Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Annerer, L.
TREATMENT-RELATED MORBIDITY IN PATIENTS WITH TESTICULAR CANCER
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp.
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- Autor*innen der Med Uni Graz:
- Terbuch Angelika
- Betreuer*innen:
- Gerger Armin
- Terbuch Angelika
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- Abstract:
- Purpose: Testicular germ cell tumours (TGCT) represent the most common solid malignancies among men aged 20 to 40 years. If detected in early stage disease, the cure rates lie between 90-100%, regardless of the treatment strategy. Therefore, we shifted the focus of our research towards the prevention of treatment-related complications and tried to investigate differences between the available treatment modalities. In our study, we focused on the adjuvant treatment of patients with stage I seminoma and the occurrence of cardiovascular complications. Methods: The retrospective cohort study included 406 patients with histologically confirmed clinical stage I seminoma, who presented to the Division of Oncology at the Medical University of Graz between 1994 and 2013. Their medical records were retrospectively reviewed and cardiovascular events (CVE), preliminarily defined as myocardial infarction, cerebrovascular event, coronary heart disease and peripheral arterial disease, were documented. The primary endpoint of the study was the CVE rate. Results: In our study population of 406 patients, 23 CVEs were observed during a median follow up of 8.6 years (10-year CVE risk: 5.6% (95%CI: 3.2 -8.8)). A univariable competing risk analysis revealed a significant association between higher age, positive smoking status, history of diabetes, hypertension and the occurrence of cardiovascular events. Further, new onset of diabetes, hypertension and hyperlipidemia during follow-up proofed to be predictive of an excessively increased CVE risk in our multi-state analysis. Our results also showed that patients receiving adjuvant radiotherapy had a significantly higher probability of cardiovascular events than patients being treated with adjuvant carboplatin (16% vs. 0%; risk difference (RD)=16%, 95%CI: 6-25%, p=0,001). Conclusion: We identified multiple baseline risk factors and predictors of cardiovascular events in patients with stage I seminoma. Those may be useful for the management of comorbidities. We also discovered an association between adjuvant radiotherapy and higher risk of cardiovascular events, which warrants further investigation.