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


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) <or=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.


CONCLUSIONS
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.
Haugnes
H S
HS
Department of Oncology, Institute of Clinical Medicine, University of Tromsø, Norway. hegesa@fagmed.uit.no
Aass
N
N
Fosså
S D
SD
Dahl
O
O
Klepp
O
O
Wist
E A
EA
Svartberg
J
J
Wilsgaard
T
T
Bremnes
R M
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D012307:Risk Factors; D017741:Survivors; D013736:Testicular Neoplasms / Q000150:complications / Q000401:mortality* / Q000628:therapy; D013997:Time Factors