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Bending the Curve Trial by Trial
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Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer

Needs review

Phase observationalN = 2,512

Population
Five-year survivors of testicular cancer treated between 1965 and 1995 (median follow-up 18.4 years; 694 cardiovascular events including 141 acute myocardial infarctions)
Design
Cohort of 5-year survivors treated between 1965 and 1995. Cardiovascular disease incidence was compared with general-population rates (standardised incidence ratios); treatment effects were estimated with multivariate Cox regression.
Arms
  • Surgery alone (control): Surgery without radiotherapy or chemotherapy (named as the comparator for the mediastinal irradiation estimate; the comparator for the BEP estimate is not stated in the abstract)
  • BEP chemotherapy (experimental): Bleomycin, etoposide and cisplatin
People
van den Belt-Dusebout AW
Myocardial infarction after treatmentHR 1.2 (95% CI 0.7–2.1)
Show the numbers
Results reported for Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer
EndpointAnalysisBEP chemotherapySurgery aloneEffect
Myocardial infarction after treatmentFive-year survivors; Cox regression, BEP chemotherapyfinalmedian follow-up 18.4 yearsvan 2006——HR 1.2 (95% CI 0.7–2.1)Hazard ratio for myocardial infarction after BEP chemotherapy. The abstract does not restate the reference group in this sentence; the preceding sentence uses surgery alone as the reference for mediastinal irradiation. The same abstract reports a 1.5-fold (95% CI 1.0 to 2.2) increased risk of cardiovascular disease overall after BEP, and a 1.9-fold (95% CI 1.7 to 2.0) increased myocardial infarction risk after cisplatin, vinblastine and bleomycin (PVB). The authors state that whether BEP increases cardiovascular risk should be evaluated after longer follow-up.
Results reported for Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer
EndpointAnalysisBEP chemotherapySurgery aloneEffect
Myocardial infarction after treatmentFive-year survivors; Cox regression, BEP chemotherapyfinalmedian follow-up 18.4 yearsvan 2006——HR 1.2 (95% CI 0.7–2.1)Hazard ratio for myocardial infarction after BEP chemotherapy. The abstract does not restate the reference group in this sentence; the preceding sentence uses surgery alone as the reference for mediastinal irradiation. The same abstract reports a 1.5-fold (95% CI 1.0 to 2.2) increased risk of cardiovascular disease overall after BEP, and a 1.9-fold (95% CI 1.7 to 2.0) increased myocardial infarction risk after cisplatin, vinblastine and bleomycin (PVB). The authors state that whether BEP increases cardiovascular risk should be evaluated after longer follow-up.
Hazard ratio (95% CI) by endpoint. Values below 1 favour the experimental arm.
Myocardial infarction after treatment0.512◀ experimentalcontrol ▶
Data table
EndpointHR95% CI
Myocardial infarction after treatment1.20.7–2.1
Primary publication: van den Belt-Dusebout AW, Nuver J, de Wit R, Gietema JA, ten Bokkel Huinink WW, Rodrigus PT, et al. Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol. 2006;24(3):467-75. PubMedDOI

Appears in

Sources

  1. van den Belt-Dusebout AW, Nuver J, de Wit R, Gietema JA, ten Bokkel Huinink WW, Rodrigus PT, et al. Long-term risk of cardiovascular disease in 5-year survivors of testicular cancer. J Clin Oncol. 2006;24(3):467-75.

    PubMedDOI