Mortality and Second Cancer Incidence After Treatment for Testicular Cancer – ASCO Journals

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Abstract

To consider whether or not chosen modifiable patient-reported adversarial well being outcomes (AHOs) in testicular most cancers survivors (TCSs) characterize prognostic components of total mortality, most cancers mortality, and first-time non–germ cell second most cancers (SecCa) incidence.

In 775 long-term TCSs (prognosis: 1980-1994) who beforehand participated in a quality-of-life survey, 20-year mortality and SecCa incidence have been in contrast between the surgical procedure group (n = 272) and TCSs after platinum-based chemotherapy (PBCT; n = 503). A PBCT commonplace group (complete cisplatin: ≤ 630 mg: n = 124) was separated from a PBCT excessive subgroup (complete cisplatin: > 630 mg; n = 379). Univariate and multivariate analyses (Kaplan-Meier; Cox proportional hazard analyses) included age, therapy, and prior main bodily comorbidity as nonmodifiable components, whereas low socioeconomic standing, unhealthy way of life, possible despair dysfunction, and neurotoxicity have been modifiable AHOs.

For all TCSs, the cumulative total 20-year mortality was 14% (95% CI, 11.8 to 16.8). Rising age, PBCT excessive, and comorbidity considerably elevated the chance of total mortality price. Compared with a low-risk group (no AHO; n = 446) and with exception of neurotoxicity, this danger was additional considerably enhanced by 80% in TCSs of a medium-risk group (one or two AHOs; n = 278). In males of a high-risk group (three AHOs; n = 47), the likelihood of total mortality and of most cancers mortality was eight-fold and five-fold elevated, respectively. Risk grouping didn’t affect on SecCa incidence.

Self-reported unfavorable modifiable AHO regarding way of life and psychosocial well being are in TCSs independently and considerably related to elevated total mortality and most cancers mortality. Health professionals and the TCSs themselves, significantly these after PBCT excessive, ought to constantly concentrate on these danger components making an attempt maximal discount of those AHOs and thereby supporting long-term survival.

© 2022 by American Society of Clinical Oncology

CONTEXT

  • Key Objective

  • We evaluated whether or not modifiable adversarial well being outcomes (AHOs) reminiscent of low socioeconomics, an unhealthy way of life, or possible depressive dysfunction improve long-term testicular most cancers survivors’ (TCSs) danger of second most cancers and total and most cancers mortality.

  • Knowledge Generated

  • Compared with TCSs not reporting any of the above three AHOs, the chance of 20-year total mortality was virtually doubled in TCSs with one or two AHOs, and was eight-fold elevated in these reporting all three AHOs. In Cox analyses of extra components, depressive dysfunction, age, and ≥ 4 cycles of platinum-based chemotherapy have been considerably related to worse total and most cancers mortality.

  • Relevance

  • In long-term TCSs, the above modifiable AHOs characterize unbiased danger components of untimely loss of life. Health professionals and the TCSs themselves ought to goal efforts at bettering socioeconomics and supporting a wholesome way of life. Evaluating and treating despair might also enhance outcomes.

SUPPORT

Supported by the Radium Hospital Foundation Grant no. 335007.

Conception and design: Sophie D. Fosså, Lene Thorsen, Cecilie E. Kiserud, Hege S. Haugnes, Tor Å. Myklebust

Financial help: Sophie D. Fosså

Administrative help: Sophie D. Fosså, Cecilie E. Kiserud

Provision of research supplies or sufferers: Sophie D. Fosså, Torgrim Tandstad, Marianne Brydøy, Hege S. Haugnes

Collection and meeting of information: Sophie D. Fosså, Torgrim Tandstad, Marianne Brydøy, Hege S. Haugnes, Tor Å. Myklebust

Data evaluation and interpretation: Sophie D. Fosså, Alv A. Dahl, Lene Thorsen, Ragnhild Hellesnes, Cecilie E. Kiserud, Hege S. Haugnes, Tor Å. Myklebust

Manuscript writing: All authors

Final approval of manuscript: All authors

Accountable for all facets of the work: All authors

Mortality and Second Cancer Incidence After Treatment for Testicular Cancer: Psychosocial Health and Lifestyle Are Modifiable Prognostic Factors

The following represents disclosure info supplied by authors of this manuscript. All relationships are thought-about compensated except in any other case famous. Relationships are self-held except famous. I = Immediate Family Member, Inst = My Institution. Relationships might not relate to the subject material of this manuscript. For extra details about ASCO’s battle of curiosity coverage, please consult with www.asco.org/rwc or ascopubs.org/jco/authors/author-center.

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No potential conflicts of curiosity have been reported.


This web page was created programmatically, to learn the article in its authentic location you may go to the hyperlink bellow:
https://ascopubs.org/doi/abs/10.1200/JCO.21.02105
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