Dyslipidemia in long-term survivors of testicular germ cell tumors.

Abstract

e17017 Background: Dyslipidemia is a significant modifiable risk factor for cardiovascular diseases (CVD). An increased risk of CVD in survivors of testicular germ cell tumors (GCT), particularly following cisplatin-based chemotherapy, has been previously reported. This study aimed to assess the lipid profile and prevalence of dyslipidemia in a Slovak population of long-term GCT survivors. Methods: Fasting plasma lipid levels were assessed in 154 GCT survivors during their annual follow-up at the National Cancer Institute in Slovakia. The median follow-up was 10 years (range: 4–32 years). Survivors were treated with orchiectomy and active surveillance (AS) (N = 17), cisplatin-based chemotherapy (CT) (N = 118), radiotherapy (RT) (N = 11), or both chemotherapy and radiotherapy (CTRT) (N = 8). Lipid profiles included total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). Measured lipid levels were compared to normal values defined by the American College of Cardiology/American Heart Association. To identify an association between dyslipidemia and specific cancer treatments, lipid levels were compared across the treatment groups. We also performed a subgroup analysis of survivors receiving cumulative doses < 400 mg/m 2 (N = 50) and ≥ 400 mg/m 2 (N = 76) of cisplatin. Results: The study population showed borderline high total cholesterol (207.59 ± 3.48 mg/dL), normal to mildly elevated triglycerides (150.57 ± 6.20 mg/dL), normal HDL (55.34 ± 1.16 mg/dL), elevated LDL (122.25 ± 3.09 mg/dL), and borderline high VLDL (29.79 ± 1.16 mg/dL). Overall, 89 patients (57.8 %) had elevated total cholesterol, 66 (42.9 %) had elevated triglycerides, 16 (10.4%) had suboptimal HDL, 111 (72.1 %) had elevated LDL, and 66 (42.9 %) had elevated VLDL. While lipid profiles did not significantly differ across treatment groups, CT patients exhibited the highest cholesterol, triglycerides, LDL, and VLDL levels, and the lowest HDL levels. The subgroup receiving cumulative cisplatin doses ≥400 mg/m² had higher total cholesterol, triglycerides, LDL, and VLDL, and lower HDL compared to the AS group, but these differences were not statistically significant. Seven patients (4.5 %) had abnormal values for all lipid tests, while 44 (28.6 %) had three abnormal values (total cholesterol, triglycerides, LDL). Notably, only 6 patients (3.9 %) were on lipid-lowering medications. Conclusions: Our study found a high prevalence of dyslipidemia among Slovak long-term GCT survivors, particularly post-cisplatin treatment. Despite significant lipid abnormalities, the use of lipid-lowering medications was surprisingly low. Regular lipid monitoring and early intervention are crucial for reducing CVD risk in this population. Addressing other cardiovascular risk factors and promoting healthy lifestyles should be integral part of the discussion with GCT survivors during each follow-up.