NEW YORK (Reuters Health) - Evidence continues to mount that long-term survivors of testicular cancer who are treated with chemotherapy or radiotherapy are at significantly increased risk of cardiovascular disease.

Findings reported by UK-based investigators in the April 15th issue of the Journal of Clinical Oncology support the results of previous studies (see Reuters Health reports May 30, 2000 and March 5, 2002).

Dr. R. A. Huddart of the Institute of Cancer Research in Surrey and associates analyzed data on cardiovascular events in 992 patients treated for testicular cancer with orchidectomy and surveillance alone, chemotherapy or radiotherapy alone, or chemotherapy plus radiotherapy.

The patients were followed for a median of 10.2 years, during which 68 cardiovascular events were recorded, including 18 deaths. According to the team, cardiac events occurred in 9.6%, 6.7%, and 3.7% of patients treated with radiotherapy, chemotherapy, and orchidectomy, respectively.

"When adjusted for differences in age, this represents a statistically significant 2.4 to 2.8 increased risk for patients receiving treatment compared with patients undergoing surveillance," Dr. Huddart and colleagues write. "This was not due to increases in cardiac risk factors, which suggests a direct or indirect treatment effect," they add.

In some men, the researchers say, this adverse cardiovascular effect "may be a greater risk to long-term survival than testicular cancer itself and argues that in good-prognosis groups, attempts to minimize treatment should continue."

J Clin Oncol 2003;21:1513-1523.

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