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.
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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.
