Components of the metabolic syndrome in long-term survivors of testicular cancer

Background: A possible explanation of the excess cardiovascular risk in testicular cancer (TC) survivors is development of metabolic syndrome. The association between metabolic syndrome and TC treatment is examined in long-term survivors. Patients and methods: In a national follow-up study (1998-2002), 1463 TC survivors (diagnosed 1980-1994) participated. Patients > 60 years were excluded in the present study, leaving 1135 patients eligible. The patients were divided in four treatment groups: surgery (n = 225); radiotherapy (n = 446) and two chemotherapy groups: cumulative cisplatin dose (Cis) <= 850 mg (n = 376) and Cis > 850 mg (n = 88). A control group consisted of 1150 men from the Tromso Population Study. Metabolic syndrome was defined according to a modified National Cholesterol Education Program definition. Results: Both chemotherapy groups had increased odds for metabolic syndrome compared with the surgery group, highest for the Cis > 850 group [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.6-4.7]. Also, the Cis > 850 group had increased odds (OR 2.1, 95% CI 1.3-3.4) for metabolic syndrome compared with the control group. The association between metabolic syndrome and the Cis > 850 group was strengthened after adjusting for testosterone, smoking, physical activity, education and family status. Conclusion: TC survivors treated with cisplatin-based chemotherapy have an increased risk of developing metabolic syndrome compared with patients treated with other modalities or with controls.