Published in:
Open Access
01-11-2017 | Research Article
Long-term cardiovascular complications in stage I seminoma patients
Authors:
A. Terbuch, F. Posch, L. M. Annerer, T. Bauernhofer, M. Pichler, J. Szkandera, G. C. Hutterer, K. Pummer, R. Partl, K. S. Kapp, H. Stöger, A. Gerger, M. Stotz
Published in:
Clinical and Translational Oncology
|
Issue 11/2017
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Abstract
Purpose
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.
Methods
This retrospective cohort study included 406 consecutive stage I seminoma patients. Primary endpoint was CVE rate.
Results
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).
Conclusion
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.