Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: A multi-institutional study

the Platinum Study Group

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among . 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were # 55 years of age at diagnosis, finished first-line chemotherapy $ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen (P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (x2 P, .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.

Original languageEnglish (US)
Pages (from-to)1505-1512
Number of pages8
JournalJournal of Clinical Oncology
Volume36
Issue number15
DOIs
StatePublished - May 20 2018
Externally publishedYes

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Testicular Neoplasms
Cisplatin
Survivors
Odds Ratio
Morbidity
Drug Therapy
Health
Etoposide
Statistical Factor Analysis
Ifosfamide
Raynaud Disease
Sick Leave
Hypogonadism
Tinnitus
Thyroid Diseases
Bleomycin
Erectile Dysfunction
Hyperlipidemias
Hearing Loss
Multicenter Studies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy : A multi-institutional study. / the Platinum Study Group.

In: Journal of Clinical Oncology, Vol. 36, No. 15, 20.05.2018, p. 1505-1512.

Research output: Contribution to journalArticle

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title = "Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: A multi-institutional study",
abstract = "Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among . 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were # 55 years of age at diagnosis, finished first-line chemotherapy $ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20{\%} had a high (15{\%}) or very high/severe (4.1{\%}) CBM score, whereas approximately 80{\%} scored medium (30{\%}) or low/very low (47{\%}). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95{\%} CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95{\%} CI, 1.04 to 1.98), older attained age (OR, 1.18; 95{\%} CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95{\%} CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95{\%} CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95{\%} CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen (P = .36). Asian race (OR, 0.41; 95{\%} CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95{\%} CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (x2 P, .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.",
author = "{the Platinum Study Group} and Kerns, {Sarah L.} and Chunkit Fung and Patrick Monahan and Shirin Ardeshir-Rouhani-Fard and {Abu Zaid}, {Mohammad I.} and Williams, {Anna Lynn M.} and Stump, {Timothy E.} and Sesso, {Howard D.} and Feldman, {Darren R.} and Hamilton, {Robert J.} and Vaughn, {David J.} and Clair Beard and Huddart, {Robert A.} and Jeri Kim and Christian Kollmannsberger and Sahasrabudhe, {Deepak M.} and Ryan Cook and Fossa, {Sophie D.} and Lawrence Einhorn and Travis, {Lois B.}",
year = "2018",
month = "5",
day = "20",
doi = "10.1200/JCO.2017.77.0735",
language = "English (US)",
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pages = "1505--1512",
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TY - JOUR

T1 - Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy

T2 - A multi-institutional study

AU - the Platinum Study Group

AU - Kerns, Sarah L.

AU - Fung, Chunkit

AU - Monahan, Patrick

AU - Ardeshir-Rouhani-Fard, Shirin

AU - Abu Zaid, Mohammad I.

AU - Williams, Anna Lynn M.

AU - Stump, Timothy E.

AU - Sesso, Howard D.

AU - Feldman, Darren R.

AU - Hamilton, Robert J.

AU - Vaughn, David J.

AU - Beard, Clair

AU - Huddart, Robert A.

AU - Kim, Jeri

AU - Kollmannsberger, Christian

AU - Sahasrabudhe, Deepak M.

AU - Cook, Ryan

AU - Fossa, Sophie D.

AU - Einhorn, Lawrence

AU - Travis, Lois B.

PY - 2018/5/20

Y1 - 2018/5/20

N2 - Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among . 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were # 55 years of age at diagnosis, finished first-line chemotherapy $ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen (P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (x2 P, .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.

AB - Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among . 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were # 55 years of age at diagnosis, finished first-line chemotherapy $ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen (P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (x2 P, .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.

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