Cardiovascular Morbidity in Long-Term Survivors of Metastatic Testicular Cancer

Meinardi, MT; Gietema, Jourik A.; Graaf, Wta van der; Veldhuisen, DJ van; Runne, MA; Sluiter, Wj; Vries, Elisabeth G.E. de; Willemse, P.H.B.; Mulder, Nh; Berg, Michel van den; Sleijfer, Dt; Koops, H. Schraffordt

doi:10.1200/jco.2000.18.8.1725

Cited by 436 publications

(240 citation statements)

References 51 publications

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“…The literature reports emphasise the increased cardiovascular risk in these patients. [35][36][37][38][39] In agreement with the literature, we found a high prevalence of hypertension among the survivors of prostate cancer. It has not been finally determined whether androgen deprivation in prostate cancer patients could lead to hypertension 40 or whether hypertension might be related to the aetiology of prostate cancer.…”

Section: Discussionsupporting

confidence: 92%

Self‐reported health and use of health care services in long‐term cancer survivors

Nord

Mykletun

Thorsen

et al. 2004

Intl Journal of Cancer

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Owing to an increasing number of long-term cancer survivors, the use of health care services and somatic health problems were compared between cancer survivors and a noncancer population. Data from the Nord-Trøndelag Health Survey 2 (HUNT 2, 1995-1997) was merged with the Cancer Registry of Norway. Six cancer subgroups were constructed with diagnosis 5 years prior HUNT 2: testicular cancer (n‫؍‬ 59), colorectal cancer (n‫؍‬ 175), prostate cancer (n‫؍‬ 87), breast cancer (n‫؍‬ 258), gynaecological cancer (n‫؍‬ 153) and lymphoma/leukaemia (n‫؍‬ 83). For each cancer survivor 3 matched noncancer controls were selected from the HUNT 2 survey. The prevalence of common health problems, use of health care services and unfavourably life style parameters were compared between the 2 groups. Cancer survivors used health care services and received social welfare benefits more often than the controls. There was an increased risk of perceiving poor health after a history of cancer. In the recent decade, the incidence of most malignancies has increased, as well as 5-year survival rates in both men and women. 1 During 1992-1996, the relative overall 5-year survival rate for all cancer patients in Norway was, respectively, 50% in males and 58%; in females compared to 25% in males and 38%; in females for the period 1957-1961. In 1999, a total of 83,636 cancer survivors with an at-least 5-year survival were alive in Norway. 1 These figures have in the last few years led to a paradigm shift: cancer should not only be considered an acute or terminal event but should likewise be viewed as a chronic condition. Quality of life and long-term effects after cancer therapy have therefore become important outcome parameters to be considered by oncologists, cancer surgeons and primary health care officers.Cancer represents a heterogeneous group of diagnoses where treatment and aetiology are far from uniform. The cancer itself and its treatment may affect the long-term health of cancer survivors at various degrees, causing adverse health conditions, which differ from those observed in the age-matched noncancer population. The recognition of common health problems reducing the overall well being among cancer survivors is of importance in order to identify these individuals' specific needs when presented to the health care service. Furthermore the recognition of long-term effects of treatment may lead to reconsideration and eventual modification of current treatment strategies.Several reports have focused on long-term medical effects after treatment for childhood cancer as well as adulthood cancer and have described specific health problems related to different treatment modalities. 2,3,4 -9 Beside causing chronic health conditions, cancer and its treatment increase the risk of secondary malignancies. 10 -13 Owing to the increased risk of developing secondary tumours and chronic diseases after treatment for malignancies, cancer survivors represent an important target population for health promotion interventions. Few studies regarding long-te...

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Section: Discussionsupporting

confidence: 92%

Self‐reported health and use of health care services in long‐term cancer survivors

Nord

Mykletun

Thorsen

et al. 2004

Intl Journal of Cancer

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“…An increased incidence of cardiovascular events has emerged as one of the most important long-term untoward sequelae. For example, patients treated with chemotherapy for advanced germ-cell cancer have a 2 -7-fold increased risk for cardiovascular events when compared to the general population (Meinardi et al, 2000). Although the exact mechanism of this increased risk is unknown, in vitro data suggest that cytotoxic agents directly cause endothelial damage.…”

Section: Cec: Marker For Vascular Toxicity?mentioning

confidence: 99%

Circulating endothelial cells in oncology: pitfalls and promises

et al. 2008

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Adequate blood supply is a prerequisite in the pathogenesis of solid malignancies. As a result, depriving a tumour from its oxygen and nutrients, either by preventing the formation of new vessels, or by disrupting vessels already present in the tumour, appears to be an effective treatment modality in oncology. Given the mechanism by which these agents exert their anti-tumour activity together with the crucial role of tumour vasculature in the pathogenesis of tumours, there is a great need for markers properly reflecting its impact. Circulating endothelial cells (CEC), which are thought to derive from damaged vasculature, may be such a marker. Appropriate enumeration of these cells appears to be a technical challenge. Nevertheless, first studies using validated CEC assays have shown that CEC numbers in patients with advanced malignancies are elevated compared to healthy controls making CEC a potential tool for among other establishing prognosis and therapy-induced effects. In this review, we will address the possible clinical applications of CEC detection in oncology, as well as the pitfalls encountered in this process.

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“…In the growing population of TC survivors, the occurrence of long-term treatment-induced organ damage is increasingly recognised as an important cause of morbidity (Feldman et al, 2008). Compared with the general population, long-term TC survivors have a higher incidence of second malignant neoplasms and cardiovascular disease (Meinardi et al, 2000;Strumberg et al, 2002;Huddart et al, 2003;van den Belt-Dusebout et al, 2007).…”

mentioning

confidence: 99%

Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

et al. 2009

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Long-term cardiovascular morbidity is increasingly observed in chemotherapy-treated testicular cancer survivors, but little is known of early sub-clinical changes in cardiac function. We prospectively evaluated cardiac function in testicular cancer patients by echocardiography. Systolic (Wall Motion Score Index) and diastolic (E/A-ratio and Tissue Velocity Imaging (TVI)) parameters, and serum levels of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) were assessed before the start of chemotherapy and 1 year later. Echocardiography data were compared with an age-matched group of healthy controls. Forty-two patients treated with bleomycin, etoposide and cisplatin were evaluated (median age 27 years, range 18 -50). Systolic function and E/A-ratio did not change, whereas the median TVI decreased (12.0 vs 10.0 cm s À1 ; P ¼ 0.002). Median levels of NT-proBNP increased (5 vs 18 pmol l À1 , P ¼ 0.034). Compared with controls, TVI before the start of chemotherapy was not significantly different. In conclusion, we found that at a median of 10 months after cisplatin-based treatment for testicular cancer, TVI decreased significantly, indicating a deterioration of diastolic cardiac function. Serum levels of NT-proBNP increased. The prognostic significance of these changes for future cardiovascular morbidity is not clear.

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Cardiovascular Morbidity in Long-Term Survivors of Metastatic Testicular Cancer

Cited by 436 publications

References 51 publications

Self‐reported health and use of health care services in long‐term cancer survivors

Self‐reported health and use of health care services in long‐term cancer survivors

Circulating endothelial cells in oncology: pitfalls and promises

Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

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