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

Johannes Stelwagen, Sjoukje Lubberts, Lars C. Steggink, Gerrie Steursma, Lara M. Kruyt, Jan Willem Donkerbroek, Arie M. van Roon, Anne I. van Gessel, Saskia C. van de Zande, Coby Meijer, Christine H. Grafin zu Eulenburg, Sjoukje F. Oosting, Janine Nuver, Annemiek M. E. Walenkamp, Igle Jan de Jong, Joop D. Lefrandt, Jourik A. Gietema*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

Samenvatting

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.

Originele taal-2English
Pagina's (van-tot)1599-1607
Aantal pagina's9
TijdschriftBritish Journal of Cancer
Nummer van het tijdschrift11
Vroegere onlinedatum14-sep-2020
DOI's
StatusPublished - 14-sep-2020

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