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SHR Neuro Krebs Kardio Lipid

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 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Bauernhofer Thomas
Gerger Armin
Hutterer Georg C.
Kapp Karin S.
Partl Richard
Pichler Martin
Posch Florian
Pummer Karl
Stoeger Herbert
Stotz Michael
Szkandera Joanna
Terbuch Angelika
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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.
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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 -
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Testicular Neoplasms - pathology
Testicular Neoplasms - therapy

Find related publications in this database (Keywords)
Testicular cancer
Seminoma
Cardiovascular risk
Radiotherapy
Carboplatin
Active surveillance
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