Terbuch A, et al. – In stage I seminoma patients, long–term cardiovascular complications were evaluated, as well as risk factors for cardiovascular events (CVEs) were explored. A panel of baseline risk factors and dynamically, occurring predictors of CVE were ascertained in these patients. This information exhibited the potential to be used for targeting comorbidity management in these patients.

Methods

• 406 consecutive stage I seminoma patients were part of this retrospective cohort study.
• CVE rate was the primary endpoint.

Results

• 23 CVEs were reported in 406 patients [10-year CVE risk 5.6% (95% CI 3.2 to 8.8)], during a median follow-up of 8.6 years.
• Higher age, positive smoking status, history of diabetes and hypertension were significantly associated with the occurrence of CVE, in univariable competing risk analysis.
• New onset of diabetes, hypertension and hyperlipidemia during follow-up predicted for an excessively increased CVE risk, in multi-state analysis.
• The development of hypertension and hyperlipidemia after tumor-specific treatment prevailed as risk factors for CVE, in multivariable analysis adjusting for age and smoking.
• Patients receiving adjuvant radiotherapy had a significantly higher probability of CVE than patients receiving adjuvant carboplatin [16% vs. 0%; risk difference (RD) = 16%, 95% CI 6 to 25%, p = 0.001], with respect to adjuvant treatment modalities.
• Moreover, this difference prevailed after adjusting for age, follow-up-time, diabetes, hypertension and smoking (RD = 11%, 95% CI 1 to 20%, p = 0.025).