Multi-institutional assessment of adverse health outcomes among north American testicular cancer survivors after modern cisplatin-based chemotherapy

Platinum Study Group

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased (P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

Original languageEnglish (US)
Pages (from-to)1211-1222
Number of pages12
JournalJournal of Clinical Oncology
Volume35
Issue number11
DOIs
StatePublished - Apr 10 2017

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Testicular Neoplasms
Cisplatin
Drug Therapy
Health
Odds Ratio
Bleomycin
Etoposide
Raynaud Disease
Health Behavior
Peripheral Nervous System Diseases
Physical Examination
Obesity
Logistic Models
Smoking

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Multi-institutional assessment of adverse health outcomes among north American testicular cancer survivors after modern cisplatin-based chemotherapy. / Platinum Study Group.

In: Journal of Clinical Oncology, Vol. 35, No. 11, 10.04.2017, p. 1211-1222.

Research output: Contribution to journalArticle

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title = "Multi-institutional assessment of adverse health outcomes among north American testicular cancer survivors after modern cisplatin-based chemotherapy",
abstract = "Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2{\%}), EPX4 (30.9{\%}), and BEPX4 (17.9{\%}). None, one to two, three to four, or five or more AHOs were reported by 20.4{\%}, 42.0{\%}, 25.1{\%}, and 12.5{\%} of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6{\%} v 21.4{\%}; P < .01), peripheral neuropathy (29.2{\%} v 21.4{\%}; P = .02), and obesity (25.5{\%} v 33.0{\%}; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P < .05). Self-reported health was excellent/very good in 59.9{\%} of TCSs but decreased as AHOs increased (P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.",
author = "{Platinum Study Group} and Chunkit Fung and Sesso, {Howard D.} and Williams, {Annalynn M.} and Kerns, {Sarah L.} and Patrick Monahan and Zaid, {Mohammad Abu} and Feldman, {Darren R.} and Hamilton, {Robert J.} and Vaughn, {David J.} and Beard, {Clair J.} and Kollmannsberger, {Christian K.} and Ryan Cook and Sandra Althouse and Shirin Ardeshir-Rouhani-Fard and Lipshultz, {Steve E.} and Lawrence Einhorn and Fossa, {Sophie D.} and Travis, {Lois B.} and Stephanie Curreri and Brames, {Mary Jacqueline} and Kelli Norton and Erin Jacobsen and Deborah Silber and Lynn Anson-Cartwright and Cox, {Nancy J.} and Dolan, {M. Eileen} and Linda Jacobs and Panzer, {Sarah Lena} and Donna Pucci and Debbie Baker and Cindy Casaceli and Eileen Johnson and Deepak Sahasrabudhe and Frisina, {Robert D.} and George Bosl and Mary Gospodarowicz and Robison, {Leslie L.}",
year = "2017",
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language = "English (US)",
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pages = "1211--1222",
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TY - JOUR

T1 - Multi-institutional assessment of adverse health outcomes among north American testicular cancer survivors after modern cisplatin-based chemotherapy

AU - Platinum Study Group

AU - Fung, Chunkit

AU - Sesso, Howard D.

AU - Williams, Annalynn M.

AU - Kerns, Sarah L.

AU - Monahan, Patrick

AU - Zaid, Mohammad Abu

AU - Feldman, Darren R.

AU - Hamilton, Robert J.

AU - Vaughn, David J.

AU - Beard, Clair J.

AU - Kollmannsberger, Christian K.

AU - Cook, Ryan

AU - Althouse, Sandra

AU - Ardeshir-Rouhani-Fard, Shirin

AU - Lipshultz, Steve E.

AU - Einhorn, Lawrence

AU - Fossa, Sophie D.

AU - Travis, Lois B.

AU - Curreri, Stephanie

AU - Brames, Mary Jacqueline

AU - Norton, Kelli

AU - Jacobsen, Erin

AU - Silber, Deborah

AU - Anson-Cartwright, Lynn

AU - Cox, Nancy J.

AU - Dolan, M. Eileen

AU - Jacobs, Linda

AU - Panzer, Sarah Lena

AU - Pucci, Donna

AU - Baker, Debbie

AU - Casaceli, Cindy

AU - Johnson, Eileen

AU - Sahasrabudhe, Deepak

AU - Frisina, Robert D.

AU - Bosl, George

AU - Gospodarowicz, Mary

AU - Robison, Leslie L.

PY - 2017/4/10

Y1 - 2017/4/10

N2 - Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased (P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

AB - Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking (P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased (P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.

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U2 - 10.1200/JCO.2016.70.3108

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