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Cardiovascular risk in long-term survivors of testicular cancer

  1. David J. Vaughn MD1,†,*,
  2. Steven C. Palmer PhD2,
  3. Joseph R. Carver MD3,
  4. Linda A. Jacobs PhD, CRNP1,
  5. Emile R. Mohler MD3

Article first published online: 13 MAR 2008

DOI: 10.1002/cncr.23389

Issue

Cancer

Cancer

Volume 112, Issue 9, pages 1949–1953, 1 May 2008

Additional Information

How to Cite

Vaughn, D. J., Palmer, S. C., Carver, J. R., Jacobs, L. A. and Mohler, E. R. (2008), Cardiovascular risk in long-term survivors of testicular cancer. Cancer, 112: 1949–1953. doi: 10.1002/cncr.23389

Author Information

  1. 1

    Department of Medicine, Hematology/Oncology Division, University of Pennsylvania, Philadelphia, Pennsylvania

  2. 2

    Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania

  3. 3

    Department of Medicine, Cardiovascular Division, University of Pennsylvania, Philadelphia, Pennsylvania

  1. †

    Fax: (215) 662-7804

*Abramson Cancer Center of the University of Pennsylvania, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104

  1. †

    Fax: (215) 662-7804

Publication History

  1. Issue published online: 21 APR 2008
  2. Article first published online: 13 MAR 2008
  3. Manuscript Accepted: 10 DEC 2007
  4. Manuscript Revised: 29 NOV 2007
  5. Manuscript Received: 20 SEP 2007

Funded by

  • National Cancer Institute Grant. Grant Number: 1R21CA097355-01
  • Pennsylvania Department of Health

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Keywords:

  • testicular cancer;
  • survivorship;
  • cardiotoxicity;
  • endothelial dysfunction

Abstract

BACKGROUND

Long-term survivors of testicular cancer (TC) who received cisplatin-based chemotherapy have an increased risk of cardiovascular disease. A cross-sectional study was performed to objectively assess cardiovascular risk, subclinical atherosclerosis, and endothelial function in long-term survivors of TC.

METHODS

Long-term survivors of TC underwent evaluation including determination of body mass index (BMI), Framingham relative risk (RR), brachial artery flow-mediated dilatation (FMD), carotid artery intima-media thickness (IMT), soluble intercellular adhesion molecule-1 (sICAM-1), high sensitivity C-reactive protein (hs-CRP), and flow cytometric analysis of peripheral blood for levels of endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs). TC survivors who received chemotherapy were compared with a chemotherapy naive cohort.

RESULTS

Twenty-four patients received cisplatin-based chemotherapy (CBCT) and 15 were chemotherapy-naive (CN). The CBCT cohort demonstrated more impairment of brachial artery FMD than the CN group (5.6% vs 8.8%; P = .05). The mean sICAM was also found to be higher in the CBCT cohort compared with the CN group (P = .04). No significant differences between the groups were noted with regard to BMI, Framingham RR, carotid IMT, or hs-CRP. In a subset of patients, TC survivors who received chemotherapy had a significantly increased level of CECs compared with CN patients (P = .04). No significant difference in EPC levels was detected.

CONCLUSIONS

Long-term survivors of TC who received chemotherapy demonstrate objective evidence of endothelial injury and dysfunction, a potential mechanism for increased cardiovascular risk. Cancer 2008. © 2008 American Cancer Society.

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