The cardiac impact of cisplatin-based chemotherapy in survivors of testicular cancer: a 30-year follow-up.

Cisplatin-based chemotherapy (CBCT) is essential in the treatment of metastatic testicular cancer (TC) but has been associated with long-term risk of cardiovascular morbidity and mortality. Furthermore, cisplatin can be detected in the body decades after treatment. We aimed to evaluate the long-term impact of CBCT on cardiac function and morphology in TC survivors 30 years after treatment.

TC survivors treated with CBCT (1980-94) were recruited from the longitudinal Norwegian Cancer Study in Testicular Cancer Survivors and compared with a control group matched for sex, age, smoking status, and heredity for coronary artery disease. All participants underwent laboratory tests, blood pressure measurement, and 2D and 3D echocardiography including 2D speckle-tracking strain analyses. Ninety-four TC survivors, on average 60 ± 9 years old, received a median cumulative cisplatin dose of 780 mg (IQR 600-800). Compared with controls, TC survivors more frequently used anti-hypertensive (55% vs. 24%, P < 0.001) and lipid-lowering medication (44% vs. 18%, P < 0.001). TC survivors had worse diastolic function parameters with higher E/e'-ratio (9.8 ± 3.2 vs. 7.7 ± 2.5, P < 0.001), longer mitral deceleration time (221 ± 69 vs. 196 ± 57ms, P < 0.01), and higher maximal tricuspid regurgitation velocity (25 ± 7 vs. 21 ± 4 m/s, P = 0.001). The groups did not differ in left or right ventricular systolic function, prevalence of arrhythmias, or valvular heart disease. Cumulative cisplatin dose did not correlate with cardiac parameters.

No signs of overt or subclinical reduction in systolic function were identified. Long-term cardiovascular adverse effects three decades after CBCT may be limited to metabolic dysfunction and worse diastolic function in TC survivors.

European heart journal cardiovascular Imaging. 2020 Nov 05 [Epub ahead of print]

Anders W Bjerring, Sophie D Fosså, Hege S Haugnes, Ragnhild Nome, Thomas M Stokke, Kristina H Haugaa, Cecilie E Kiserud, Thor Edvardsen, Sebastian I Sarvari

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, N-0372 Oslo, Norway., Department of Oncology, University Hospital of North Norway, N-9019 Tromsø, Norway., Department of Medical Biochemistry, Oslo University Hospital, N-0027 Oslo, Norway., Department of Cardiology, Oslo University Hospital, Rikshospitalet, N-0027 Oslo, Norway.

email news signup