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Treatment-related differences in cardiovascular risk factors in long-term survivors of testicular cancer

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Journal of Cancer Survivorship: Research and Practice Aims and scope Submit manuscript

Abstract

Objective

Treatment in testicular cancer survivors (TCSs) may be followed by cardiovascular disorders. We have examined whether today’s three treatment modalities are assicated with a biochemical cardiovascular risk profile.

Materials and methods

In this cross sectional study serum inflammatory markers, atherogenic lipoproteins and gonadal hormones were measured in 589 orchiectomized TCSs who have been treated 5–20 years previously. There were 140 patients treated by surgery alone (SURG), 231 who had had infradiaphragmatic radiotherapy alone (RAD), and 218 who had chemotherapy with or without additional surgery (CHEM).

Results

(1) The RAD group had higher levels of high-sensitivity C-reactive protein and soluble CD40 ligand compared to the SURG group. (2) The CHEM group had lower levels of high density lipoprotein cholesterol and an increased apolipoprotein B/apolipoprotein A-1 ratio than the SURG group. The prevalence of metabolic syndrome was higher in the CHEM group than in the SURG group. (3) Hypogonadism was significantly more prevalent in the CHEM than in the SURG group.

Conclusion

Treatment for TC was related to long-term biochemical cardiovascular risk factors by different pathways: Radiation treatment is followed by elevated serum markers of chronic inflammation and endothelial dysfunction, whereas chemotherapy is followed by the development of atherogenic lipid changes and of the metabolic syndrome. This study provides justification for a prospective study of the impact of these treatment modalities on cardiovascular risk in testical cancer survivors. In the interim testicular cancer survivors should monitor cardiovascular risk over time.

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Acknowledgements

The Norwegian Foundation for Health and Rehabilitation. Norwegian Cancer Society. The study is part of Norwegian Urological Cancer Group. Study III. The Nord-Trøndelag Health Study (HUNT Study), a collaboration between the HUNT Research Center, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Verdal, is acknowledged.

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Authors and Affiliations

  1. Department of Cardiology, Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway

    T. Wethal & J. Kjekshus

  2. Section of Biostatistics, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway

    J. Røislien

  3. Research Institute for Internal Medicine, Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway

    T. Ueland & P. Aukrust

  4. Department of Medical Biochemistry, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway

    R. Wergeland

  5. Section of Clinical Immunology and Infectious Diseases, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway

    P. Aukrust

  6. Department of Clinical Cancer Research, Rikshospitalet-Radiumhospitalet Medical Centre, Ullernschausséen 70, 0310, Oslo, Norway

    S. D. Fosså

  7. Department of Cardiology, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway

    A. K. Andreassen

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  1. T. Wethal
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Correspondence to S. D. Fosså.

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Wethal, T., Kjekshus, J., Røislien, J. et al. Treatment-related differences in cardiovascular risk factors in long-term survivors of testicular cancer. J Cancer Surviv 1, 8–16 (2007). https://doi.org/10.1007/s11764-007-0012-3

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  • DOI: https://doi.org/10.1007/s11764-007-0012-3

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