No evidence of acute cardiovascular complications of chemotherapy for testicular cancer: an analysis of the Testicular Cancer Intergroup Study.
OBJECTIVE
The purpose of this study is to evaluate the risk of acute vascular events in patients receiving cisplatin-based chemotherapy for testicular cancer.


METHODS
A questionnaire assessing cardiovascular toxicity was distributed to all participants in the Testicular Cancer Intergroup study and details of toxicity from the chemotherapy flow sheets were reviewed. Patients with pathologic stage I testicular cancer were registered on to the study and observed after retroperitoneal lymphadenectomy. Patients with pathologic stage II disease were randomized to receive two postoperative courses of adjuvant cisplatin-based chemotherapy or observation. Any patient who had disease recurrence after observation or adjuvant therapy was given four cycles of cisplatin-based chemotherapy.


RESULTS
Review treatment-related toxicity for those patients receiving adjuvant chemotherapy (n = 97) or chemotherapy for recurrent disease (n = 83) showed no cases of acute cardiovascular toxicity. The median follow-up period after study enrollment was 5.1 years; 459 questionnaires were mailed and 270 were returned. The percent return was equal among the observed adjuvant and recurrent groups (59%, 54%, and 64%). There was a significant increase in the incidence of extremity paresthesias in the two groups receiving chemotherapy. Fatal myocardial infarction was reported in two patients in the observation group and one nonfatal infarction was reported in the adjuvant treatment group. No patient in any group reported an incidence of stroke. Three patients in the observation group and one patient in the recurrent group experienced a thromboembolic event.


CONCLUSIONS
Despite sporadic case reports suggesting a causal association between chemotherapy for testicular cancer and acute vascular events, this retrospective analysis provides no evidence of an increased risk for subsequent cardiovascular disease in this patient population.
Nichols
C R
CR
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Roth
B J
BJ
Williams
S D
SD
Gill
I
I
Muggia
F M
FM
Stablein
D M
DM
Weiss
R B
RB
Einhorn
L H
LH
D000208:Acute Disease; D000328:Adult; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000601:surgery
D002945:Cisplatin