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睾丸癌幸存者的长期健康影响。

Long-term health effects among testicular cancer survivors.

作者信息

Hashibe Mia, Abdelaziz Sarah, Al-Temimi Mohammed, Fraser Alison, Boucher Kenneth M, Smith Ken, Lee Yuan-Chin Amy, Rowe Kerry, Rowley Braden, Daurelle Micky, Holton Avery E, VanDerslice James, Richiardi Lorenzo, Bishoff Jay, Lowrance Will, Stroup Antoinette

机构信息

Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, USA.

Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.

出版信息

J Cancer Surviv. 2016 Dec;10(6):1051-1057. doi: 10.1007/s11764-016-0548-1. Epub 2016 May 11.

Abstract

PURPOSE

Testicular cancer is diagnosed at a young age and survival rates are high; thus, the long-term effects of cancer treatment need to be assessed. Our objectives are to estimate the incidence rates and determinants of late effects in testicular cancer survivors.

METHODS

We conducted a population-based cohort study of testicular cancer survivors, diagnosed 1991-2007, followed up for a median of 10 years. We identified 785 testicular cancer patients who survived ≥5 years and 3323 men free of cancer for the comparison group. Multivariate Cox regression analysis was used to compare the hazard ratio between the cases and the comparison group and for internal analysis among case patients.

RESULTS

Testicular cancer survivors experienced a 24 % increase in risk of long-term health effects >5 years after diagnosis. The overall incidence rate of late effects among testicular cancer survivors was 66.3 per 1000 person years. Higher risks were observed among testicular cancer survivors for hypercholesterolemia, infertility, and orchitis. Chemotherapy and retroperitoneal lymph node dissection appeared to increase the risk of late effects. Being obese prior to cancer diagnosis appeared to be the strongest factor associated with late effects.

CONCLUSIONS

Testicular cancer survivors were more likely to develop chronic health conditions when compared to cancer-free men.

IMPLICATIONS FOR CANCER SURVIVORS

While the late effects risk was increased among testicular cancer survivors, the incidence rates of late effects after cancer diagnosis was fairly low.

摘要

目的

睾丸癌多在年轻时被诊断出来,且生存率较高;因此,需要评估癌症治疗的长期影响。我们的目标是估计睾丸癌幸存者中远期效应的发病率及其决定因素。

方法

我们对1991年至2007年被诊断出的睾丸癌幸存者进行了一项基于人群的队列研究,中位随访时间为10年。我们确定了785名存活≥5年的睾丸癌患者,并选取3323名无癌症的男性作为对照组。采用多变量Cox回归分析来比较病例组与对照组之间的风险比,并对病例组患者进行内部分析。

结果

睾丸癌幸存者在诊断后>5年出现长期健康问题的风险增加了24%。睾丸癌幸存者中远期效应的总体发病率为每1000人年66.3例。在睾丸癌幸存者中,高胆固醇血症、不育症和睾丸炎的风险更高。化疗和腹膜后淋巴结清扫术似乎会增加远期效应的风险。癌症诊断前肥胖似乎是与远期效应相关的最强因素。

结论

与无癌男性相比,睾丸癌幸存者更易出现慢性健康问题。

对癌症幸存者的启示

虽然睾丸癌幸存者远期效应的风险有所增加,但癌症诊断后远期效应的发病率相当低。

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