Longitudinal Assessment of Cognitive Function in Survivors of Testicular Germ Cell Tumor.

IF 8.3 1区 医学 Q1 ONCOLOGY European urology oncology Pub Date : 2024-12-18 DOI:10.1016/j.euo.2024.12.003
Zuzana Orszaghova, Daniela Svetlovska, Lucia Vasilkova, Peter Lesko, Zuzana Sycova-Mila, Jana Obertova, Patrik Palacka, Katarina Rejlekova, Veronika Remenarova, Katarina Kalavska, Beata Mladosievicova, Jozef Mardiak, Michal Mego, Michal Chovanec
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Abstract

Background and objective: Survivors of testicular germ cell tumor (TGCT) may experience long-term cognitive changes. The aim of our prospective study was to longitudinally assess cognitive function among TGCT survivors to identify potential lasting cognitive changes over a period of 5 yr.

Methods: TGCT survivors (n = 151) completed Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) questionnaires annually, with median time to first follow-up visit (FUV) of 8 (range 4-24) yr since completion of treatment. Treatment after orchiectomy included: active surveillance (AS) alone (n = 21); chemotherapy (CTx; n = 109); radiotherapy (RT) to the retroperitoneum (n = 11); and combined CTx + RT (n = 10). Scores for four FACT-Cog domains and overall cognitive scores were evaluated annually for 5 yr. In a subgroup analysis we compared results for survivors who received cisplatin at a dose of <400 mg/m2 (n = 48) versus ≥400 mg/m2 (n = 70).

Results: The CTx + RT group had persistently lower scores for the perceived cognitive abilities (CogPCA) domain annually between the first and fifth FUVs in comparison to the AS group (all p < 0.05), with lower overall cognitive scores from the second to the fifth FUV (all p < 0.03). The group that received ≥400 mg/m2 cisplatin had lower CogPCA scores at the first and second FUVs, and lower overall cognitive scores at the second FUV in comparison to the AS group. However, no significant change in cognitive scores across all domains was observed over 5 yr for all survivors.

Conclusions: Cognitive impairment in TGCT survivors persisted over long-term follow-up. Survivors who received both CTx and RT consistently had the worst cognitive performance at all FUVs over a 5-yr period. In addition, survivors who received a higher cisplatin dose showed worse cognitive function at all FUVs.

Patient summary: Our study results show that survivors of testicular cancer experienced long-term cognitive dysfunction that persisted over time. Survivors who underwent both chemotherapy and radiotherapy and those who received a higher dose of chemotherapy had the worst cognitive problems.

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来源期刊
CiteScore
15.50
自引率
2.40%
发文量
128
审稿时长
20 days
期刊介绍: Journal Name: European Urology Oncology Affiliation: Official Journal of the European Association of Urology Focus: First official publication of the EAU fully devoted to the study of genitourinary malignancies Aims to deliver high-quality research Content: Includes original articles, opinion piece editorials, and invited reviews Covers clinical, basic, and translational research Publication Frequency: Six times a year in electronic format
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