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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Terbuch, A; Posch, F; Annerer, LM; Bauernhofer, T; Pichler, M; Szkandera, J; Hutterer, GC; Pummer, K; Partl, R; Kapp, KS; Stöger, H; Gerger, A; Stotz, M.
Long-term cardiovascular complications in stage I seminoma patients.
Clin Transl Oncol. 2017; 19(11):1400-1408 Doi: 10.1007/s12094-017-1742-y [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz

Gerger Armin

Terbuch Angelika

Co-Autor*innen der Med Uni Graz

Bauernhofer Thomas

Hutterer Georg

Kapp Karin S.

Partl Richard

Pichler Martin

Posch Florian

Pummer Karl

Stöger Herbert

Stotz Michael

Szkandera Joanna

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Abstract:

The cure rate of stage I seminoma patients is close to 100% and so the recent focus of clinical research has shifted onto the prevention of treatment-related complications. We assessed long-term cardiovascular complications and identified risk factors for cardiovascular events (CVEs) in stage I seminoma patients. This retrospective cohort study included 406 consecutive stage I seminoma patients. Primary endpoint was CVE rate. During a median follow-up of 8.6 years, we observed 23 CVEs in 406 patients [10-year CVE risk 5.6% (95% CI 3.2 to 8.8)]. In univariable competing risk analysis, higher age, positive smoking status, history of diabetes and hypertension were significantly associated with the occurrence of CVE. In multi-state analysis, new onset of diabetes, hypertension and hyperlipidemia during follow-up predicted for an excessively increased CVE risk. In multivariable analysis adjusting for age and smoking, the development of hypertension and hyperlipidemia after tumor-specific treatment prevailed as risk factors for CVE. Regarding adjuvant treatment modalities, patients receiving adjuvant radiotherapy had a significantly higher probability of CVE than patients receiving adjuvant carboplatin [16% vs. 0%; risk difference (RD) = 16%, 95% CI 6 to 25%, p = 0.001]. This difference prevailed after adjusting for age, follow-up-time, diabetes, hypertension and smoking (RD = 11%, 95% CI 1 to 20%, p = 0.025). We identified a panel of baseline risk factors and dynamically, occurring predictors of CVE in stage I seminoma patients. This information may be used for targeting comorbidity management in these patients. The observed association of adjuvant radiotherapy with higher CVE risk warrants further investigation.

Find related publications in this database (using NLM MeSH Indexing)

Adult -

Carboplatin - adverse effects

Cardiovascular Diseases - diagnosis

Cardiovascular Diseases - etiology

Chemotherapy, Adjuvant -

Combined Modality Therapy - adverse effects

Follow-Up Studies -

Humans -

Male -

Middle Aged -

Neoplasm Staging -

Radiotherapy, Adjuvant - adverse effects

Retrospective Studies -

Risk Factors -

Seminoma - complications

Seminoma - pathology

Seminoma - therapy

Survival Rate -

Testicular Neoplasms - complications

Testicular Neoplasms - pathology

Testicular Neoplasms - therapy

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Testicular cancer

Seminoma

Cardiovascular risk

Radiotherapy

Carboplatin

Active surveillance

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