Haugnes HS et al. (2007) Components of the metabolic syndrome in long-term survivors of testicular cancer. Ann Oncol 18: 241–248

Although advances in the treatment of testicular cancer have markedly increased life expectancy, a number of reports have indicated an increased risk of cardiovascular disease in survivors, possibly mediated through the metabolic syndrome. Haugnes et al. examined the prevalence of metabolic syndrome in a national follow-up study involving 1,135 survivors of testicular cancer. Median follow-up was 11.1 years.

Participants were classified into the following groups on the basis of treatment regimen: surgery (n = 225); radiotherapy (n = 446); chemotherapy with a cumulative cisplatin dose of ≤850 mg (n = 376); and chemotherapy with a cumulative cisplatin dose of >850 mg (n = 88). A control cohort of 1,150 men was recruited from the Norwegian population-based Tromsø Study. Metabolic syndrome was defined, in accordance with a modified US National Cholesterol Education Program definition, as the presence of two or more of the following components: obesity; hypertension; hypercholesterolemia; or diabetes.

Metabolic syndrome was documented in 40% of the patient population. The age-adjusted prevalence of metabolic syndrome was markedly higher in the two chemotherapy groups than in the surgery group (odds ratios: 1.48 for cisplatin ≤850 mg and 2.76 for cisplatin >850 mg). Compared with the control cohort, the age-adjusted prevalence of metabolic syndrome was not increased in the total patient population. By contrast, subgroup analysis revealed an odds ratio of 2.1 for metabolic syndrome in the cisplatin >850 mg group compared with the control cohort. On the basis of these results, the authors suggest that clinicians should consider screening cisplatin-treated survivors of testicular cancer for metabolic syndrome.