Clinical, sociodemographic, and behavioral factors associated with cumulative burden of morbidity (CBM) among testicular cancer survivors (TCS) in the Platinum study.

Authors

Sarah Kerns

Sarah L. Kerns

University of Rochester Medical Center, Rochester, NY

Sarah L. Kerns , Chunkit Fung , AnnaLynn Williams , Mohammad Issam Abu Zaid , Howard D. Sesso , Patrick Monahan , Shirin Ardeshirrouhanifard , Darren R. Feldman , Robert James Hamilton , David J. Vaughn , Clair Beard , Robert Anthony Huddart , Jeri Kim , Christian K. Kollmannsberger , Deepak M. Sahasrabudhe , Ashley Amidon Morlang , Ryan Cook , Sophie D. Fossa , Lawrence H. Einhorn , Lois B. Travis

Organizations

University of Rochester Medical Center, Rochester, NY, Indiana University School of Medicine, Indianapolis, IN, Division of Preventive Medicine, Harvard Medical School, Boston, MA, Indiana University, Indianapolis, IN, Memorial Sloan-Kettering Cancer Center, New York, NY, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Abramson Cancer Center, Philadelphia, PA, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA, Institute of Cancer Research, Sutton, United Kingdom, The University of Texas MD Anderson Cancer Center, Houston, TX, BC Cancer Agency - Vancouver Centre, Vancouver, BC, Canada, Wilmot Cancer Center, Rochester, NY, Oslo University Hospital, University of Oslo, Oslo, Norway, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN

Research Funding

NIH

Background: TCS are an important group in which to characterize late effects of cancer and its therapy given their young age at diagnosis and high cure rate. We comprehensively evaluated CBM and identified associated clinical, sociodemographic, and behavioral risk factors among TCS given cisplatin based chemotherapy in a multicenter study. Methods: TCS completed a comprehensive health questionnaire. Responses were grouped into 22 adverse health outcomes (AHO) and graded by severity. A CBM score was calculated based on AHO number and severity, following Geenen et al (JAMA 2007). Multivariable ordinal logistic regression examined the association of clinical, sociodemographic, and behavioral factors with CBM. Variable-based hierarchical clustering identified individual AHOs that co-occurred. Results: Among 1,215 TCS (median age at evaluation 38 y, range 19-68 y; time since chemotherapy 4.6 y), over 20% had a CBM score of high (17%), very high (4%) or severe (0.4%). Most TCS, however, had CBM scores of low (37%), medium (28%), very low (9%) or none (5%). In a multivariable model controlling for time since chemotherapy, older attained age (OR 1.2; 95% CI 1.1 - 1.3), being widowed/divorced/separated (OR 1.8; 95% CI 1.1 - 3.1), having less than college-level education (OR 1.7; 95% CI 1.3 - 2.2), being retired/on disability (OR 2.5; 95% CI 1.2 - 5.3), and receipt of 4 cycles of BEP vs. 4 cycles of EP or 3 cycles of BEP (OR 1.3; 95% CI 1.01 - 1.8) were associated with increased odds of a worse CBM score; vigorous exercise (OR 0.7; 95% CI 0.5 - 0.9) and non-white race (OR 0.6; 95% CI 0.4 - 0.9) were associated with decreased odds. A separate cluster analysis revealed five groups of AHOs: those known to be cisplatin-related (e.g. neuropathy, ototoxicity); metabolic abnormalities (e.g. hypercholesterolemia, diabetes); vascular damage (e.g. stroke); testicular cancer-related (e.g. hypogonadism); and other (e.g. thyroid disease). Conclusions: TCS with factors associated with worse CBM may be candidates for closer monitoring. If confirmed, our cluster analysis showing that groups of conditions tend to co-occur in TCS could provide guidance for survivorship care plans.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Patient and Survivor Care

Track

Patient and Survivor Care

Sub Track

Survivorship

Citation

J Clin Oncol 35, 2017 (suppl; abstr 10075)

DOI

10.1200/JCO.2017.35.15_suppl.10075

Abstract #

10075

Poster Bd #

64

Abstract Disclosures

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