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Vascular aging in long-term survivors of testicular cancer more than 20 years after treatment with cisplatin-based chemotherapy.

Abstract：

BACKGROUND:Late effects of cisplatin-based chemotherapy in testicular cancer survivors (TCS) include cardiovascular morbidity, but little data is available beyond 20 years. The objective was to assess vascular damage in very long-term TCS. METHODS:TCS (treated with chemotherapy or orchiectomy only) and age-matched healthy controls were invited. Study assessment included vascular stiffness with ultrasound measurement of carotid-femoral pulse wave velocity (cf-PWV). RESULTS:We included 127 TCS consisting of a chemotherapy group (70 patients) and an orchiectomy group (57 patients) along with 70 controls. Median follow-up was 28 years (range: 20-42). The cf-PWV (m/s) was higher in TCS than in controls (geometrical mean 8.05 (SD 1.23) vs. 7.60 (SD 1.21), p = 0.04). The cf-PWV was higher in the chemotherapy group than in the orchiectomy group (geometrical mean 8.39 (SD 1.22) vs. 7.61 (SD 1.21), p < 0.01). In the chemotherapy group cf-PWV increased more rapidly as a function of age compared to controls (regression coefficient b 7.59 × 10-3 vs. 4.04 × 10-3; p = 0.03). CONCLUSION:Very long-term TCS treated with cisplatin-based chemotherapy show increased vascular damage compatible with "accelerated vascular aging" and continue to be at risk for cardiovascular morbidity, thus supporting the need for intensive cardiovascular risk management. CLINICAL TRIAL REGISTRATION:The clinical trial registration number is NCT02572934.

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Stelwagen J,Lubberts S,Steggink LC,Steursma G,Kruyt LM,Donkerbroek JW,van Roon AM,van Gessel AI,van de Zande SC,Meijer C,Gräfin Zu Eulenburg CH,Oosting SF,Nuver J,Walenkamp AME,Jan de Jong I,Lefrandt JD,Gietema JA

doi

10.1038/s41416-020-01049-3

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

1599-1607

issue

11

eissn

0007-0920

issn

1532-1827

pii

10.1038/s41416-020-01049-3

journal_volume

123

pub_type

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