title: Age-related variation and predictors of long-term quality of life in germ cell tumor survivors.
abstract: OBJECTIVE
  To compare long-term health-related quality of life (QoL) in germ cell tumor survivors (GCTS) and age-adjusted men and to identify predictors of variation in long-term QoL in GCTS.
  
  
  METHODS
  We used the Short-Form Health Survey to measure QoL in a cross-sectional sample of 164 survivors of germ cell tumors from Hamburg, Germany. QoL was compared with age-adjusted German norm data. Sociodemographic and medical data from questionnaires and medical records were used to find predictors of QoL.
  
  
  RESULTS
  On average, patients were 44.4 years old (standard deviation = 9.6 y) and average time since first germ cell tumor diagnosis was 11.6 years (standard deviation = 7.3 y). We found significantly lower mental component scores in GCTS when compared with norm data (Hedges g =-0.44, P<0.001). An exploratory analysis by age group showed the largest difference in mental QoL in survivors aged 31 to 40 years (Hedges g =-0.67). Linear regression analysis revealed age (β =-0.46, P<0.001), marital status (β = 0.20, P = 0.024), advanced secondary qualifications (β =-0.25, P = 0.001), time since diagnosis (β = 0.17, P = 0.031), and tumor stage (β = 0.17, P = 0.024) as statistically significant predictors of the physical component score, accounting for 22% of the variance. Statistically significant predictors of the mental component score were higher secondary qualifications (β = 0.17, P = 0.033) and unemployment (β =-0.21, P = 0.009), accounting for 6% of the variance.
  
  
  CONCLUSIONS
  Survivors of germ cell tumors can expect an overall long-term QoL similar to that of other men of their age.
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany. Electronic address: tim.hartung@medizin.uni-leipzig.de.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Hartung
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany; Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
authors.affiliation: Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedrich
authors.affiliation: Department of Urology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hartmann
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Vehling
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation With Section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Bokemeyer
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation With Section of Pneumology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Oechsle
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality* / Q000473:pathology; D011788:Quality of Life; D017741:Survivors; D013736:Testicular Neoplasms / Q000401:mortality* / Q000473:pathology; D055815:Young Adult
keywords: Germ cell tumor; Long-term quality of life; Mental health; Psycho-oncology; Survivor; Testicular cancer