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dc.contributor.authorKerns, SL
dc.contributor.authorFung, C
dc.contributor.authorMonahan, PO
dc.contributor.authorArdeshir-Rouhani-Fard, S
dc.contributor.authorAbu Zaid, MI
dc.contributor.authorWilliams, AM
dc.contributor.authorStump, TE
dc.contributor.authorSesso, HD
dc.contributor.authorFeldman, DR
dc.contributor.authorHamilton, RJ
dc.contributor.authorVaughn, DJ
dc.contributor.authorBeard, C
dc.contributor.authorHuddart, RA
dc.contributor.authorKim, J
dc.contributor.authorKollmannsberger, C
dc.contributor.authorSahasrabudhe, DM
dc.contributor.authorCook, R
dc.contributor.authorFossa, SD
dc.contributor.authorEinhorn, LH
dc.contributor.authorTravis, LB
dc.contributor.authorPlatinum Study Group
dc.date.accessioned2018-05-08T15:04:17Z
dc.date.issued2018-05
dc.identifier.citationJournal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018, 36 (15), pp. 1505 - 1512
dc.identifier.issn0732-183X
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1672
dc.identifier.eissn1527-7755
dc.identifier.doi10.1200/JCO.2017.77.0735
dc.description.abstractPurpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among > 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were ≤ 55 years of age at diagnosis, finished first-line chemotherapy ≥ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen ( P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (χ2 P < .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.
dc.formatPrint-Electronic
dc.format.extent1505 - 1512
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
dc.subjectPlatinum Study Group
dc.subjectHumans
dc.subjectNeoplasms, Germ Cell and Embryonal
dc.subjectTesticular Neoplasms
dc.subjectCisplatin
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectPhysical Examination
dc.subjectExercise
dc.subjectSeverity of Illness Index
dc.subjectFactor Analysis, Statistical
dc.subjectRisk Factors
dc.subjectHealth Status
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectSurveys and Questionnaires
dc.subjectLong Term Adverse Effects
dc.subjectCancer Survivors
dc.titleCumulative Burden of Morbidity Among Testicular Cancer Survivors After Standard Cisplatin-Based Chemotherapy: A Multi-Institutional Study.
dc.typeJournal Article
dcterms.dateAccepted2018-02-02
rioxxterms.versionofrecord10.1200/JCO.2017.77.0735
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
rioxxterms.licenseref.startdate2018-05
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of clinical oncology : official journal of the American Society of Clinical Oncology
pubs.issue15
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.publication-statusPublished
pubs.volume36
pubs.embargo.termsNot known
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
dc.contributor.icrauthorHuddart, Roberten


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