Metabolic Syndrome More Likely After Platinum-Based Chemotherapy for Testicular Cancer

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Metabolic is a possible side effect following platinum-based chemotherapy for  testicular cancer.
Metabolic is a possible side effect following platinum-based chemotherapy for testicular cancer.

One in 5 men with testicular cancer treated with platinum-based chemotherapy developed metabolic syndrome (MetS). These results were presented at 2017 Cancer Survivorship Symposium.1

The introduction of platinum-based chemotherapy has led to excellent prognosis for patients with testicular cancer. Several European studies, however, show a prevalence of MetS ranging from 13% to 39% in patients who were treated for testicular cancer. MetS is a constellation of cardiovascular risk factors that double the risk of cardiovascular disease.

In this North American study, researchers assessed the prevalence of MetS and its potential risk factors following platinum-based chemotherapy for testicular cancer.

Eligible patients were younger than 50 years at diagnosis and were treated only with first line chemotherapy after 1990. These patients underwent physical examinations, responded to questionnaires about co-morbidities and health behaviors, and had lipid panels, testosterone, and serum soluble cell adhesion molecule-1 (sICAM-1) measured.

Researchers genotyped a single nucleotide polymorphism, rs523349 (V89L), in 5-alpha-reductase gene (SRD5A2) previously correlated with the development of MetS in patients with testicular cancer.

This study defined MetS as exhibition of at least 3 of the following traits: hypertension, waist circumference 102 cm or greater, triglycerides 150 mg/dL or higher, HDL 40 mg/dL or less, and diabetes. A ratio of 1:1 controls derived from the National Health and Nutrition Examination Survey were matched for age, race, and education.

The researchers assessed 486 patients with testicular cancer who received platinum-based chemotherapy. Median age at evaluation was 38 years. Patients with testicular cancer experienced a higher prevalence of hypertension compared with controls (43% vs 31%, P <.01). These patients also experienced a lower prevalence of low HDL (24% vs 35%, P <.01) and abdominal obesity (28% vs 40%, P <.01) than controls.

Prevalence of MetS was similar in both groups (21% patients; 22% controls, P =.59).

Age at evaluation, serum testosterone less than 3.0 ng/mL, and elevated sICAM-1 significantly associated with the development of MetS. The variant rs523349 (VL/LL) did not correlate with MetS.

These results suggest screening patients for MetS; appropriately treat hypertension, hypogonadism, and hyperlipidemia; and encourage patients to develop and maintain a healthy lifestyle. The significant elevations in sICAM-1 highlight the role of inflammation in the development of MetS.

Reference

1. Zaid MI, Gathirua-Mwangi WG, Williams A, et al. Metabolic syndrome (MetS) after platinum-based chemotherapy (CHEM): a multicenter study of North American testicular cancer survivors (TCS). Research presented at: 2017 Cancer Survivorship Symposium; January 27-28, 2017; San Diego, California. Abstract 102.

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