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Annals of Oncology Advance Access originally published online on October 23, 2006
Annals of Oncology 2007 18(2):241-248; doi:10.1093/annonc/mdl372
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© 2006 European Society for Medical Oncology

urogenital tumors

Components of the metabolic syndrome in long-term survivors of testicular cancer

HS Haugnes1,*, N Aass2, SD Fosså2,3, O Dahl4,5, O Klepp6, EA Wist7, J Svartberg8, T Wilsgaard9 and RM Bremnes1,10

1 Department of Oncology, Institute of Clinical Medicine, University of Tromsø, Tromsø
2 Department of Clinical Cancer Research, Rikshospitalet-Radiumhospitalet Medical Center, Oslo
3 Medical Faculty, University of Oslo, Oslo
4 Section of Oncology, Institute of Medicine, University of Bergen, Bergen
5 Department of Oncology, Haukeland University Hospital, Bergen
6 Department of Oncology, St Olav University Hospital, Trondheim
7 Department of Oncology, Ullevål University Hospital, Oslo
8 Department of Endocrinology, University Hospital of North Norway, Tromsø
9 Institute of Community Medicine, University of Tromsø, Tromsø
10 Department of Oncology, University Hospital of North Norway, Tromsø, Norway

* Correspondence to: Dr H. S. Haugnes, Department of Oncology, Institute of Clinical Medicine, University of Tromsø, N-9037 Tromsø, Norway. Tel: +47-77-64-54-27; Fax: +47-77-64-53-00; E-mail: hegesa{at}fagmed.uit.no

Background: A possible explanation of the excess cardiovascular risk in testicular cancer (TC) survivors is development of metabolic syndrome. The association between metabolic syndrome and TC treatment is examined in long-term survivors.

Patients and methods: In a national follow-up study (1998–2002), 1463 TC survivors (diagnosed 1980–1994) participated. Patients >60 years were excluded in the present study, leaving 1135 patients eligible. The patients were divided in four treatment groups: surgery (n = 225); radiotherapy (n = 446) and two chemotherapy groups: cumulative cisplatin dose (Cis) ≤850 mg (n = 376) and Cis >850 mg (n = 88). A control group consisted of 1150 men from the Tromsø Population Study. Metabolic syndrome was defined according to a modified National Cholesterol Education Program definition.

Results: Both chemotherapy groups had increased odds for metabolic syndrome compared with the surgery group, highest for the Cis >850 group [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.6–4.7]. Also, the Cis >850 group had increased odds (OR 2.1, 95% CI 1.3–3.4) for metabolic syndrome compared with the control group. The association between metabolic syndrome and the Cis >850 group was strengthened after adjusting for testosterone, smoking, physical activity, education and family status.

Conclusion: TC survivors treated with cisplatin-based chemotherapy have an increased risk of developing metabolic syndrome compared with patients treated with other modalities or with controls.

Key words: cisplatin, metabolic syndrome, radiotherapy, testicular cancer

Received for publication May 16, 2006. Revision received August 3, 2006. Accepted for publication August 30, 2006.


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