Late adverse effects and quality of life in survivors of testicular germ cell tumour
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Late adverse effects and quality of life in survivors of testicular germ cell tumour. / Chovanec, Michal; Lauritsen, Jakob; Bandak, Mikkel; Oing, Christoph; Kier, Gry Gundgaard; Kreiberg, Michael; Rosenvilde, Josephine; Wagner, Thomas; Bokemeyer, Carsten; Daugaard, Gedske.
In: NAT REV UROL, Vol. 18, No. 4, 04.2021, p. 227-245.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Late adverse effects and quality of life in survivors of testicular germ cell tumour
AU - Chovanec, Michal
AU - Lauritsen, Jakob
AU - Bandak, Mikkel
AU - Oing, Christoph
AU - Kier, Gry Gundgaard
AU - Kreiberg, Michael
AU - Rosenvilde, Josephine
AU - Wagner, Thomas
AU - Bokemeyer, Carsten
AU - Daugaard, Gedske
N1 - Publisher Copyright: © 2021, Springer Nature Limited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Currently, ~95% of patients with testicular germ cell tumour (TGCT) are cured, resulting in an increasing number of TGCT survivors. Although cured, these men face potential late adverse effects and reduced quality of life. Survivors face a twofold increased risk of second malignant neoplasms after chemotherapy and radiotherapy, with evidence of dose-dependent associations. For survivors managed with surveillance or treated with radiotherapy, the risk of cardiovascular disease (CVD) is comparable to the risk in the general population, whereas treatment with chemotherapy increases the risk of life-threatening CVD, especially during treatment and after 10 years of follow-up. Other adverse effects are organ-related toxicities such as neuropathy and ototoxicity. Pulmonary and renal impairment in patients with TGCT treated with chemotherapy is limited. Survivors of TGCT might experience psychosocial distress including anxiety disorders, fear of cancer recurrence and TGCT-specific issues, such as sexual dysfunction. Late adverse effects can be avoided in most patients with stage I disease if followed on a surveillance programme. However, patients with disseminated disease can experience toxicities associated with radiotherapy and chemotherapy, and/or adverse effects related to surgery for residual disease. The severity of adverse effects increases with dose of both chemotherapy and radiotherapy. This Review discusses the most recent data concerning the late adverse effects of today's standard treatments for TGCT.
AB - Currently, ~95% of patients with testicular germ cell tumour (TGCT) are cured, resulting in an increasing number of TGCT survivors. Although cured, these men face potential late adverse effects and reduced quality of life. Survivors face a twofold increased risk of second malignant neoplasms after chemotherapy and radiotherapy, with evidence of dose-dependent associations. For survivors managed with surveillance or treated with radiotherapy, the risk of cardiovascular disease (CVD) is comparable to the risk in the general population, whereas treatment with chemotherapy increases the risk of life-threatening CVD, especially during treatment and after 10 years of follow-up. Other adverse effects are organ-related toxicities such as neuropathy and ototoxicity. Pulmonary and renal impairment in patients with TGCT treated with chemotherapy is limited. Survivors of TGCT might experience psychosocial distress including anxiety disorders, fear of cancer recurrence and TGCT-specific issues, such as sexual dysfunction. Late adverse effects can be avoided in most patients with stage I disease if followed on a surveillance programme. However, patients with disseminated disease can experience toxicities associated with radiotherapy and chemotherapy, and/or adverse effects related to surgery for residual disease. The severity of adverse effects increases with dose of both chemotherapy and radiotherapy. This Review discusses the most recent data concerning the late adverse effects of today's standard treatments for TGCT.
KW - Cancer Survivors
KW - Drug-Related Side Effects and Adverse Reactions
KW - Humans
KW - Male
KW - Neoplasms, Germ Cell and Embryonal/therapy
KW - Orchiectomy/adverse effects
KW - Quality of Life
KW - Radiotherapy/adverse effects
KW - Testicular Neoplasms/therapy
KW - Time Factors
UR - http://www.scopus.com/inward/record.url?scp=85102350739&partnerID=8YFLogxK
U2 - 10.1038/s41585-021-00440-w
DO - 10.1038/s41585-021-00440-w
M3 - SCORING: Review article
C2 - 33686290
AN - SCOPUS:85102350739
VL - 18
SP - 227
EP - 245
JO - NAT REV UROL
JF - NAT REV UROL
SN - 1759-4812
IS - 4
ER -
