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Abu Zaid MI, Fung C, Williams A, Sesso HD, Kerns SL, Ardeshir-Rouhani-Fard S, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Monahan P, Fossa SD, Einhorn LH, Travis LB. Cardiovascular disease (CVD) risk factors and health behaviors after cisplatin-based chemotherapy (CHEM): A multi-institutional study of testicular cancer survivors (TCS) in the Platinum study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.10087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - AnnaLynn Williams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | | | | | | | | | - David J. Vaughn
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | - Clair Beard
- Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | | | | | | | - Lois B. Travis
- Department of Medical Oncology, Indiana University, Indianapolis, IN
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Fung C, Feldman DR, Hamilton RJ, Case-Eads S, Vaughn DJ, Beard C, Moore MJ, Sahasrabudhe DM, Brames MJ, Fossa SD, Sesso HD, Einhorn LH, Travis LB. Cardiovascular disease (CVD) risk factors among cisplatin-treated testicular cancer survivors (TCS): A multicenter clinical study of U.S. and Canadian patients. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.7_suppl.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
391 Background: The remarkable success of cisplatin-based chemotherapy in curing metastatic TC has been accompanied by potential life-threatening sequelae, including CVD. Most prior studies, however, have been conducted in Europe and included older chemotherapy regimens. We examined CVD risk factors in an ongoing multi-center clinical study of TCS given modern cisplatin-based chemotherapy (CHEM) at centers in North America (NCI 1R01 CA157823-02). Methods: TCS aged ≤49 years at time of first-line CHEM were eligible to undergo clinical examination and complete a questionnaire regarding co-morbidities, lifestyle behaviors, and prescription drug use. Results: We evaluated the first 443 consecutively enrolled TCS (23% seminoma; 77% nonseminoma) with most having stage II (52%) or III (28%) disease. The median age at time of TC diagnosis was 32 years (range 15-49 years) and median time since completion of chemotherapy was 59 months (range 1-24 years). Patients were largely white (90%), married (62%), and had full-time employment (82%) and health insurance (88%). 8% of TCS were current smokers. 48% of TCS had gained >10 lbs after CHEM with 29% having a ≥102 cm (40 inch) waist circumference, and 43% and 31% having a body mass index of 25 to <30 kg/m2 (overweight) and ≥ 30 kg/m2 (obese), respectively. A sizable proportion of men had abnormal systolic (21% with 130-139 mm Hg and 17% with ≥140 mm Hg) and diastolic (35% with 80-89 mm Hg and 13% with ≥90 mm Hg) blood pressure. 14%, 11%, and 5% TCS indicated that they currently used medications for hypertension, cholesterol and diabetes, respectively. Cardiac conditions were reported by 32 TCS (7%), including angina (N=2), angioplasty/stent placement (N=1), myocardial infarction (N=1), transient ischemic attack (N=1), stroke (N=2), peripheral vascular disease (N=12), deep vein thrombosis (N=23), and pulmonary embolism (N=15). Conclusions: A number ofCVD risk factors are present in a contemporary North American cohort of TCS after CHEM. Future analytic studies should focus on mechanistic investigations to facilitate the development of screening and preventive efforts for CVD in high-risk patients.
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Affiliation(s)
- Chunkit Fung
- Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY
| | | | - Robert James Hamilton
- Division of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada
| | | | - David J. Vaughn
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | - Clair Beard
- Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | | | | | - Mary J. Brames
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | - Sophie D. Fossa
- Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | | | | | - Lois B. Travis
- University of Rochester School of Medicine and Dentistry, Rochester, NY
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