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Annals of Oncology Advance Access published online on October 23, 2006
Annals of Oncology, doi:10.1093/annonc/mdl372
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© 2006 European Society for Medical Oncology
Received May 16, 2006
Revised August 3, 2006
Accepted August 30, 2006

original article

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

H. S. Haugnes 1 *, N. Aass 2, S. D. Fosså 3, O. Dahl 4, O. Klepp 5, E. A. Wist 6, J. Svartberg 7, T. Wilsgaard 8, and R. M. Bremnes 9

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

* To whom correspondence should be addressed.
H. S. Haugnes, E-mail: hegesa{at}fagmed.uit.no


  Abstract

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.

Keywords: cisplatin; metabolic syndrome; radiotherapy; testicular cancer.
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