Metabolic syndrome in long-term testicular cancer survivors

Abstract

4576 Background: The purpose of this study was to investigate if treatment for testicular cancer (TC) increases the risk of metabolic syndrome (MetS) in long-term survivors of TC. Methods: 1264 patients, treated for unilateral TC during 1980–1994, were included in this study (1998–2002), including measurements of systolic (SBP) and diastolic (DBP) blood pressure, body mass index (BMI), blood tests and a questionnaire providing information about medical history. For the present analyses we excluded patients > 60 years at follow-up, leaving 1135 patients eligible. Patients were categorized in four treatment groups: Surgery (n=225), radiotherapy (RT, n=446), and two chemotherapy groups: Cumulative cisplatin dose ≤850 mg (n=376) and cumulative cisplatin dose >850 mg (cis>850, n=88). A healthy control group consisted of males from the Tromsø Population Study (n=1150). MetS was present if ≥ 2 of the following four components were present: Hypertension (SBP≥140 mmHg and/or DBP≥90 mmHg and/or use of antihypertensive medication); obesity (BMI≥30); hypercholesterolemia (total cholesterol ≥5.2 mmol/l and/or use of statins); diabetes mellitus. Results: Median observation time was 11.1 years (range 4–22). Median age at follow-up was 43 years (range 23–60). Age-adjusted logistic regression analyses were performed to compare the prevalence of MetS between treatment groups, using the surgery group as reference. The RT group did not differ from the surgery group, while both chemotherapy groups had significantly increased odds of MetS, highest for the cis>850 group (OR 2.8, 95% CI 1.6–4.7). When MetS was classified as ≥ 3 components present, only the cis>850 group differed from the surgery group (OR 2.6, 95% CI 1.1–6.0). The prevalence of MetS for the total patient group did not differ from that of healthy controls. Subgroup analysis showed that the cis>850 group had significantly increased odds of having MetS (OR 2.1, 95% CI 1.3–3.4), while the other treatment groups did not differ from healthy controls. Conclusion: Long-term TC survivors treated with cisplatin-based chemotherapy have a significantly increased risk of developing metabolic syndrome, compared to patients treated with other modalities or to healthy controls. No significant financial relationships to disclose.