Originally published as JCO Early Release 10.1200/JCO.2008.20.9189 on July 27 2009

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Chronic Physical Effects and Health Care Utilization in Long-Term Ovarian Germ Cell Tumor Survivors: A Gynecologic Oncology Group Study

Daniela Matei, Anna M. Miller, Patrick Monahan, David Gershenson, Qianqian Zhao, David Cella, Victoria L. Champion, Stephen D. Williams

From the Indiana University Melvin and Bren Simon Cancer Center; Walther Oncology Center, Indianapolis, IN; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Center on Outcomes Research and Education; Evanston Northwestern Healthcare Research Institute, Evanston, IL.

Corresponding author: Daniela Matei, MD, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive RT-473, Indianapolis, IN 46202; e-mail: dmatei{at}iupui.edu.

Purpose This study compares late effects of treatment on physical well-being and utilization of health care resources between ovarian germ cell tumor (OGCT) survivors and age/race/education-matched controls.

Patients and Methods Eligible patients had OGCT treated with surgery and chemotherapy and were disease-free for at least 2 years at time of enrollment. The matched control group was selected from acquaintances recommended by survivors. Symptoms and function were measured using previously validated scales. Health care utilization was assessed by questions regarding health insurance coverage and health services utilization.

Results One hundred thirty-two survivors and 137 controls completed the study. Survivors were significantly more likely to report a diagnosis of hypertension (17% v 8%, P = .02), and marginally hypercholesterolemia (9.8% v 4.4%, P = .09), and hearing loss (5.3% v 1.5%, P = .09) compared with controls. There were no significant differences in the rates of self-reported arthritis, heart, pulmonary or kidney disease, diabetes, non-OGCT malignancies, anxiety, hearing loss, or eating disorders between groups. Among chronic functional problems, numbness, tinnitus, nausea elicited by reminders of chemotherapy (v general nausea triggers for controls), and Raynaud's symptoms were reported more frequently by survivors. Patients who received vincristine, dactinomycin, and cyclophosphamide in addition to cisplatin therapy had increased functional complaints, particularly numbness and nausea. Health care utilization was similar, but 15.9% of survivors reported being denied health insurance versus 4.4% of controls (P < .001).

Conclusion Although a few sequelae of treatment persist, in general, OGCT survivors enjoy a healthy life comparable to that of controls.

Deceased.

Supported by National Cancer Institute R01 Grant No. CA 77470 and the National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (Grant No. CA 27469) and the Gynecologic Oncology Group Statistical Office (Grant No. CA 37517).

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

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