title: Chronic physical effects and health care utilization in long-term ovarian germ cell tumor survivors: a Gynecologic Oncology Group study.
abstract: OBJECTIVE
  This study compares late effects of treatment on physical well-being and utilization of health care resources between ovarian germ cell tumor (OGCT) survivors and age/race/education-matched controls.
  
  
  METHODS
  Eligible patients had OGCT treated with surgery and chemotherapy and were disease-free for at least 2 years at time of enrollment. The matched control group was selected from acquaintances recommended by survivors. Symptoms and function were measured using previously validated scales. Health care utilization was assessed by questions regarding health insurance coverage and health services utilization.
  
  
  RESULTS
  One hundred thirty-two survivors and 137 controls completed the study. Survivors were significantly more likely to report a diagnosis of hypertension (17% v 8%, P = .02), and marginally hypercholesterolemia (9.8% v 4.4%, P = .09), and hearing loss (5.3% v 1.5%, P = .09) compared with controls. There were no significant differences in the rates of self-reported arthritis, heart, pulmonary or kidney disease, diabetes, non-OGCT malignancies, anxiety, hearing loss, or eating disorders between groups. Among chronic functional problems, numbness, tinnitus, nausea elicited by reminders of chemotherapy (v general nausea triggers for controls), and Raynaud's symptoms were reported more frequently by survivors. Patients who received vincristine, dactinomycin, and cyclophosphamide in addition to cisplatin therapy had increased functional complaints, particularly numbness and nausea. Health care utilization was similar, but 15.9% of survivors reported being denied health insurance versus 4.4% of controls (P < .001).
  
  
  CONCLUSIONS
  Although a few sequelae of treatment persist, in general, OGCT survivors enjoy a healthy life comparable to that of controls.
authors.affiliation: Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive RT-473, Indianapolis, IN 46202, USA. dmatei@iupui.edu
authors.forename: Daniela
authors.initials: D
authors.lastname: Matei
authors.forename: Anna M
authors.initials: AM
authors.lastname: Miller
authors.forename: Patrick
authors.initials: P
authors.lastname: Monahan
authors.forename: David
authors.initials: D
authors.lastname: Gershenson
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Zhao
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Williams
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D002908:Chronic Disease; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005260:Female; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010052:Ovariectomy / Q000009:adverse effects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult