Division of Medical Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA.
JNCI Cancer Spectr. 2024 Sep 2;8(5). doi: 10.1093/jncics/pkae068.
No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.
没有研究全面检查与认知功能相关的因素（不良健康结果、健康行为和人口统计学），这些因素影响长期睾丸癌幸存者（TC 幸存者）。接受顺铂为基础的化疗的 TC 幸存者完成了全面、经过验证的调查，包括评估认知的调查。病历摘录提供了癌症和治疗史。多变量逻辑回归检查了潜在相关因素与认知障碍之间的关系。在 678 名 TC 幸存者中（中位数年龄为 46 岁；四分位距 [IQR] = 38-54）；中位数化疗后时间为 10.9 年，IQR = 7.9-15.9），13.7%报告认知功能障碍。听力损失（比值比 [OR] = 2.02；P =.040）、神经病理性疼痛（OR = 2.06；P =.028）、疲劳（OR = 6.11；P <.001）和焦虑/抑郁（OR = 1.96；P =.029）在多变量分析中与认知障碍相关。残疾（OR = 9.57；P =.002）或退休（OR = 3.64；P =.029）也与认知下降相关。与认知受损相关的因素确定了需要更密切监测、咨询和重点干预的 TC 幸存者。听力损失、神经病理性疼痛、疲劳和焦虑/抑郁构成了长期 TC 幸存者认知障碍预防或降低的潜在目标。
