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Long-term cardiovascular complications in stage I seminoma patients.
Terbuch, A; Posch, F; Annerer, L M; Bauernhofer, T; Pichler, M; Szkandera, J; Hutterer, G C; Pummer, K; Partl, R; Kapp, K S; Stöger, H; Gerger, A; Stotz, M.
Afiliação
  • Terbuch A; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Posch F; Research Unit Genetic Epidemiology and Pharmacogenetics, Medical University of Graz, Graz, Austria.
  • Annerer LM; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Bauernhofer T; Research Unit Genetic Epidemiology and Pharmacogenetics, Medical University of Graz, Graz, Austria.
  • Pichler M; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Szkandera J; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Hutterer GC; Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
  • Pummer K; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Partl R; Department of Experimental Therapeutics, The University of Texas, MD Anderson Cancer Center, Houston, USA.
  • Kapp KS; Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
  • Stöger H; Department of Urology, Medical University of Graz, Graz, Austria.
  • Gerger A; Department of Urology, Medical University of Graz, Graz, Austria.
  • Stotz M; Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria.
Clin Transl Oncol ; 19(11): 1400-1408, 2017 Nov.
Article em En | MEDLINE | ID: mdl-28852960
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Doenças Cardiovasculares / Carboplatina / Seminoma / Terapia Combinada / Radioterapia Adjuvante Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans / Male / Middle aged Idioma: En Revista: Clin Transl Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Áustria País de publicação: Itália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Doenças Cardiovasculares / Carboplatina / Seminoma / Terapia Combinada / Radioterapia Adjuvante Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans / Male / Middle aged Idioma: En Revista: Clin Transl Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Áustria País de publicação: Itália