Age-related variation and predictors of long-term quality of life in germ cell tumor survivors

PURPOSE: To compare long-term health-related quality of life (QoL) in germ cell tumor survivors (GCTS) and age-adjusted men and to identify predictors of variation in long-term QoL in GCTS.

METHODS: We used the Short-Form Health Survey to measure QoL in a cross-sectional sample of 164 survivors of germ cell tumors from Hamburg, Germany. QoL was compared with age-adjusted German norm data. Sociodemographic and medical data from questionnaires and medical records were used to find predictors of QoL.

RESULTS: On average, patients were 44.4 years old (standard deviation = 9.6y) and average time since first germ cell tumor diagnosis was 11.6 years (standard deviation = 7.3y). We found significantly lower mental component scores in GCTS when compared with norm data (Hedges g =-0.44, P<0.001). An exploratory analysis by age group showed the largest difference in mental QoL in survivors aged 31 to 40 years (Hedges g =-0.67). Linear regression analysis revealed age (β =-0.46, P<0.001), marital status (β = 0.20, P = 0.024), advanced secondary qualifications (β =-0.25, P = 0.001), time since diagnosis (β = 0.17, P = 0.031), and tumor stage (β = 0.17, P = 0.024) as statistically significant predictors of the physical component score, accounting for 22% of the variance. Statistically significant predictors of the mental component score were higher secondary qualifications (β = 0.17, P = 0.033) and unemployment (β =-0.21, P = 0.009), accounting for 6% of the variance.

CONCLUSIONS: Survivors of germ cell tumors can expect an overall long-term QoL similar to that of other men of their age.