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Blood Pressure and Body Mass Index in Long-Term Survivors of Testicular Cancer

From the Department of Oncology, Institute of Clinical Medicine, and Institute of Community Medicine, University of Tromsø; Department of Oncology, University Hospital of Northern Norway, Tromsø; Department of Clinical Cancer Research, The Norwegian Radium Hospital; Medical Faculty, University of Oslo; Department of Oncology, Ullevål University Hospital, Oslo; Department of Oncology, Haukeland University Hospital, Bergen; and Department of Oncology, St Olav University Hospital, Trondheim, Norway

Address reprint requests to Hege Sagstuen, MD, Department of Oncology, Institute of Clinical Medicine, University of Tromsø, N-9037 Tromsø, Norway; e-mail: hegesa{at}fagmed.uit.no

PURPOSE: To evaluate blood pressure and body mass index (BMI) in long-term survivors of testicular cancer (TC) treated with different modalities.

PATIENTS AND METHODS: One thousand eight hundred fourteen patients treated for unilateral TC in Norway (1980 to 1994) were invited to participate in a follow-up study (1998 to 2002), including measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. Of these patients, 1,289 patients (71%) participated in the study. The patients were categorized into four treatment groups: surgery (n = 242), radiotherapy (n = 547), and two chemotherapy groups, cumulative cisplatin dose 850 mg (n = 402) and cumulative cisplatin dose more than 850 mg (n = 98). A control group consisted of healthy males from the Tromsø Population Study (n = 2,847).

RESULTS: At diagnosis, age-adjusted regression analyses showed no differences between the treatment groups for any variables. After a median follow-up time of 11.2 years, age-adjusted SBP and DBP were significantly higher for both chemotherapy groups compared with the surgery group. Chemotherapy-treated patients had increased odds for hypertension at follow-up compared with the surgery group, and the odds were highest for the cisplatin more than 850 mg group (odds ratio = 2.4; 95% CI, 1.4 to 4.0). The cisplatin more than 850 mg group had a significantly higher 10-year BMI increase and a higher prevalence of obesity at follow-up than the surgery group. Compared with healthy controls, chemotherapy-treated patients had, at follow-up, increased SBP, increased DBP, excessive BMI increase, and a higher prevalence of hypertension.

CONCLUSION: Five to 20 years after therapy, cured TC patients treated with cisplatin-based chemotherapy had significantly higher levels of blood pressure, a higher prevalence of hypertension, and an excessive weight gain compared with patients treated with other modalities and compared with healthy controls.

Supported in part by grants from the Erna and Olav Aakres Legacy, the Odd Fellow Medical-Scientific Research Fund, and the Norwegian Foundation for Health and Rehabilitation (grant No. 1998/27).

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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