolic syndrome (35%), regardless of the treatment received.

The study findings indicated that cardiovascular events in TC survivors negatively impacted QoL. Many TC survivors have undetected cardiovascular risk factors. Early lifestyle adjustments and lifelong follow-up with the low-threshold treatment of cardiovascular risk factors are recommended, particularly for obese and smoking patients treated with platinum-based chemotherapy.

Suorce: ascopubs.org/doi/full/10.1200/JCO.22.01016